CERTIFICATE OF LIABILITY INSURANCE (24)
ACORDm CERTIFICATE OF LIABILITY INSURANCE OP ID P~ DATE (MM/DDIYYVY)
UNIVENG 07/10/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
J Rolfe Davis Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 945255 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Maitland FL 32794-5255
Phone:407-691-9600 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Hudson Spec.Ins.Co. (Freberg)
INSURER B: Zurich-American Ins. (Orlando) 16535
Universal Engineering Sciences INSURER C:
Inc.; eta1 Great American Ins. (Marietta)
3532 Mag~ie Blvd. INSURER 0:
Orlando L 32811
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.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD9N~iM~rJ~~E Pgk~CE\~~IfD-wgN LIMITS
GENERAL LIABILITY EACH OCCURRENCE $2000000
- LJAMAGt:
A X X COMMERCIAL GENERAL LIABILITY FEC6102911 07/17/05 07/17/06 PREMISES (Ea occurence) $ 50000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000 --
~ Incls X,C,U BLKT WAIVER SUBROGATION PERSONAL & ADV INJURY $ 2000000
X Blanket Contract. IF RBQ WRITTBN CONTRACT GENERAL AGGREGATE $ 4000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 4000000
1 !xl PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1000000
B X ANY AUTO BAP279579705 05/01/06 07/17/07 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
--
X HIRED AUTOS BODILY INJURY
- (Per accident) $
X NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ClNL Y - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
! AUTO ClNL Y: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 9000000
C ~ OCCUR D CLAIMS MADE TUU554486402 05/01/06 07/17/07 AGGREGATE $ 9000000
i $
frl DEDUCTIBLE $
X RETENTION $10000 $
WORKERS COMPENSATION AND I TORY L1Mm; I Iv.,r-
ER
EMPLOYERS' L1"BILlTY
!- ANY PROPR1ETCi<lPARrNERiEXcCUTIVE I - - - e.EACH ACCIDENT ~-~~
~----
OFFICERiMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under E.L. DISEASE - POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER i
A Professional and ! FEC6102911 07/17/05 07/17/06 Ea Claim 2000000
Pollution Liab. i Aaareaate 4000000
I
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
General Liability policy includes a blanket additional insured endorsement
for the Certificate Holder if required by written contract. Policy Limits
are shared for #FEC6102911. Liability is limited to loss/damage arising out
of negligent acts of insured. *Except as required by FL Statute. RE: LaBella
Vista Condominiums, Clearwater, FL. Requested by Fawn Foreman/7-10-06
CERTIFICATE HOLDER
CANCELLATION
CITYCLE
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
City of Clearwater
Attn: Robbie Ackerman
100 S. Myrtle Avenue #210
Clearwater FL 33756
ACORD 25 (2001/08) @ACORDCORPORATION 1988