CERTIFICATE OF LIABILITY INSURANCE (39)
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CERTIFICATE OF LIABILITY INSURANCE
FAX (305)827-0585
Fowler, Dowling
DATE (MM/DDIYYYY)
10/03/2006
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.
I
,., "PRODUC lit (305}822 -7800
Collinsworth, Alter,
& French Group Inc.
P. O. Box 9315
Miami Lakes, FL 33014-9315
INSURED Post, Bue. kley, Schuh'I~1~~i~nl~I~c.W I~ f' "". '.
~~ia N:B~:: Avenue ," ~ < r 1 i i! :::~:::::
Miami, FL 33172-2507 lUll/I OCT I 7 lno~ I' I~ INSURERD:
INSURER E:
C .! CITY m W"~Tl:D
THE PoLICIES OF INSURANCE LISTED .,,:::, ~lSWJ16ffINS RED NAMED ABOVE FOR THE POLfCY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OK '-', , UMENT WITH ~ESPECT 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. AG'GREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
I,,: ~~m TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POUCY EXPIRAnON
! GENERAL UABILlTY
~
INSURERS AFFORDING COVERAGE
INSURER ALl oyds of London A XV
NAIC#
COMMERCIAL GENERAL LIABILITY
I CLAIMS MADE D OCCUR
EACH OCCURRENCE
DAMAGE TO RENTED
LIMITS
$
$
$
PERSONAL & ADV INJURY $
$
PRODUCTS.. COMP/OP AGG $
MED EXP (Anyone person)
-
GENERAL AGGREGATE
-
GEN'L AGGREGATE LIMIT APPLIES PER:
~ POLICY n ~~8r n LOC
AUTOMOBILE UABILITY
-
ANY AUTO
-
-
~
NON-OWNED AUTOS
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
OTHER THAN EA ACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $
AGGREGATE $
$
$
$
I T"J.'j,~Tf':T,'=!-~ I 10J~-
ALL OWNED AUTOS
-'--
-
SCHEDULED AUTOS
HIRED AUTOS
GARAGE LIABILITY
R ANY AUTO
EXCESS/UMBRELLA LIABILITY
tJ OCCUR D CLAIMS MADE
RDEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
IWY PROPRIETORlPARTNERlEXECUTIVE
OFFICERlMEMBER EXCLUDED?
If yes, describe under
SAECIAL PROVISIONS below
p';'ressi ona 1/
A ponlution Liability
EL. EACH ACCIDENT $
E.L DISEASE.. EA EMPLOYEE $
E.L DISEASE.. POLICY LIMIT $
LDUSA0600811 09/30/2006 09/30/2007 $1,000,000 Limits
Ea Claim and Annual Aggregate
CLAIMS-MADE FORM 11/11/1961 Retrodate
'p'E8CRlFlTION OF OPERAnONS I LOCAnONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
~ef: City of Clearwater.
C
HOL
C
Clearwater, City of
~ngineer of Record
100S. Myrtle Avnue
Engineering - Suite 220
Clearwater, FL 33756
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NonCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
- ~-..'
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Meade Collinsworth FVM
ACORD 25 (2001/08)
@ACORD CORPORATION 1988