CERTIFICATE OF LIABILITY INSURANCE (29)
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. ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
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 #I
INSURED INSURER A: United States Fidelity ". Guaranty 25887
Jones Edmunds & Associates, Inc. INSURER B: St. Paul Fire & Marine Insurance Co 24767
730 H.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 INSlJRANCE LiSTED BEL,OW HAVE SEEN ISSl)~P TO THl:.IN$URI;P NAMED ABOVE FOR THE POLlCYPE~loD INpICATE!). NoTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH nils CERTIFICATE MAY BE ISSUED bA.
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.
~ TYPE OF INSURANCE POLICY NUMBER PDUCY EFFEcnvE POLICY EXPIRATION LIMITS
A ~NERAL LIABILITY BK02194041 06/30/06 06130107 EACH OCCURRENCE $1 000 000
X COMMERCIAL GENERAL LIABILITY R~~~!l~IO RENTED $1 000.000
I CLAIMS MADE ~ dCCUR MED EXP (Anyone person) $10.000
PERSONAL & ADV INJURY $1.000.000
GENERAL AGGREGATE $2.000.000
GEN\. AGGREnE LIMIT APnS PER: PRODUCTS - COMPIOP AGG $2.000.000
n POLICY ~~8T LOC
D ~TOMOBILE LIABILITY BA02194122 06/30/06 06130107 COMBINED SINGLE LIMIT
~ ANY AUTO (Ea accident) $1,000,000
ALL OWNED AUTOS BODILY INJURY
t--- (Per person) $
t--- SCHEDULED AUTOS
!.... HIRED AUTOS BODILY INJURY
(Per accident) $
!.... NON-OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
~GE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESSlUMBRELLA LIABILITY BK02194041 06/30/06 06130107 EACH OCCURRENCE $5 000 000
Xl OCCUR 0 CLAIMS MADE AGGREGATE $5 000 000
$
=1 DEDUCTIBLE $
RETENTION $ S
B WORKERS COMPENSATION AND BW02193378 06130/06 06130/07 X I WC STATU- I 10J~
EMPLOYERS' LiABILITY E.L. EACH ACCIDENT $1.000.000
ANY PROPRIETORlPARTNERlEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE 51.000.000
~~~~~.r~~~S10'NS below E.L. DISEASE - POLICY LIMIT 51.000.000
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 I SPECIAL PROVISIONS ~:I ~ ~ : ~I.~ ~ J illl
Professional Liability is written on a claims made and reported basis.
Certificate holder is listed as an additional insured with respects to the
General Liability policy.
"'TV nr \
CERTIFICATE HOLDER CANCELLA nON !>"nuc WORKS ADMINISTRATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL --3ll- DAYS WRmEN
Attn: City Engineer NOTICE TO THE CERTIACATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
POBox 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Clearwater, FL 33758 REPRESENTATIVES.
A~ZEDREPR~TIVE
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ACORD 25 (2001/08) 1 of 2
#M125266
MOL
(/) ACORD CORPORATION 1988