CERTIFICATE OF LIABILITY INSURANCE (2)
09/01/2005 14:19
7272988850
Cm.'1t'..1ERCIAL
PAGE 02/02
ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOIYYYY)
! TM, 09/01/2006
PRODUCER PhoM: 727-'14$-$77.1 Fa~: 727-29$-9950 T.,15 CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
ALL L.INES INSURANCE: GROUP INC ONLY AND CONFERS NO RIGHTS uPON THE CERTIFICATE
1345 S MISSOURI AVE HOL.DER THIS CERTIFICATE DOES NOT AMI:~D, EXTEND OR
CLEARWATER Fl.- 33756 AL TE~ THE COVERAGE AFFORDED BY THE POLICIES BELOlllt
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: SCOTTSDAl.-EINSURANCE
688 SKATE PRO SHOP II lNSURE:R B:
E)140 ULMERTON RD ."
CLEARWATER FL 33760 INSURER C:
INSURE.R 0: .-
,
! INSURER E:
1HE pOLICIES OF INSURANCE LISTED BELOW HAVE BEEN IsSuED TO nlE INSUReD NAMED ABOVE FOR THE POLICY PERIOD INDIcATE.[), NOlWlTliSTANOING
f:.NY REQUIREMI:;NT, TERM OR CONDITION OF ANY CONTRACT OR OTHr;;R DOCUMENT WITH RESPECT TO WHICI'! THIS CERTIFICATE MAY eE ISSUED OR
rt<A.Y PERTAlt-I, THE; INSURANoe AFFORDED BY THe POLICIES DESCRIBED HEREIN 1$ SUI;IJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
~OI,ICIES. AGGREGAT!;: LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR -
~DO'c lYf'E O~ INSURANce POLICY NUMBER Pgi~~~~.;~\~ POLIcY ~X~IIlATION I.IMITS
UTR 'NSFl~ DA TO 'MM/l'lrvvv,
~ERAI.I.IM!ll.ITY CPS0705948 05/30/06 05/30/07 EACH OCCURRENCE S 1,000,000
X COMMERCIAL GENERAL L!ABILlTY DAMAGE TO IU!NTEr.> $ 100,000
~~J~d occurononl
.~ CLAIMS MAce I.iJ ocCuR. MEO, EXP (AnY on~ pRr~Dn) $ 5,000
~
Po. PERSONAL ilo ADV INJURY $ 1,000,000
- ,
, GENERAL AGGREGATE $ 2,000,000
-
! GEN'L AGGR[;:GATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 1,000,000
I nPRO- n
POLICY JECT LOC
AUTOIJIOBII.E LIASILllY COMBINED SINGLE LIMIT
- $
ANY AuiO (E. .r,clcRnl)
, -
ALl_ OWNED AUTOS BODILY INJURY
- (P~r po!r!o n) $
SCHEDUlF.D AUTOS
- -, ,-
HIRED AUTOS BCDll Y INJ~IRY
f-- $
NON^DWNED AUTOS (Per acoldent)
I--
f-- ~ I ~ROPERTYRAMAC3F. $
pI>[ ~oeidenl
! GARAGE LIABILITY $
, ~ ANY AUTO ~)JTO ONLY - EAACC.I.Q.ENT
OTHER n-ll'.N _E~ ACe $
AUTO ONLY: AGG 3>
EXCESS J uMElREl.LA L1ABILrTY EliCH OCCURRF.;NCE $
=:J OCCUR 0 CLAIMS MilOS AGGREGATE :1\
"
:0
R DF.OUCTIBLE $
RETENTION $ S
WO~KERl! COMPENSATION AND I WC STAW- I I OTHER
=MPl.OY!!RS' UABIl.lty 'rO~V I,IMITS
ANY ~RQ~"II!!TORIPARTNE~~x~eUTIVE E,l, F.ACH ACCIDENT $
."
Ol'?'ICERIMEM8ER El(e~uop.O? e.I., DISEASE.EII EMPI.OYEE 5;
If ya., da-Jtirl~ uMllr E.l. DISF.ASE.POLlOY LIMIT $
BPECl/l.L P~OVISION8 balow
OTHER:
A
DESCRIPTION OF OPERATlONS/LOCATIONSNEH1CLES/EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS
1426 MARTIN LUTHER KING JR AVE
CLEARWATER, FL 33756
CERTIFICATE HOL.DER CANCELLATION
CITY OF CLEARWATER SHOULD ANY OF THE ABOVE DESCRIElel:l POLlOIES 6= CANCRLED BEFORE; THE
1426 MARTIN LUTHER KING JR AVE eXPIRATION DATE THeREOF, THE ISSUING INSURER Will ENDE;AVOR TO MAil 10 DAYS
WRI1iEN NOTICE TO THE CERTIFICATE HOLOER toJAMED TO THE LEFT, BUT FAilURE
CLEARWATER, FL 32756 TO DO sO SHALl. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.
ITS AGENTS OR RF.PRESENTIITlVES.
AUTHORIZED REPRE8ENTAT[V~ ~c-
At1:entJ on:
ACORD 25 (Z001/08)
Certificate # 78337
@ACORD CORPORATION 1966
:COVERAGES