CERTIFICATE OF LIABILITY INSURANCE (4)
ACORDN
CERTIFICATE OF LIABILITY INSURANCE
CSR LS DATE (MM/DDIYYYY)
CIVAI-l 09 01 06
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
Huntleigh McGehee
8235 Forsyth Boulevard, #1200
Clayton MO 63105
Phone: 314-746-4700 Fax:314-889-3700
INSURED
INSURERS AFFORDING COVERAGE
INSURER A: Old Republic Insurance
INSURER B' St. Paul Travelers
INSURER C:
INSURER 0:
INSURER E:
NAIC#
Co.
Civil Air Patrol Inc.
Bldg714,Maxwell Air Force Base
Mon~gomery AL 36112-6332
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.
lTR "'SRi: TYPE OF INSURANCE POLICY NUMBER 'D~~1MM/DDIY'i)- I P2!;J1{(f.~!,IRA~N liMITS
DATE MM/DDIYY
GENERAL liABiliTY EACH OCCURRENCE $1,000,000
f--
A X COMMERCIAL GENERAL LIABILITY AP690409 09/01/05 03/01/07 PREMffiES(EaO~~n~) $100,000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 25,000
PERSONAL & ADV INJURY $ 1,000,000
-
GENERAL AGGREGATE $2,000,000
-
GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
Xl n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1,000,000
B ~ ANY AUTO P810507DI067TCT06 - ADS 09/01/06 10/01/06 (Ea accident) ,
All OWNED AUTOS P810750K8747TIL06 - ADS 10/01/06 10/01/07 BODilY INJURY
- $
SCHEDULED AUTOS POCAP515D013806 - '1 It 09/01/06 10/01/06 (Per person)
-
~ HIRED AUTOS BA750K8760COF06 - '1 It 10/01/06 10/01/07 BODilY INJURY
$
X NON-OWNED AUTOS P810328D4643TIL06 - HI 09/01/06 10/01/06 (Per accident)
-
P810750K8759TIL06 - HI 10/01/06 10/01/07 PROPERTY DAMAGE
- $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
t=J OCCUR D CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY LIMITS I IU~lt
A EMPLOYERS' LIABILITY OCAWOl779706 09/01/06 10/01/07
ANY PROPRIETOR/PARTNER/EXECUTIVE El. EACH ACCIDENT $1,000,000
OFFICER/MEMBER EXCLUDED? E.l. DISEASE - EA EMPLOYEE $ 1,000,000
If yes, describe under $ 1,000,000
SPECIAL PROVISIONS below E l. DISEASE - POLICY LIMIT
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
City of Clearwater is included as an additional insured in relation to the
general liability regarding the trailer at 1000 Hercules Ave.
CERTIFICA TE HOLDER
CANCELLATION
City of Clearwater
Clearwater Municipal Marina
25 Causeway Blvd
Clearwater FL 33767
CITOFCL SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ 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.
A~
@ACORDCORPORATION 1988
ACO D 25 (2001/08)
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed.
A statement on this certificate does not confer rights to the certificate holder in lieu of
such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain
policies may require an endorsement. A statement on this certificate does not confer
rights to the certificate holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a
contract between the issuing insurer(s), authorized representative or producer, and the
certificate holder, nor does it affirmatively or negatively amend, extend or alter the
coverage afforded by the policies listed thereon.
ACORD 25 2001/08)