CERTIFICATE OF LIABILITY INSURANCE (12)
Client#: 84252
1GLOBSPE
AGOROT.
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIDDNYYY)
04/02/07
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
HRH of Philadelphia
600 W. Germantown Pike
Suite 300
Plymouth Meeting, PA 19462-9998
Global Spectrum LP
3601 S. Broad Street
Philadelphia, PA 19148
INSURERS AFFORDING COVERAGE
INSURER A: Great Divide Insurance Company
INSURER B: Berkley Regional Insurance Company
INSURER C: Hartford Fire Ins Co
NAIC #
25224
29580
19682
INSURED
INSURER 0:
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.
LTR NSRr TYPE OF INSURANCE POLICY NUMBER PDo;~~~~~~~~~,E Pg~il,~~~~N LIMITS
~NERAL LIABILITY EACH OCCURRENCE S
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEr~~_'_' S
I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $
-
- GENERAL AGGREGATE $
n'L AGGREGATE LIMIT APAS PER: PRODUCTS. COMP/OP AGG $
. n- PRO.
POLICY JECT LOC
C ~TOMOBILE LIABILITY 39UENLE9029 10/18/06 10/18/07 COMBINED SINGLE LIMIT
..!.- ANY AUTO (Ea accKlenl) $1,000,000
- All OWNE 0 AUTOS BODll Y INJURY
$
SCHEDULED AUTOS (Per person)
-
.!.- HIREO AUTOS BODIL Y INJURY
$
.!.- NON.OWNED AUTOS (Per accidenl)
_. PROPERTY DAMAGE $
(Per accidenl)
RAGE LIABILITY AUTO ONl Y - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONl Y: AGG $
OESSIUMBRELLA LIABILITY EACH OCCURRENCE S
OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION AND WCA102145010 03/30/07 03/30/08 X I WC STATU":! I OJ,';!'
B EMPLOYERS' LIABILITY WCA102230610 03/30/07 03/30/08 51,000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE U. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.l DISEASE. EA EMPLOYEE $1,000,000
If yes, describe under E.l. DISEASE. POLICY LIMIT 51.000.000
SPECIAL PROVISIONS below
OTHER
C. -" ~, .,
DESCRIPTION OF OPERATIONS' LOCATIONS' VEHICLES' EXCLUSIONS ADDED BY ENDORSEMENT' SPECIAL PROVISIONS 'L.'vL.' Vt:i]
Re: Harborview Center; 300 Cleveland Street; Clearwater, FL 33755
APR 1 1 2007
City of Clearwater, Florida is included as Additional Insured where
required by contract, solely with respect to the operations of the Named RISK MANAGEMENT
Insured.
CERTIFICATE HOLDER
CANCELLATION
CITY OF CLEARWATER
112 S. OSCEOLA AVENUE
CLEARWATER, FL 34618-0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL.--3.lL- 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,ITSAGENTS OR
~ - ~t<.
~~ L~
ACORD 25 (2001/08) 1 of 2
(2..( "; t
#M365180
1JVAN
@ 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 25-5 (2001/08)
2 of2
#M365180