CERTIFICATE OF LIABILITY INSURANCE (26)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYVY)
06/25/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 22668 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33622-2668
813289-5200 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURERA: United States Fidelity & Guaranty 25887
Jones Edmunds & Associates, Inc. INSURER B: S1. Paul Fire & Marine Insurance Co 24767
730 N.E. Waldo Road INSURER C: XL Specialty Insurance Company 37885
Gainesville, FL 32641 INSURER 0: Fidelity & Guaranty Insurance Com pan 35386
INSURER E:
Client#. 3970
JONEEOM3
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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER PJ>.k~~Y ~~i~8~\E Pg~fJ/'fl~~t~N LI MITS
A GENERAL LIABILITY BK02194041 06/30/06 06/30/07 EACH OCCURRENCE $1 000000
r-- DAMAGE TO RENTED
X COMMERCIAL GENERAL LIABILITY :;;-1 000 000
I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $10000
r-- PERSONAL & ADV INJURY $1,000,000
r-- GENERAL AGGREGATE $2,000,000
n'L AGGREAE LIMIT APFlS PER: PRODUCTS - COMP/OP AGG $2,000,000
POLICY jr8i LOC
0 AUTOMOBILE LIABILITY BA02194122 06/30/06 06/30/07 COMBINED SINGLE LIMIT
f--- $1,000,000
~ ANY AUTO (Ea accident)
f-- ALL OWNED AUTOS BODILY INJURY
(Per person) $
f-- SCHEDULED AUTOS
~ HIRED AUTOS BODILY INJURY
$
X NON-OWNED AUTOS (Per accident)
f---
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESS/UMBRELLA LIABILITY BK02194041 06/30/06 06/30/07 EACH OCCURRENCE $5 000 000
W OCCUR D CLAIMS MADE AGGREGATE $5 000 000
$
R DEDUCTIBLE $
.' ,.
RETENTION T .- - .. '. .. .
y
B WORKERS COMPENSATION AND BW02193378 06/30/06 06/30/07 X I WC STATU- I IOJ~-
EMPLOYERS' LIABILITY $1 000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $1,000,000
If yes, describe under $1,000,000
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT
C OTHER Professional OPR9419399 06/30/06 06/30/07 $1,000,000 per claim
Liability $1,000,000 annl aggr.
- -.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS D. l~ l~ I~ IJ W l~ I r!~
Professional Liability is written on a claims made and reported basis. , Ii.:
Certificate holder is listed as an additional insured with respects to the nol Jl)J 2 8 2006 I ~
General Liability policy.
;;nv-"c,;, c :; ;.-~ . Ten J
CERTIFICATE HOLDER CANCELLATION n"ollS \\!ORKS ACHi\!jSTR,HlON
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---30..... DAYS WRITTEN
Attn: City Engineer NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
POBox 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Clearwater, FL 33758 REPRESENTATIVES.
~'GED REPR~TIVE
. ~ cJ.., .a ~
ACORD 25 (2001/08) 1 of 2
#M125266
MOL
@ ACORD CORPORATION 1988