CERTIFICATE OF LIABILITY INSURANCE (3)
" ':JILL/UI IJ:tll
(IV 441 7695
Brown & Brown
Adrlane Blnjel ~M' _ Ayer
212
CERTIFICATE OF LIABILITY INSURANCE I'''ID~S DAn (MMlDDIYVVY)
GRHEN-5 . 05 22/07
PROllIJCER THIS CERTIFICATE IS ISSlJE5j~~ . MAnER OF INFORMATION
.Brown " lIx:own Insurance ONLY AND CONFERS Ne ~IGH"S JPO~ THE CERTIFICATE
17757 us Highway 19 ~, Ste 660 HOLDER.THISCERTIFlCI~TECCIEjNOrAMe~D.EXTENDOR
p _ 0 . Box 2456 . AL fER THE COVERAGE .~~~ 0 B" THE~LICIES BELOW.
Clearwater FL 33757-2456
Phon~; 727-461-6044 Fax:121-'42-169~
ACDIlD..
1"~iURED
Willa Carson Health
Resource Cent.e:r, J;nc.
1106 N. ML1C Avenu.e
Clearwater FL 3~755
INSURERS AFFORDING COVERAeiE
MURal '"
IrtlluRCR e:
IH8URER C:
Hartr..:.oI b~~..!~ ..!:.!:~
HSlJReR O.
I'IIIURER'"
COVIiRAGES
----
THE POLICIES OF INSURANCE LISTED BELOW HAII'C BEEN ISSUE;D TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD NlICA TEJ: NOn I/ITl-lSiI
IlNY REQUIREMENT, TERM OR CONomoN OF INY CONTRACT ~ oTHER DOCUMENT WITH RESPl:cT 10 IIIIHCH THIS CERl FlCATE W I !II: I: :SUED C
MAY PER'l'A1N. THE INSIJRANCE AFFOADED BY THE POLICIES DEScRIBED ~ IS ~CT TO ALL THE TERMS, EXCLUSlOIIIS ANI) Ct NtJin'lNS OF
POLICIES. AGGREGATE WITS SHOII\IN MIIY HAVE 8EEN REDUCED BY PAID CLANS.
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TYpe: al"'lliISURANOi
fOUC:V NU~leM
41.
Ci6NERAL UASIUTY
ll: OQl,t,tERCIAI. ~E.E~i\l.L.J.'.aIUTY
CI.AIMB ....C. ' ~ oec~
U$BMkQ7532
A
CJel>/L AClaREQA TE LIMIT AflPJjJEB PER:
PRo..
J~CT
AlITDMOBl1.E UABIUr/
ANYI>JJTO
ALL OW.EO Autos
21SBMRQ7532
Sic:HI!!cul-.;O AUTOS
X MI'IED AUTOS
% NON-DWNEO Auras
GARAGE UABILITY
ANY AUTO
Exees9lUMIlllIlt.LA UABILITY
OOC~R D Mt.tS MACE
~01JQTIIIL ~
fltr~TJON
WOJlJ(IlRs C:OMl'EN&A11ON AND
EM~l.OY~RS' LIABIUTY
ANY PROPRISTOQIPAATNERIElECUTWC
OFFICE~Me...eEQ EXCLUCED?
"yel, Oettl'lD. ",tier
SpeOIAL P~OvISION9 tl<llIW
OlHER
=r::o~
PO~Y EKPlRAT' 011
DIllE (MNIDMY
OS/02/07
05/02/08
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PF!E~~ ~oI8f'C~l .
",EO EI(p lib OIlU."onl
05/02/07
05/02/08
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oe&CRJPTION OF OP_l1QN& I LDCATIOH! 1\/eHIOLII~' BXCLU&IC/llIS ADDED BY ~ I SPEcw. PROVI~5
Cnr~fioate Ha1d~r is named ~~'Additiona1 In5ured as re$pects to
General Liabi1ity ohly.
CERTIFICATE HOLDER
CITYC-2
Ci.ty of Cle~ater
P 0 5o11 4748
Clearwater FL 33758-4748
ACORD 25 (2001/08)
CANCELLATION
---,---
&HOUUI ANY OF _A15DV.lI&~ED P<llJClES B, OAf, :a.ua: S~QRIl'HE EXPIRAnON
30' DAY6WR/lTEIIl
O"'IIl"l'_OF, THE 1&alINS INSURER 'oI1I.1_VJlll' 'MAJL.
NAIC #
39261
Ell
HClNc;
ft
lUCH
......TS
11. 000. 000
~ 300 000
110,000
$ 1,000,000
12,000 000
~ 2.000.000
$1,000,000
I
$
$
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.,.cc $
'GG $
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$
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-, TO THE CERTlFICAllE HOUlSlI'lloMJ'D"I'O ntl' IS' , BlrT F \ll.URE ~ Go &0 AW.L
'''DE NO OBUllA11ON oa LWIUTY ~ OJ"" IWIII IIf DI' ritE IN! <IB_, ITS ....."" OR
RSPRESENT.Q1VB.
REPREBENTA1IVE
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: -~ ; '!lACQRO CORPORATION 1988