CERTIFICATE OF LIABILITY INSURANCE (21)
~
i
/2006-L8:26AM;ICACUMBEY & FAIR, INC ITV INSURANCE
" '" .'111 1'\.........,1 ....I'""~.- E-2 03 16 06
"" . THIS CERTIFtCArE IS ISSUED AS A MATTER OF INFORMATION
-'/l.ch '& Willingham tnc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE!
IAvenue South, 5th Fl HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
133020 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
~sburg FL 33733
~7-522-7777 Fax:727-S21-2902
';
CumbEilY & ~~i:r:, Inc,
2463 ~nte~rise ad.
Clearwa~er F.L 33763
i €RAGES
INSURERS AFFORDING COVERAGE
INSU~E~ A:
INSUReR 5:
INSURER C:
IKSU~ D;
INSUREI\ IE;
. Mat'l 1'1.":8 %1\8 eo 011 Ha..trClM
Arah! taat:s ..nd II:noiol\lll-' %1)3 e
Trans o~tation Ins. Co.
IE :"O:'!~IIiiS OF INSURANCE LISTED BELOW HAV~ BEEl'IlSSUeO TO THe: INSURED NAMED ABOVe !'lOR 'tHE POLlCVPERlOD tNDICATEtl. NOTWITHSTANDING
f?>' R.",QlJl~NT. TERM OR CONDITION 01" ANY CONTRACT OR OTKER DOCUMEN'r W1'l't1 RESPeCT TO WHICH THIS CER"FICA~ MAY BE ISSUED OR
i 'jAAY I"SI\TAlN.1li1i INS\.I~NCE AFFORDED BY fHe POuCIES DESCRISED ~~IN IS .eUSJECTTO ALL THE 'r'ERMS, EXCLUSIONS Atoll) COI'IDlTlOI'lS OF SUCH
t WLlClI:5. AGGReGATE LIMITS SHOWI'I MAY HAVE Bl!EN REDuCED BY PAID ClAIMS.
'L':;:<O: "N~R~ mE OF INSURANce POLICY NUMBER ~ DATE;'Iiii,wntril.
GSNERAlllAIiILl1Y
Xl COMM&RCIALGION~LLIAli!IUTY 2096949437
! I Cr..AIMS MADE ~ OCCUR
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~;,,":'~.'~~"RE/3AT!O LIMIT APPLIES PER:
i-' POLI~-r~f):8r - n- LOC
~TO~~~~ UASILfrY
S ALL OWNeD AUTOS
, SCHr:OULED AUTOS
U HIRED AUTOS
P NON-OWNeD AUTOS
2088208783
, GARt<GE LlABllI1Y
: ' /lHf AUTO
r
I
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EXC'ESSIUMBRELlA LIABIUTV
ttJ OCCUR D ClAIMS MADE
Ii DI!DI.ICTlBLE
/xi RETENTION S 10000
WORKe~COMPEN$A~ONAND
EMI"LOYll'tS'LIAIlIl.rrv
,: ANY PROPRIETORlI"ARTNlOJViXECUTlVE;
, O"'l"'CERlMEMBEFt EXCLUI)5tl?
! 'f \98. c,<scn"blil u~der
, S"::CIA'. P~VISIONS 1;1..0..
2086949471
i
03/16/06
03/16/07
LIMITS
EACH OCCURRIiiNCe
:Dye;:~~C;Cl
MED EXP (Any one person)
PeRSONAl & ADV INJURY
GEIoERAL AGGREGA Tli
PAOOUCTS-CO~P~PAGG
Ean Ben.
03/16/06
COMBtNJ;:D SINGLE LIMIT
03/16/07 (Ellil~dlllll)
BODILY INJURY
(Per pet$Qtl)
s
s
S
$ 2.000.000
$2,000,000
s
$
$
I:roRYUMrfs I IO~~.
1O.L- eACH ACCiDeNT S
1O.L. DISIiA6E -lOA liMPLOYeE S
e.L. DISEASE - POWCY LIMIT s
BODILY INJURY
(Per accltlenl)
PROPIORlY OAIMGE
(Per accident)
AUTO OI'lL Y . EA ACCIDeNT
EAACC
AGG
OTHER THAN
AUTO ONl.. Y:
~... OCCURRENce
AGG~(lATE
'C' ~:':,::::,f@ssional Li.ab AErCPG05 03/16/05 03/16/08
:::? '=; .. 0 00 Deductib1e
c'~ S~q ,~""";)N 0" OPEKA TJONS I LOCATIONS I VEHICLES f EXCLUSIONS ADDED IY f1NDORSEIIENT I SPECIAL PROVISIONS
.0""" ,70:0 No: 712B proj ect Name: General ancl P~ofessiona.1 Liability. the
;~~ Clgarwater is Additional. insured with regard to General Liability.
03/16/06
03/16/07
CERTIFICATE HOLDER
1,000,000
1, 000,000
City
NAlC #
01.505
20494
61,000,000
s 300 000
$ 10.000
$ 1.000.000
$ 2,000 000
$ 2 , 000 . 000
1,000.000
$ 1,000,000
s
$
s
Each Claim
Aan-:r:eaate
CANCELLATION
CI:ry -CL SHOULD ANY Of THE ABOVE O.ESCRJIlED I'OUCMS BE! CANCELlED BEFORE utE Ei)(PIRA'I'IO
PATI! THEREOF. lift; ISSUING INSURER WlLL ENDEAVOR. TO MAIL. ~ DAYS WRITTEN
"'OTlCj; TO THE CER'TlFlCATE HOLDER NAMEJ:l TO 'tHE LEFT. BUT FAllURI!i TO DO SO SHAll
IMPOSli NO OBUGATION OR l.IABIUlY OF ANY KIND UPON THE INSURER. ITS AGI;;NTS OR.
Rl!PRIOSE!NTA 11VES.
AUTHO ESE
City of Clearwater
:20 Box 4746
~le~ater FL 33758
,:\-:;QRD 2S (2001/08)
@ACORD CORPORATION 1988