CERTIFICATE OF LIABILITY INSURANCE (47)
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Client#: 5243
ADVAENG3
ACORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YYYY)
02/21/07
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
Suncoast Insurance Associates
P.O. Box 22668
Tampa, FL 33622-2668
813289-5200
Advanced Engineering & Design, Inc.
6161 Dr. MLK Jr. St. N.
Suite 101
St. Petersburg, FL 33703
COVERAGES
INSURERS AFFORDING COVERAGE
INSURER A: United States Fidelity & Guaranty
INSURER B: St. Paul Fire & Marine Insurance CO
INSURER C: XL Specialty Insurance Company
INSURER 0:
INSURER E:
NAIC#
25887
24767
37885
INSURED
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::iR N~~[ TYPE OF INSURANCE POLICY NUMBER P~l-~S1:~~~'wlE Pgi'fJ (~J;~~reN LIMITS
LTR
A ~NERAL LIABILITY BK01313775 02/15/07 02/15/08 EACH OCCURRENCE $1 000 000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $1 000000
I CLAIMS MADE [Xl OCCUR MED EXP (Anyone person) $10000
f-- PERSONAL & ADV INJURY $1 000 000
f-'- GENERAL AGGREGATE $2 000 000
n'L AGGREAE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $2,000.000
PRO-
POLICY JECT LOC
A ~TOMOBILE LIABILITY BK01313775 02/15/07 02/15/08 COMBINED SINGLE LIMIT
ANY AUTO (Ea accident) $1,000,000
f--
f-- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
f--
~ HIRED AUTOS BODILY INJURY
$
~ NON-OWNED AUTOS (Per accident)
- ~r-:~IVED
UI PROPERTY DAMAGE $
(Per accident)
RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO FE B 2 G 2007 OTHER THAN EA ACC $
AUTO ONLY: AGG $
OESS/UMBRELLA LIABILITY OFFICIA RECORDS At 0 EACH OCCURRENCE $
OCCUR D CLAIMS MADE LEGISLA rIVE SRVCS DE 'T AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
B WORKERS COMPENSATION AND BW02194388 09/01/06 09/01/07 X I WCSTATU-.I IOJ~-
EMPL-GYERS' LIABILITY-- . . $100000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $100000
If yes, describe under $500 000
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT
C OTHER Professional DPF9603642 02115/07 02/15/08 $1,000,000 per claim
Liability $1,000,000 annl aggr.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Professional Liability Is written on a claims made and reported basis.
RECEIVED
City of Clearwater
J
P.O. Box 4748
Clearwater, FL
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---30.... DAYS WRITTEN
CITY OF CLEARWAtE~ NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
PUBLIC WORKS CONst~lJetl-POSENOOBLIGATION DR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
33758-4748 REPRESENTATIVES.
A~ED REPR~TIVE
. 'i1. 01,.., .4J.
CANCELLATION
CERTIFICATE HOLDER
~
ACORD 25 (2001/08) 1 of 2
#M139171
KHK
@ ACORD CORPORATION 1988
.....,,,.-; I If!
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 25-5 (2001/08)