CERTIFICATE OF LIABILITY INSURANCE (36)
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ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
8/31/2006
.~:>L,C:"R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
:':'C'Nn & Brown Insurance - Clearwater
:.0. Box 2456 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
',~ite 660 I NAIC#
leClTwater FL 33757-2456 INSURERS AFFORDING COVERAGE
~;UR:"D INSUR~P.",: Hartford Casualty Insurance C 129424
-isinger Campo & Assoc. Corp. INSURFR 3: Travelers Cslty & Surety Co. 119038
:CCS, Inc INSURER G: Continental Casualty Insuranc 120443
0 Box 25261 Hartford Fire Insurance Co_ 119682
INSUR:"R D:
:ampa FL 33622-5261 I
INSURER E:
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COVERAGES
TEE POLICIES OF INSURANCE LISTED BELOW fUWE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRJ\.CT OR OTHER DOCill"lENT 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 MJ\.Y RZWE BEEN REDUCED BY PiUD CLAIMS.
INS~DD'~ TYPE OF INSURAN CE I POLICY NUMBER 1 POLlC~.EFFECTI~~ Pg~lfll~~~t~N LIMITS
L TR NSRt> DATE MMfDDIYY
D Ix ~NERAL LIABILITY 21UUNAG7547 9/1/2006 9/1/2007 ~..QCCUF<RENCE $1, 000, 000
X COMMERCIAL GENERAL LIABILITY ~~~~~~9E~~~~~~nce) $100,000
e- =:J CLAIMS MADE ~ OCCUR
e- MED EXP (Anyone person) $5,000
- PERSONAL & ADV INJURY $1,000,000
- GENERAL AGGREGATE $2,000,000
Tl'L AGGREAE LIMIT APFSPER: I PRODUCTS. COMP/OP AGG $2,000,000
X PRO. l
r POLICY JECT LOC
X ~TOMOBILE LIABILITY 21UUNAG7547 9/1/2006 9/1/2007 COMBINED SINGLE LIMIT $1,000,000
X (Ea accident)
- ANY AUTO
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
- --.
~ HIRED AUTOS BODILY INJURY
$
X NON.OWNED AUTOS (Per accident)
- -
L' - PROPERTY DAMAGE $
(Per accident)
RRAGE LIABILITY 1;;;00","""'"," $
ANY AUTO OTHER THAN EA ACC $
AUTO ClNL Y: AGG $
IX I 9/1/2006 9/1/2007 Is2,OOO,OOO
1.--.... ~"""""~ o'^o",~ !2lXHUAG 760'1 ~S:H OCCURRENCE
X OCCUR D CLI\IIJ,S M,I\DE AGGI'l.EGATE s2,OOO,000
~
I , i 0
"
Ix1 DEDUCTIBLE i Is
I
....;. I X RETENTION S10,OOO $
B .1 ~~~~~:ESR~?~:~~L~~IO~At-l~ ........ .. PVYANUB863K437A05 1.Q/3.J ;200':'- 1.0 / ~ /2..006_ X I WC STATU. I IOTH-
---.- ----.-- TORYIIM!T:S EP. .
! ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S 500,000
, I OFFICER/MEMBER EXCLUDED? ~~ASE-EAEMPLOYEE $500,000
If yes, desCribe under I I
SPECI."L PROVISIONS below I E.L. Di:;EASE. POLICY LIMIT $500,000
, OTHER F"EAO 0 823112 8 10/24/2005 10 4/2006 Per Claim 2,000,000
- Professional Liability l'.ggr"ga te 5,000,000
Deductible 200,000
1-,
C,'ESCRIPTlON OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT J SPECIAL PROVISIONS
:''2r-::ificate Holder is an additional insureci ,....:ith respect to :::r2:::1e!-al liability, auto liability and umbrella liability.
'~,3.i-_rer of Subrogation applies to general liabil i ty and workers compensation. *10 Days for Non Payment.
