CERTIFICATE OF LIABILITY INSURANCE (10)
,
Client#: 84252
ACORD'M
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDIYYYY)
4/26/06
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.
PRDDUCER
HRH Df Philadelphia
600 W. Germantown Pike
Suite 300
Iymouth Meeting, PA 19462-9998
Global Spectrum LP
3601 S. Broad Street
Philadelphia, PA 19148
INSURERS AFFORDING COVERAGE
INSURER A; CDmmerce & Industry
INSURER B; Axis Specialty Insurance Company
INSURER C;
INSURER D;
NAIC #
19410
15610
,H6URED
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 PERT AIN. 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.
L'fR NSR[ TYPE OF INSURANCE PDLlCY NUMBER PDOAL,'~~~~~~,w\E p~~iJ ~~~t'~N LIMITS
~ERAL LIABILITY EACH OCCURRENCE $
~ COMMERCIAL GENERAL LIABILITY !2~~f.~~ yo, RENTE,?pnc.\ $
~ ~CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
~
- GENERAL AGGREGATE $
~'L AGGREAE LIMIT APAS PER; PRODUCTS. COMP/OP AGG $
PRO.
POLICY JE CT L OC
~OMDBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea acciden1)
-
- ALL OWNED AUTOS BODIL Y INJURY
$
SCHEDULED AUTOS (per person)
-
- HIREDAUTOS BODIL Y INJURY
$
NON.OWNED AUTOS (Per accidenl)
f---
PROPERTY DAMAGE $
(Per accident)
RAGE LIABILITY AUTO ONL y. EA ACCIDENT $
I ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y; AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
o OCCUR 0 CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
A WDRKERS COMPENSATION AND 9688960 03/30/06 03/30/07 X I T~~VS~ 'iJ.~~ I IOJ~'
EMPLDYERS'L1ABILlTY $1,000,000
ANY PROPRIETORlPARTNER/EXECUTIVE E.l. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.l. DISEASE. EA EMPLOYEE $1,000,000
If yes, describe under E.l. DISEASE. POLICY LIMIT $1,000,000
SPECIAL PROVISIONS below
B OTHER Professional . ENN581653 04/01/06 04/01/07 $2,000,000 Each Claim
liability $2,000,000 Aggregate
$5,000 Deductible
DESCRIPTIDN DF DPERA TIDNS / LDCA TlDNS / VEHICLES / EXCLUSIDNS ADDED BY ENDORSEMENT / SPECIAL PRDVISIDNS
Re: Harborview Center; 300 Cleveland Street; Clearwater, FL 33755
City of Clearwater, Florida is included as Additional Insured where
required by cDntract, sDlely with respect to the operations of the Named
Insured.
CERTIFICATE HOLDER
CANCELLATION
CITY OF CLEARWATER
112 S. OSCEOLA AVENUE
CLEARWATER, FL 34618-0000
SHDULD ANY DF THE ABDVE DESCRIBED PDLICIES BE CANCELLED BEFORE THE EXPIRATIDN
DATE THEREDF. THE ISSUING INSURER WILL ENDEAVDR TO. MAIL -31L- DAYS WRITTEN
NDTICE TO. THE CERTIFICATE HDLDER NAMED TO. THE LEFT. BUT FAILURE TO. DO. so. SHALL
IMPDSE NO. DBLlGATIDN DR LIABILITY DF ANY KIND UPON THE INSURER. ITS AGENTS DR
ACORD 25 (2001/08) 1 of 2
#M313756
1 LDAR
@ ACORD CORPORATION 1988
CERTIFICATE OF INSURANCE
0711112006
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 POLICY BELOW.
RODUCER
American Specialty Insurance & Risk Services,lnc.
1142 North Main Street
Roanoke, Indiana 46783
SURED
C3Iobal Facillties, L.P.. Global Spectrum, Inc.
