CERTIFICATE OF LIABILITY INSURANCE
A CORD_
CERTIFICATE OF LIABILITY INSURANCE
CSR AI DATE (MM/DDIYYYY)
BELLO-l 05 25 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
SIHLE INSURANCE GROUP, INC.
P. O. BOX 160398
ALTAMONTE SPRINGS FL 32716
Phone:407-869-0962 Fax:407-774-0936
INSURERS AFFORDING COVERAGE
NAIC#
BELLOMO-HERBERT & COMPANY, INC.
100 E PINE STREET STE 204
ORLANDO FL 32801
INSURER f><
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
11991
INSURED
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 MAYBE 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 NSRJ: TYPE OF INSURANCE POLICY NUMBER ~wrMII1OMY-t DATE MMlDD1YYl LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
f--
A ~ COMMERCIAL GENERAL LIABILITY 21SBABK8880 10/23/06 10/23/07 PREMISES lEa occurence) $ 500,000
---- -"-~ =tCD'JIVIs-MADE - ffi-occUR" -- ---.-----"--------- -- -._-.. -----._-- - - ~- -- ---- .---- - .' -~(Anyun~fJt:fl:sull) - -,. ~. --10-,-i}Oa---
PERSONAL & ADV INJURY $1,000,000
f--
GENERAL AGGREGATE $ 2,000,000
f--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000
n n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
-
A ANY AUTO 21SBABK8880 10/23/06 10/23/07 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
X HIRED AUTOS BODILY INJURY
- $
~ NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==i ANY AUTO' OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000
A ~ OCCUR D CLAIMS MADE 21SBABK8880 10/23/06 10/23/07 AGGREGATE $ 2,000,000
$
==i DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 1~1 :IU.!.!:I-
TORY LIMITS X ER
A EMPLOYERS' LIABILITY 21WECGF6280 10/23/06 10/23/07 $ 1,000,000
~16~~~1~W~E~U.~~~. E.L. EACH ACCIDENT
--- -- ------ ---- ---~-- l::t:-DtSCA"" - "" "t--1,OO (1 ,06-0-
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000
SPECIAL PROVISIONS below
OTHER
B Professional AROOO02248 05/13/07 05/13/08_ - - --- Jl=n $1,000,000
Liability I, 'I-r v r '.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
t,~~Y 31 2007
OFFICIAL RECORDS AND
lEGISLATIVE SRVCS DEPT
CITY OF CLEARWATER
112 SOUTH OSCEOLA AVE
CLEARWATER FL 33756
CANCELLA nON
CLEARWl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIACATE 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 HORIZED REPRESE
@ ACORD CORPORATION 1988
CERTIFICATE HOLDER
ACORD 25 (2001/08)