CERTIFICATE OF LIABILITY INSURANCE (6)
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ACORD'M CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYVY)
06/14/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Gowrie, Barden & Brett, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
70 Essex Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Westbrook, CT 06498
860 399-5945 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Federal Insurance Company 20281
Clearwater Community Sailing Assoc.,lnc INSURER B:
1001 Gulf Blvd. INSURER C:
Clearwater, FL 33767 INSURER D:
INSURER E:
Client#: 13438
CLEARCOMMU
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN is SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
L TR NSR[ TYPE OF INSURANCE POLICY NUMBER PJ>,N~~,,\'~i88~IE P~~fl (if~~~N LIMITS
A
~NERAL LIABILITY 35823516
~hMERCIAL GENERAL LIABILITY
f--W CLAIMS MADE [!] OCCUR
f--
11/06/05
11/06/06
EACH OCCURRENCE
~~~~~E TO RENTu~?ence)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
$1.000.000
$1.000.000
$10000
$1 000,000
$2 000 000
$included
f--
GEN'L AGGREGATE LIMIT APPLIES PER:
n POLICY n r;r8-i n LOC
~TOMOBILE LIABILITY
ANY AUTO
f--
COMBINED SINGLE LIMIT
(Ea accident)
f--
ALL OWNED AUTOS
BODILY INJURY
(Per person)
f-- SCHEDULED AUTOS
f-- HIRED AUTOS
f-- NON-OWNED AUTOS
BODILY INJURY
(Per accident)
$
f--
PROPERTY DAMAGE
(Per accident)
RGARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT
$
EA ACC $
$
$
$
$
$
$
AGG
OTHER THAN
AUTO ONLY:
EXCESS/UMBRELLA LIABILITY
tJ OCCUR D CLAIMS MADE
R DEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRiETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
EACH OCCURRENCE
AGGREGATE
I T~~.g~~S I IOJ~-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Clearwater is named as Additional Insured on General
Liability Policy only.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
25 Causeway Boulevard
Indian Rocks Beach, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---10.- DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08) 1 of 2
#S19121/M19120
"
MED
@ ACORD CORPORATION 1988
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (2001/08) 2 of 2
#S19121/M19120