CERTIFICATE OF LIABILITY INSURANCE (27)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
08/09/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Sun coast 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
INSURED INSURER A: United States Fidelity & Guaranty
Aude, Shand & Williams, Inc INSURER B: Fidelity & Guaranty Ins Underwrite
19353 U.S. Hwy 19 N INSURER c: St Paul Fire & Marine
Ste 101 INSURER 0: XL Specialty Insurance Company
I Clearwater, FL 33764 INSURER E: ..
Client#: 3206
AUDESHA3
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.
~~L' TYPE OF INSURANCE POLICY NUMBER Pgk'fe",~';f~gJ.X\' P%~fl,'f::)~~l)$r LIMITS
A GENERAL LIABILITY BK01430766 07/22/06 07/22/07 EACH OCCURRENCE $1.000.000
f--
eX- COM M ERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $300.000
f-- tJ CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $10000
f-- PERSONAL & ADV INJURY $1.000 000
f-- GENERAL AGGREGATE $2.000 000
GEN'L AGGREGATE L1M IT APPLIES PER: PRODUCTS .COMP/OP AGG $2.000 000
n POLicy-iii jr6>,: n LOC
B ~TOMOBILE LIABILITY BA01444272 08/07/06 08/07/07 COMBINED SINGLE LIMIT
~ ANY AUTO (Ea accident) $1,000,000
f-- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
f--
X HIRED AUTOS BODILY INJURY
f-- $
X NON-OWNED AUTOS (Per accident)
f--
f-- PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY AUTO ONLY- EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESS LIABILITY BK01430766 07/22/06 07/22/07 EACH OCCURRENCE $1 000 000
~ OCCUR D CLAIMS MADE AGGREGATE $1 000000
$
~ DEDUCTIBLE $
RETENTION- $ .. $
C WORKERS COMPENSATION AND BW02194387 09/01/06 09/01/07 X I_WC STATU- I IOJ~-
EMPLOYERS' LIABILITY $500,000
E.L. EACH ACCIDENT
E.L. DISEASE - EA EMPL OYEE $500,000
E.L. DISEASE - POLICY LIMIT $500 000
0 OTHER DPR9419696 07/20/06 07/20/07 $2,000,00 per claim
Professional $2,000,000 aggregate
iabilitv
DESCRIPTION OF OPERATIONS/LOCA TIONSNEHICLESJEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Professional Liability is claims made and reported.
City of Clearwater is an additional insured w/respect to General Liability
and Auto Liability. Waiver of Subrogation is included except for Workers
Compensation.
CERTIFICATE HOLDER I X I ADDIT1ONALINSURED'INSURERLETTER: CANCELLATION
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL3n--DAYSWRITTEN
Attn: City Clerk NOTICE TO THE CERTIFICATE HOLDER NAMED TOTHELEFT, BUTFAlLURE TODOSOSHALL
P.O. Box 4748 1M POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Clearwater, FL 33758-4748 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
I
ACORD 25-8 (7/97)1 of 2
#S128324/M128322
KEB
@ ACORD CORPORATION 1988