CERTIFICATE OF LIABILITY INSURANCE (24)
12006
THIS CERTIFICATE IS ISSUED AS A MATTER OF'INF' ~ lION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIF ""E
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Hartford Fire Insurance CO
INSURER B: Hartford Ins Co of the Mi dwest
INSURER c:
INSURER D:
INSURER E:
C V RAGES
THE POLlCIIES 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.
NSR DO' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRAT10N
GENERAL LIABILITY 22UUNIA9447 05/15/2006 05/15/2007 EACH OCCURRENCE
X COMMERCIAL GENERAL L1ABIUTY DAMAGE TO RENTED
CLAIMS MADE 00 OCCUR
~'.",...".
..'c.~' .,
~ ~,_.
~
"",_,-,t .:':'__'_
"~"<
~1l9:.~~~.,.~t!.:.!riye 1302
"',l11l1l_j ':8(i2J+'3
, ,," ',-,
INSURf!DMc.Killl.(:-:;~~d, PA
P.O. Box 80'
Wi.l.lD:iIUJ'~nl,'" .tolf",~8402
A
X
LIMITS
$
$
$
$
$
PRODUCTS - COMP/OP AGG $
MED EXP (Any one person)
PERSONAL & ADV INJURY
GENERAL AGGREGATE
22UENAM0684 05/15/2006 05/15/2007
COMBINED SINGLE LIMIT
(Ea accident)
X
ALL OWNED AUTOS
A X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
BODilY INJURY
(Per parton)
BODilY INJURY
(Per accident)
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
EA ACC $
AGG $
OTHER THAN
AUTO ONLY:
EXCESSlUMBRELLA LIABILITY
X OCCUR D CLAIMS MADE
22XHUUA0618 05/15/2006 05/15/2007 EACH OCCURRENCE
AGGREGATE
A X
DEDUCTIBLE
X RETENTION $
WORKERS COMPENSAT10N AND 22WBIG6643 05/15/2006
EMPLOYERS' LIABILITY
B ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICERlMEMBER EXCLUDED? IN lUDES COVERAGE FOR FL
If yes, describe under
SPECIAL PROVISIONS beloW
OTHER
05/15/2007
$
E.L. DISEASE - EA EMPLOYE $
E.L. DISEASE - POLICY LIMIT $
/'
/" .
~
DESCRlPT10N OF OPERA T10NS I LOCAT10NS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
\..'~ r""/.- .-i';-
~(/ \ ~-o;..-_
;'~~\ ~:-
t~,'.;:~. ~~,
\. ,. ,.....
..,."',:','
Policy Conditions and Exclusions apply.
CERTIFICATE HOLDER
CANCELLATION
$
1,000,000
$
$
$
$
$
$
$
$
4,000,00
4,000,000
1,000,000
1,000,000
1,000,00
City of Clearwater
Engineering Dept - Suite 220
Attn: Dina Katsougrakis
P.O. Box 4748
Clearwater, FL 33756-4782
SHOULD ANY OF THE ABOVE DESCRIBED POLltie' B CaNCELLEP EiEFORE THE
'r.Jr, . 'i
EXPIRATION DATE THEREOF, THE ISSUING INsu~eWlll ENUeAYOR TO MAil
~ '
~ DAYS WRllTEN NOT1CE TO THE CERT1FICATE H~~~AMED TO THE LEFT
BUT FAILURE TO MAil SUCH NOT1CE SHALL IMPosif.io OBLlGAT10N OR liABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTAT1VES.
AUTHORIZED REPRESENTAT1VE
Deborah Church/DC
b~~ C-h
ACORD 25 (2001/08) FAX: (727) 562-4755
@ACORD CORPORATION 1988