CERTIFICATE OF LIABILITY INSURANCE (23)
AC_QRll CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
05/12/2006
PRODUCER (910) 509-9000 FAX (910)509-9006 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Walker Taylor Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
1430 Commonwealth Drive #302 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Wilmington, NC 28403
INSURERS AFFORDING COVERAGE NAIC#
INsURED McKi m & Creed, --.-- ..-- ---- -.---..-.- -- .--
PA INSURER A Hartford Fi re Insurance Co
P.O. Box 806 INSURER B: Hartford Ins Co of the Midwest
Wilmington, NC 28402 --- -- ---
INSURER c:
-.-...- --- --_...~
INSURER D:
--- .----- ----..
INSURER E:
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.
----.. --- ----_.._--~.
I~~~ ~I?,~i TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY 22UUNIA9447 05/15/2006 05/15/2007 EACH OCCURRENCE $ I,OOO,OOQ
~ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 300,000
_E'REMlSES ..(Ea_occur.ence.l--
I ~ CLAIMS MADE I=:KJ OCCUR I MED EXP (Anyone person) $ -- 10 , 000
A X ~--- - I PERSONAL-& ADV INJURY $ 1,000,000
I GENERAL AGGREGATE $ 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
I 'IXl PRO. nLOC ---
POLICY JECT
AUTOMOBILE LIABILITY 22UENAM0684 05/15/2006 05/15/2007 COMBINED SINGLE LIMIT
- $
X ANY AUTO (Ea accident) I,OOO,OOQ
- ----."."
ALL OWNED AUTOS BODILY INJURY
-- (Per person) $
SCHEDULED AUTOS
A X -- --,--
X HIRED AUTOS BODILY INJURY
----- (Per accident) $
X NON-OWNED AUTOS
---...._- -"... -------
-- --- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
_~ ANY AUTO ------..-
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY 22XHUUA0618 05/15/2006 05/15/2007 EACH OCCURRENCE $ 4 , 000., 000
..!J OCCUR I~ CLAIMS MADE -. " .--
AGGREGATE $ 4.LQOO,OOO
A X $
--- -.- --..--"
~ DEDUCTIBLE $
10,OO(] -...-----...-
X RETENTION $ $
WORKERS COMPENSATION AND 22WBIG6643 05/15/2006 05/15/2007 ~'1CSTATU-;1 10J~-
_0 RY_L1MITS .-
EMPLOYERS' LIABILITY E.L EACH ACCIDENT $ 1,000,000
B ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? - tN( LUDES - COVERAGE FORFL . _n,_.__. --- - - --- n~DISEASF'El>: EMPLOYEE $ 1; 000, OO()
If yes, describe under .-.
SPECIAL PROVISIONS below E.L DISEASE - POLlCX LIMIT $ 1,000,000
OTHER
..
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS /
,
Policy Conditions and Exclusions apply. '.
\
(5~
, '
CERTIFICA TE HOLDER
City of Clearwater
Engineering Dept - Suite 220
Attn: Dina Katsougrakis
P.O. Box 4748
Clearwater, FL 33756-4782
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLlCIEs'B~GANCELLED BEFORE THE
)-;, ,.- ,
EXPIRATION DATE THEREOF, THE ISSUING INSUR~JtWILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICA';';: H~'RNAMED TO THE LEFT
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE'NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE be:h~ ~
Deborah Church/DC
ACORD25(2001/08) FAX: (727)562-4755
@ACORD CORPORATION 1988