CERTIFICATE OF LIABILITY INSURANCE (8)
Client#: 13438
CLEARCOMMU
A CORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
11/03/06
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
Gowrie, Barden & Brett, Inc.
70 Essex Road
Westbrook, CT 06498
860 399-5945
Clearwater Community Sailing Assoc.,lnc
1001 Gulf Blvd.
Clearwater, FL 33767
INSURERS AFFORDING COVERAGE
INSUReR A Federal Insurance Company
INSURER B:
NAIC#
20281
INSURED
INSURER c:
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 TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN"" ~~~~ TYPE OF INSURANCE POLICY NUMBER PJ1..}f~~J~~g~~11E p~~fJ 1~~~t'~~N LIMITS
LTR
A GENERAL LIABILITY 35823516 11/06/06 11/06/07 EACH OCCURRENCE $1.000.000
- 8~~6~1~9E~~~;r~?encel
X- COMMERCIAL GENERAL LIABILITY $1.000.000
- ~ CLAIMS MADE ~ OCCUR MED EXF' (Anyone person) $10 000
- PERSONAL & ADV INJURY $1 000 000
GENERAL AGGREGATE $2 000.000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $included
I .nPRO. n
POLICY JECT LOC
~TOMOBILE LIABILITY COMBIN=D SINGLE LIMIT $
ANY AUTO (Ea accident)
-
- ALL OWNED AUTOS BODILY NJURY
(Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY NJURY
- $
NON.OWNED AUTOS (Per accident)
-
- PROPEFTY DAMAGE $
(Per accdent)
GARAGE LIABILITY AUTO OI,L y. EA ACCIDENT $
=1 ANY AUTO OTHER -'HAN EA ACC $
AUTO ONLY: AGG S
~Ess/UMBRELLA LIABILITY EACH OCCURRENCE S
OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I we STATU., I 10TH.
TOllY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EAC H ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISFASE. EA EMPLOYEE $
If yes, describe under E.L. DISIOASE. POLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Clearwater is named as Additional Insured on General
Liability Policy only.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
25 Causeway Boulevard
Clearwater, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---11L. 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
,
ACORD 25 (2001/08) 1 of 2
#S20189/M20188
MED
GJ ACORD CORPORATION 1988
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 endorsernent(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 holdel', nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD 25-5 (2001/08) 2 of 2
#S20189/M20188