3101 Soulh Broad Street
Philadelphia, PA 19148-5290
CERT NUMBER: 1000433634
COVERAGES
THIS IS TO CERTIFY THAT THE POLICiES OF INSURANCE LISTl:D ~ELOW HAVE BEEN ISSueD TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
IoJDlCATED, NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDlT10N OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERl1F1CATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDeo BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDIT10N OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INS POLICY POLICY POLICY
LTR TYPE POLICY NUMBER EFFECTIVE EXPIRATION LIMITS
General AtImeaale . Per location 2 oon nnn
GL PHPK178272 0613012006 06/3012007 ProcIucf.8.Comnleled Ooerations Acoreeale 1 000 000
A . . InluN 1 000 000
12:01 a.m. 12:01 a.m. ce 1 000 000
FInt Down..".. .. , nn.. FI.A 1 100000
Medlca'-~v""nse Ilmll lAnv One Personl Blcluded
L1auor UablillV 1 000000
5 000 000
UMB QK06500871 0613012006 0613012007 ~_.. 10000000
B 5 000 000
12:01 a.m. 12:01 a.m.
!DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/sPECIAL PROVISIONS
. The Umbrella Policy contains a Sail Insured RetenUon In \he amount of $10,000.
. The CertlflcalBhofder Is only an AddlUonallnsured with _pect to lIebllly caused by lhe negllgenlllcls or omissions ofll1e Named Insured, but only whh respect 10 HARBORVIEW
CENTER, 300 CLEVELAND ST, CLEARWATER, FL.
· General Liability policy is subJecl10 a $10,000 per occurrence Self-Insured Retention with no annllBr e9gregate.
CERTIFICATE HOLDER
CITY OF CLEARWATER
112 S OSCEOLA AVE
CLEARWATER, FL 34618
CANCELLATION
StlOULO NoIY OF THE ABOVE OE8CRlIlED POLICIES eE
CANCaED BEFORE THE EXPIRATION DATE THEREOF.
THE ISS\JING COMPANY WIU ENDeAVOR TO MAIL 30
DAYS WRITTEN NOllCE TO THE CERllFICATE HOl.DER.
BUT FAILURE TO MAIL SUCH NOllCE SHALL IMPOSE
NO OBUGATlON OR UABILlTY OF ANY KINO UPON THE
COMPNfY. ITS ~NTS OR REPREseNTATlVES.
AUTHORIZED REPRESENTATIVE
~t.~
: ~ ~ORI?:..:::.~!:~~~~-J(~AT:E 'O~:;,.~j~~:~LJ~;}i~~:~:~:NC.E . "," ,',. : DA6~5~~~g~/YY)
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.
COMPANIES AFFORDING COVERAGE
PRoDUCER
Aon Risk services, Inc. of pennsylvania
One Liberty place
1650 Market Street
suite 1000
Philadelphia PA 19103
PHONE. (215) 255-2000 FAX. (215) 255-1893
INlSURED
Global Facilities, LP / Global spectrum,
comcast-spectacDr, LP
3601 south Broad Street
philadelphia PA 19148-5290 USA
COMPANY
A
St paul Fire & Marine Insurance Co.
