CERTIFICATE OF LIABILITY INSURANCE (6)
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CERTIFICATE OF LIABILITY INSURANCE
OP ID 1
ALLTE-8 09 29
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.
06
PRODLCER
Rt3bsamen Insurance Inc (LR)
1500 Riverfront Drive
Little Rock AR 72202
Phone: 501-661-4800 Fax:501-666-9592
INSURERS AFFORDING COVERAGE
ALLTEL Wireless Holdings LLC
P. O. Box 2177
Little Rock AR 72203-2177
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
Ace American Insurance Company
NAIC#
22667
INSURED
Liberty Insurance Corp*
Lexington Insurance Company
*Marsh USA Broker of Record
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.
LT"~ NSRC TYPE OF INSURANCE POLICY NUMBER PDOA~~iJ~fJ6W;;E PgktCEY(~~6RD~~~~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,850,000
- UAMAl,
A X X COMMERCIAL GENERAL LIABILITY XSLG21714550 10/01/06 10/01/07 PREMISES (Ea occurence) $ 150,000
I CLAIMS MADE [1U OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,850,000
-
GENERAL AGGREGATE $9,850,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $1,850,000
Xl n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $2,000,000
A X ANY AUTO ISAH08221297 10/01/06 10/01/07 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHEH THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH .oCCURRENCE $10,000,000
A. !J OCCUR D CLAIMS MADE XOOG23713652 10/01/06 10/01/07 AGGRI=GATE $10,000,000
$
=1 DEDUCTIBLE $
RETENTION S $
f--- X I TORY LIMITS I IU~~-
WORKERS COMPENSATION AND
B EMPLOYERS' LIABILITY 64D-005098-066* 10/01/06 10/01/07 $1,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
.. .. ... OFFTcER/MEMBElH,XC[UDEDT--' ..-- - '.. -6'41-= OCfS09 8- 076*- .- 10/01/06' 'lCY/01/0, E:.l. DiSEASE - EAi::r;;,-pLOYEE $T,O O-O-~'UUO ...........
Ii' yes, describe under $ 1,000,0.00
SPECIAL PROVISIONS below E.L. 01 SEASE - POLICY LIMIT
OTHER
C Prop-Direct Risk 7086600 12/31/05 12/31/06 Limit 5,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: McMullen Booth (FL0182) City'S "Del Oro Park Water Tank"
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
Attn: Earl Barrett
Real Estate Services Mgr.
P.O. Box 4748
Clearwater FL 33758-4748
CIOFC11 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
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~IZ D ~ATIVE
ACORD 25 (2001/08)
@ACORD CORPORATION 1988