~
City of Clearwater
Attn: City Clerk
POBox 4748
Clearwater FL 33758.4748
CANCELLATION
SHOULD ANY OF THE ABOVE DESCEIBED POLICIES BE CANCELLED
BEFORE THE EXPIR"Z\.TION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL 30* DA,cS WRITTEN NOTICE TO THE
CERTIFICl'_TE HOLDER Nl'.MED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE NO OBLIGATION OE LIABILITY OF ANY KIND UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
bERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVE
~ 1R. tJudrV~
ACORD 25 (2001/08)
@ACORDCORPORATION1988
[~~,ORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
8/31/2006
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
E:~O""n & Brown Insurance - Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
:?O. Box 2456 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
::"~i '~e 660
C!~elrwater FL 33757-2456 INSURERS AFFORDING COVERAGE ~I^ IJ""'-.u.
..,...,..I.......t1"
.--- Hartford Casualty C 29424
IN::;,URED INSURE? A: Insurance
t~is inger Campo & Assoc. Corp. INSURER B: Travelers Cslty & Surety Co. 19038
}::':~CS , Inc INSURER c: Continental Casualty Insuranc 20443
P-O Box 25261 Hartford Fire Insurance Co. 19682
Tampa FL 33622-5261 INSURER D:
INSURER E:
TEE 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 INSUPJffiCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO l".LL
TEE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN ~4Y HAVE BEEN REDUCED BY PAID CLAIMS.
INsRjAODJ[ POLICY NUMBER P6'k+~';ri~7gg~~ Pgk'fJ,~:'~6'~N LIMITS
L TR INSR TYPE OF INSURANCE
D X I GENERAL LIABILITY 21UUNAG7547 9/1/2006 9/1/2007 EACH OCCURRENCE $1,000,000
,X1 COMMERCIAL GENERA.L liABiliTY ~~~~~;~~9E~E:C~~~nce\ $100,000
R~C~'M'M'" Ix] OIT", MED E):P (Anyone person) $5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'LAGGREn liMIT APPliES PER: PRODUCTS. COMP/OP AGG $2,000,000
Xl POliCY jrg+ n LOC
D X ~OMOBILE LIABILITY 21UUNAG7547 9/1/2006 9/1/2007 COMBINED SINGLE liMIT $1,000,000
~ ANY AUTO (Ea accident)
-'
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
- SCHEDULED AUTOS
X HIRED AUTOS BODIL '( INJURY
X (Per accident) $
- NON.OWNED AUTOS
- PROPERTY DAMAGE $
(Per ac,iclent)
GARAGE LIABILITY I ~)NL y. EA ACCIDENT $
R ANY AUTO EAACC $
I OTHEFnHAN AGG I $
AUTO ')NL Y:
-1-- 19/1/2006 I EACH JCCURRENCE $2,000,000
L.. X tfJESSIUMBRELLA LIABILITY 21XHLJAG7607 9/1/2007 I
X OCCUR U CLAIMS MADE i AGGR=GATE $2,000,000
I $
r--,
U DEDUCTIBLE $
I"r I 510,000 Is
I A RET"NTION
13 WORKERS COMPENSATION AND PVYANUB863K437A05 10/3/2005 10/3/2006 X I WC STATU- I 10TH.
TORY LIMITS ER
EMf'LOYERS~LIABILJn..... __n___ _ _ .. - .-' - - -- ...... .-- J=.:!:o EACH ACCIDENT -- $500,-000 -
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $500,000
If yes, describe under E.L. DISEASE. POliCY liMIT 5500,000
---'. SP:"CIAL PROVISIONS belo"
, , OTHER 10/24/2005 10/24/2006 Per Claim 2,000,000
'::: AEA008231128
, i Professional Liability Aggregate 5,000,000
Deductible 200,000
i
DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability.
7~aiver of Subrogation applies to general liability and workers compensation. *10 Days for Non Payment.
L
COVERAGES
CERTIFICATE HOLDER
CANCELLATION
-, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPI~4TION DATE THEREOF, THE ISSUING INSURER
City of Clearwater WILL ENDEAVOR TO ~"'IL 30* DAYS WRITTEN NOTICE TO THE
Attn: City Clerk CERTIFIC"'TE HOLDER NN;,ED TO THE LEFT, BUT FAILURE TO DO SO
P 0 Box 4748 SHALL IHPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON
Clearwater FL 33758-4748 THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~.l<.~
ACORD 25 (2001/08)
@ACORDCORPORATION1988