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CERTIFICATE OF LIABILITY INSURANCE (46) , ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID D DATE (MMlDDIYYVY) COHBB-2 03/30/05 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 Wlllace Welch & willingham Inc 3bo First Avenue South, 5th Fl P.O. Box 33020 St. Petersburg FL 33733 Phone:727-522-7777 Fax:727-521-2902 INSURED INSURER A; Zurich Insurance C any NAlC# 16535 INSURERS AFFORDING COVERAGE CUmbey & Fair, Inc. 2463 Enterprise Rd. Clearwater FL 33763 INSURER B: Arc:hi te"ta lUI4 BIllrineera Xu C INSURER C: INSURER 0: INSURER E: 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. LTR NSR~ TYPE OF INSURANCE PQUCY NUMBER ~ DATE IMMkorrii" LIMITS GENERAL UABIUTY EACH OCCURRENCE $1,000,000 ~ A ~ COMMERCIAL GENERAL LIABILITY PAS42162868 03/16/05 03/16/06 ~RE;;~'Es (Ea occurencel $ 300,000 I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $10,000 - PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 ~'L AGGRn LIMIT APPLIES PER: PRODUCTS.COM~OPAGG $2,000,000 PRO- n ' BIIIP BeD. 1,000,000 POLICY JECT LOC ~OMOBILE UABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) - - ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - '--- HIRED AUTOS BODILY INJURY (Per accident) $ - NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABIUTY AUTO ONLY - EA ACCIDENT $ R 'ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSlUMBRELLA UABIUTY EACH OCCURRENCE $2,000,000 A !J OCCUR 0 CLAIMS MADE PAS42162868 03/16/05 03/16/06 AGGREGATE $2,000,000 $ ;l'DEDUCTIBLE $ X RETENTION $10000 $ WORKERS COMPENSATION AND I TORY LIMITS I IU~~- ER EMPLOYERS' UABILITY E.L. EACH ACCIDENT $ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ If yes, describe under E.LD1SEASE - POLICY LIMIT .S- SPeCtAt. i'RGVfSlONS below .- OTHER B Professional Liab 05-0019801 03/16/05 03/16/08 1,000,000 Bach Claim $25,000 Deductible 1,000,000 Aagregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RB: Job No: 712B Project Name: General and Professional Liability. the City of Clearwater is Additional insured with regard to General Liability. COVERAGES City of Clearwater Risk llanagement P.O. Box 4748 Clearwater FL 33758-4748 CANCELLATION CI'l'Y -CL SHOULD ANY OF THE ABOVE DESCRIBED POUClES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOncE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHO o ACORD CORPORATION 1988 CERTIFICATE HOLDER ACORD 25 (2001108) ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYY) 3/31/05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P~DDUCER ACORDIA EAST - TAMPA BAY P.O. Box 31666 Tampa. FL 33631-3666 727-796-6666 INSURERS AFFORDING COVERAGE INSURED Cum bey & Fair. Inc. 24~3 Enterprise Road Clearwater FL 33763 INSURER A: INSURER B: INSURER C: INSURER 0: INSURER E: Florida Retail Federation COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~.$l: TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE P~~.f..v EXPIRATION UMITS ~ERAL UABIUTY EACH OCCURRENCE $ I-- AMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone firel $ CLAIMS MADE 0 OCCUR MED EXP (Anyone personl $ I-- PERSONAL & ADV INJURY $ - GENERAL AGGREGATE $ ~'L AGGREfl LIMIT APn PER: PRODUCTS - COMP/OP AGG $ POLICY ~~gi- LOC ~TOMOBILE UABIUTY COMBINEO SINGLE LIMIT $ ANY AUTO (Ea accidentl .. - I-- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) I-- ,.-- HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) >-- - PROPERTY DAMAGE $ (Per accidentl RRAGE UABIUTY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS UABIUTY EACH OCCURRENCE $ ~ OCCUR 0 CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ $ 3/16/05 3/16/06 I WC STATU-; I IOTH- A WORKERS COMPENSATION AND 52024651 X I TORY LIMITS ER EMPLOYERS' UABIUTY E.L. EACH ACCIDENT $ 100000 E.L. DISEASE - EA EMPLOYEE $ 100000 E.L. DISEASE - POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/EXCWSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION CITY OF CLEARWATER DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN RISK MANAGEMENT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL PO BOX 4748 IMPOSE NO OBUGATION OR UABIUTY OF ANY KIND UPON THE INSURER. ITS AGENTS OR CLEARWATER FL 33758-4748 REPRESEI'(T ATlVES. AUT'fIpI7IArVl -ill_ V. I '\~. V.AF--' . , ACORD 25-S (7/97) 46- 36 @ 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 endorsement(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 holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-8 (7/97)