COMPANY
B
COMPANY
C
COMPANY
D
':;GbVE~GES!:' .;; ":::1)~~~f~;:;i!f:i~!j::j;:j;~;!;:;:~';:; ~.: ,1" ::: :':; 1,',' 'j;' ::~.'! ::....:::. ":;.':~i'~~),:~ :" :::-. ,';,'.: li~:;"..: ;.C :;~\~::i:;~1:~:I!I~:{1:i:~:::i!;!;~!j,~~L;:~:;:;:.:~~:<;~::..:', ""
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOlWlTHSTANDING ANY REQUIREMENT. TERM OR CONDmON Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
I;XCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
~
POLIcY 'EFFECrIVE POLIcY EXPIRA nON
DATE(MMlDDJY\') DATE(MM/DD/YY)
LIMITS
TYPE OF INSURANCE
POLlcY NUMBER
GENERAL LIABILITY
I--
COMMERCIAL GENERAL LIABILIlY
f.::--, D
~. --I CLAIMS MADE OCCUR
_ OWNER'S & CONTRACTOR'S PROT
-
GENERAL AGGREGATE
PRODUCTS - COMPIOP AGG
PERSONAL & ADV INJURY
EACH OCCURRENCE
FIRE DAMAGEIAnv one firel
MED EXP IAnv one personl
AUTOMOBILE LIABILITY
-
ANY AUTO
-
ALL OWNED AUTOS
-
SCHEDULED AUTOS
- HIRED AUTOS
~
'-
-
COMBINED SINGLE LIMIT
BODILY INJURY
( Par pemm)
NON-oWNED AUTOS
BODilY INJURY
(Per eccictenl)
PROPERTY DAMAGE
: ~RAGE LIABILITY
, _ ANY AUTO
-
AUTO ONLY - EAACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
S25,OOO,OOC
$25.000,00
.. ., :
Ai EXCESS LIABILITY
· fx1 UMBRELLA FORM
n OTHER THAN UMBRELlA FORM
Q1 06400426
06/30/06
06/30/07
WORKER'S COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
I TWC STATU- I 10m:. ".. .
El EACH ACCIDENT
EL DISEASE.POLlCY LIMIT
El DISEASE-EA EMPLOYEE
RINCL
EXCL
~r: RtPTION OF OPERATlONSlLOCATlONSNeHICLESlSPECIAL m;MS
C ty of clearwater is included as an Additional Insured regarding Harborview Center, 300 Cleveland Street,
c earwater, FL.
;C!R:nFICATE'JIOt9ER1~!:;li'!'~':::i:'i'"., 'l;';:."::
;...:' ',;:"\',:,::' ::1::;'~::: ::::~:;:.:;;:::~ Tl,:;.:!l;~ ;...
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SHOULD ANY OF THE ABove DESCRIBED POLICIES BE CANCELLED BEFORE THE
city of clearwater
112 S. osceola Avenue
Clearwater FL 34618 USA
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE 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 COMPANY. ITS AGENTS OR REPRESF'NTATIVES.
AUTHORIZED REPRESENTATlIIE
~r""'/ d. "J""u.;n d
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ACORDTM ::~:::' ::;:::Wwtc~j~::iilfi!~BlmBJ.tiig!:j':.!::::~ .......li:~;,~(..:.....::,:..';.:i.;"::'.,:1 DATE (I'H/DD/VV) r
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P~OOCER nos CERTIFICATE IS ISSUED AS A MATI'ER OF INFORMATION ONLY "ND
AOn Risk services, Inc. of pennsylvania CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
One Liberty place DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
1650 Market Street POLICIES BELOW.
Suite 1000
philadelphia PA 19103 USA COMPANIES AFFORDING COVERAGE
COMPANY zuri ch American Ins Co
PHONE. (21s) 255-2000 FAX- (215) 255-1893 A
QlStIIlED COMPANY ..
..
Gl oba 1 Facilities, LP/ B ~
=
Global spectrum, Inc. -
COMPANY s::
3601 S. Broad Stree1: II>
phi 1 adel phi a PA 19148 USA c :2
..
COMPANY ~
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TIllS IS TO CERTIFY THA TllIE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO tHE INSURED NAMED ABOVE FOR TIm POLlCY PERIOD
INDICATED, NOlWIIHSTANDING ANY REQUIREMENT. TERM OR CONDmON OF ANY CONlRACT OR OTHER DOCUMENT wrm RESPECT TO WHICH nus
CERTIFlCAlE MAY BE ISSUED OR MAYPERTAlN.mE INSURANCE AFFORDED BY tHE POLICIES DESCRJDED HEREIN IS SUBJECT TO ALL mE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS.
to TYPE 01' INSURANCE POLICY NUMBER POLICY EFFECTIVE roLlCY EXPlRAno~ COVERED PROPERTY LIMITS
l>1R DATE (MMIDIIIYY) DATE (MMIDDIYY)
=r PROPERTY BUILDINO
-
CAUSES OF LOSS PERSONAL PROPERTY
- - BUSINESS INCOME
BASIC - vd.l!aa~
I-- BROAD ExrRA EXPENSE
i-- f-
SPECIAL BLANKET BUILDING r-.
