CERTIFICATE OF LIABILITY INSURANCE (37)
ACORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYY)
10/9/2006
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Brown & Brown Insurance - Clearwater
P.o. Box 2456
Suite 660
Clearwater FL 33757-2456
INSURED
Kisinger Campo & Assoc.
KCCS, Inc
POBox 25261
Tampa FL 33622-5261
Corp.
INSURERS AFFORDING COVERAGE NAIC #
INSURER A: Hartford Fire Insurance Co. 19682
INSURERB: Hartford Casualty Insurance C 29424
INSURERC: Continental Casualty Insuranc 20443
INSURER D:
INSURER E:
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 'I'ERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR ~t~L TYPE n~ ''''SUl>A''"'~ Pci>.k+~1.'i~~gg~E Pgk!fJI~~~~N LIMITS
LTR POLICY NUMBER
A X ~NERAL LIABILITY 21UUNAG7547 9/1/2006 9/1/2007 EACH OCCURRENCE $1,000,000
X 3MMERCIAL GENERAL LIABILITY ~~~~~~~9E~~~~~nce ) $100,000
I I--
CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $5,000
f---
f--- PERSONAL & ADV INJURY $1,000,000
I-- GENERAL AGGREGATE $2,000,000
i n'L AGGREr9E LIMIT APAS PER: PRODUCTS.COM~OPAGG $2,000,000
POLICY ~~WT LOC
A ~TOMOBILE LIABILITY 21UUNAG7547 .. 9/1/2006 9/1/2007 COMBINED SINGLE LIMIT $1,000,000
~ ANY AUTO (Ea accident)
- ALL OWNED AUTOS BODILY INJURY
I RECEIV ~[) (Per person) $
I SCHEDULED AUTOS
-
X HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
- 1 20 6
..\.. -'--
- PROPERTY DAMAGE $
(Per accident)
~RAGE LIABILITY ~)I:I K,;A~ i;:::(.>.A~t .) ANL> AUTO ONLY - EAACCIDENT $
ANY AUTO LE<: ISLATIVF. SRVC. DFOT OTHER THAN EAACC $
AUTO ONLY: AGG $
B X EXCESS/UMBRELLA LIABILITY 21XHUAG7607 9/1/2006 9/1/2007 EACH OCCURRENCE $2,000,000
KJ OCCUR D CLAIMS MADE AGGREGATE $ 2,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
A WORKERS COMPENSATION AND 21WBNW1033 10/3/2006 10/3/2007 X I WCSTATU-: I 10TH.
TORY LIMITS ER
EMPLOYERS' LIABILITY $ 500,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
--."- -PFF/6ER/MEMBER EXCLUDED?-.. - -------......-."--.--.-- -- - --- ".-------"---- _n ___ - - E:t: DISEASE. EAEMPtOYEf $- SD.D, OOJl--
If yes, describe under $500,000
SPECIAL PROVISIONS below E.L. DISEASE. POLICY LIMIT
C OTHER AEA008231128 10/24/2005 10/24/2006 Per Claim 2,000,000
Professional Liability Aggregate 5,000,000
Deductible 200,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate Holder is an additional insured with respect to general liability, auto liability and umbrella liability.
Endorsements available upon request. Waiver of Subrogation applies to general liability 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 DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER
WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO
SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND.UPON
THE INSURER, ITS AGENTS OR REPRESENTATIVES.
CERTIFICATE HOLDER
AUTHORIZED REPRESENTATIVE
~72.~
ACORD 25 (2001/08)
@ ACORD CORPORATION 1988