CERTIFICATE OF LIABILITY INSURANCE (40)
.. DATE (MMlDDIYYYY)
ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 8~
WADET-8 10/23/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Professional Underwriters, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
39475 13 Kile Road, Suite 106 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Novi KI 48377
Phone: 248-553-8300 Fax:248-553-8305 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Charter Oak rire Insurance Co.
INSURER B: Traveler. Property Casualty
Wade Trim, Inc. i 220 INSURER C: CODtiDental calualtyCampany 20443
Renaissance 5, Suite
8745 Henderson Road INSURER 0: . .'.
.... Tampa, FL33634 .... .'
... .... INSURER E:
COVERAGES . '. '.
THE pbLlCIES 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 MAYBE 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 NSRI TYPE OF INSURANCE POLICY NUMBER ~MMIODiYYi I "8k!feY(MM/DDrffl' LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
I---
A X ~ COMMERCIAL GENERAL.LIABILlTY 630-9921B797 10/01/06 10/01/07 p~lS'Es lea occui-'E;nce) $1,000,000
f-- =:J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10,000
f-- PERSONAL & ADV INJURY $ 1,000,000
f-- GENERAL AGGREGATE $ 2 , 000 , 000
GEN'L AGGREGATE LIMIT APnS PER: PRODUCTS-COM~OPAGG $ 2,000,000
h POLICY Iil ~~8r LOC
'.. AUTOMOBILE LIABILITY
- .. COMBINED SINGLE LIMIT $ 1,000,000
A.' Xl { ANY AUTO 8io-9921B797 10/01/06 10/01/67 (Ea accident)
ALL OWNED AUTOS ... . ..
....i-- .. BODILY INJURY $
.SCHEDULED AlJTOS; (Per person)
- . ...
.
- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident) .
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $
~ ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ 15,000,000
B I :!J OCCUR D CLAIMS MADE CO'P-9921B797 10/01/06 10/01/07 AGGREGATE $ 15,000,000
$
~ DEDUCTIBLE $
RETENTION $ $
. I we STATlJ- I IUElt .._,-
WORKERS COMPENSATION AND X TORY LIMITS
B EIfIPLOYERS' LIABILITY 0'8-9921B797 10/01/06 10/01/07 $ 500,000
AWY PROPRIETORlPARTNER1EXECUTIVE E.L EACH ACCIDENT
o FICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ 500,000
If res, describe under
S ECIAL PROVISIONS below E.L DISEASE.. POLICY LIMIT $ 500,000
,q rtiER
C I~ iRCH/ENG PROF LIAB ABA 1333326027 10/01/06 10/01/07 EA. CLAIK 5,000,000
C ~IMS MADE BASIS DBD. AS STATSII OJ! POLZC1C AGGREGATE 10,000,000
DESCRlITION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
PRO~CT : ENGINEER OF RECORD. THE CITY OF CLEARWATER IS NAMED AS AN
ADD~TIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY AND AUTO LIABILITY.
I
CLEARW1
CANCELLATION
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.
CERTFICA TE HOLDER
CITY OF CLEARWATER
ATTENTION: . --_....-1<~"\ ~tl'\,
100 SOUTH MYRTLE AVENUE J
CLEARWATER, FL 33758
@ACORDCORPORATION 1988
A
25 (2001/08)