- - N
BLANKET PERS PROP rl
- EARTHQUAKIl - ;!i
BLANlCET BLDG" PP M
FLOOD - ,...
- .-I
0
- - 0
,...
lI'I
INLAND MARINE
- -
TYPE OF POLICY ..
i-- t
,
i-- ,oC:l
I 2USES OF LOSS E
I-- ;I
NAMED PER.lLS Z
- i-- 011
OTHER ....
1S
A X CRIME FID3739206-02 04/01/06 04/01/07 Employee Sl, 000,00( =
~ -
..
- Deductible 011
TYPE OF POLICY ~ 55,DOC U
crime coverage
U BOILER" MAClONERY -
, [J OTHER
: LOCAnON 01' pREMISES \ DESCRIPTION OF PROPERTY -
~
..-:-;
~
~
SPECIAL CONDlnONS f OTIIER COVERAGES "--="
~
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. , . . -=-=
SHOULD ANY OF THI! ABOVE DESCRIBED POUCIES BE CANCELLED BEFOIlETHE ~
city of clearwater EXPIRATION D" TE THER.l!Ol' THI! ISSUING COMPANY WILL ENDEAVOR TO MAIL !IIO..!!
112 south osceola Avenue 30 DAYS WRITTEN NOTICE TO nm CERTIFICATE HOLDER NAMED TO THE LEFT. ~
cl earwater FL 34..618 USA BUT PAlLtlIlE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY ~
OF ANY KIND uPONTHI! COMPANY, ITS AGENTS OR I\EPRESeJlITATIVES. ~
~
AUTHORIZED IlEPIlESENTATIVE ~
lOOItD::2l iliJI9.5)'j!r.1!f !i;111!m~~til!lM~!!I:H!i;;~:::{;!mt:~~:;:;:~. :l;';.:;::.I~:~ ;~. ;:;'1; ,ili!l~?:;'tr.:ii:ii~~i!i,!r;!!:,:HI'!iII:t~i!i:iii:~:~i!:!;g:'1H:~I;~~!H~l!him~:n~~:li!r:ll:ii.i1ih.!'~~l~i;,::n:I~:: ;~:~11';:~Jei:A:MRD!~mip!OR)iffrtiSli~ 99~:!~~\;!;:~l, -
.
i
POLICY NUMBER: FID 373920601
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY',
CR 104701 89
JOINT LOSS PAYABLE
This endorsement applies only to COVERAGE FORM A X
COVERAGE FORM 0 0
COVERAGE FORM P 0
A. PROVISIONS
You agree that any loss payable under the Coverage Form indicated above shall be paid jointly to you and
the Loss Payee designated below:, as their interest may appear:
See attached schedule
City of Clearwater
(NAME OF lOSS PAYEE)
and any such payment shall constitute payment to you. We agree that we will make all such payments jointly to
,.you and the Loss Payee, and we will not make any payment solely to you unless we receive a request in writing
from the Loss Payee to make such payment to you.
B. Our liability under the Coverage Form indicated above as extended by this endorsement shall not be
cumulative.
,C. No rights or benefits are bestowed on the Loss Payee other than payment of loss as set forth herein.
!D. No termination or cancellation of the Coverage Form, whether at your request or ours, shall take effect prior
to the expiration of 30 clays after written notice of such termination or cancellation has been filed with the
above named Joint Loss Payee.
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