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CERTIFICATE OF LIABILITY INSURANCE (39) CORDTM ATE (MM/DD/YYYY) 06/27/2007 PRODUCER Aon Risk services, Inc. of. pennsylvania One Liberty place 1650 Market Street Suite 1000 philadelphia PA 19103 USA PHONE. 866 283-7122 INSURED cigna corporation Et.Al 1601 chestnut Street TWo Liberty place philadelphia PA 19192 USA 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. FAX- 847 953-5390 INSURERS AFFORDING COVERAGE NAIC # INSURER A: Lexington Insurance company 19437 .. .. INSURER B: Lloyd's of London 0005FI I: ;:: = ACE American Insurance company 22667 .. INSURER C: ~ .... Indemnity Insurance Co of North America 43575 .. INSURER D: .. ~ INS.URER E: Great American Insurance Co. 16691 -= =: TIlE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIlE INSURED NAMED ABOVE FOR TIlE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIF1CATE MAYBE ISSUED OR MAY . PERTAIN, TIlE INSURANCE AFFORDED BY TIlE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TIlE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD' LTR INS TYPE OF INSURANCE c ~ERAL LIABILITY X COMMERCIAL G.ENERAL LlAB. . ILITY . CLAIMS MADE ~ OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: D POLICY D PRO- /'Xl LOC JECT ~ c AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS E GARAGE LIABILITY B ANY AUTO EXCESS /UMBRELLA LIABILITY ~ OCCUR D CLAIMS MADE ~:~;;:~-L.$io.~ooo---_... D c WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR / PARTNER / EXECUTIVE OfFICERlMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below o A OTHER prof Liability POLICY NUMllER POLICY EFFECTIVE POLICY EXPIRATION DATE(MM\DDlYY) DATE(MM\DDlYY) 07/01/07 07/01/08 EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurence) MED EXP (Anyone oerson LIMITS HDOG23726609 $1,000,000 , $1,000,000 PERSONAL & ADV INJURY o N M 'M N v N'\ N o o "- LI'l GENERAL AGGREGATE $1,000,000 $3,000,000 $1,000,000 PRODUCTS - COMP/OP AGG ISAH08230596 07/01/07 07/01/08 COMBINED SINGLE LIMIT (Ea accident) $1,000,000 Q Z .. ... CC ... I: t. .. U BODILY INJURY ( Per perwn) BODILY INJURY (Pc:' accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY AGG Tuu357925605 07/01/07 07 01 08 EACH OCCURRENCE AGGREGATE $25,000,000 WLRC44 AOS WLRC44464974 CA SCFc44464962 -RETRO $1,000,000 = $1,000,000 == $1,000,000 _ $5,000,000 ~ ~ ~ ~ ~ ~ E.....I ~ id ~ ~ ::"'!-;. ~ .:a... I'i-: ~ ..... ~ - 07/01/07 07/01/08 E.L. EACH ACCIDENT E.L. DISEASE-EA EMPLOYEE E.L DISEASE-POLICY LIMIT 07/01/07 07/01/08 3905767 Errors and Omissions Limit 03/30/07 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLESiEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS City of Clearwater PO Box 4748 Attn: city Clerk clearwater FL 33758 USA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE .4.-~9'...-~, <#~ '...or Attachment to ACORD Certificate for cigna corporation Et Al The terms, conditions and provisions noted below are hereby attached to the captioned certificate as additional description of the coverage afforded by the insurer(s). This attachment does not contain all terms, conditions, coverages or exclusions contained in the policy. INSURER INSURED cigna corporation Et Al 1601 chestnut Street TwO liberty place philadelphia PA 19192 USA INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits. ADD'L POLICY NUMBER POLICY POLICY INSR EFFECTIVE EXPIRATION INSRD TYPE OF INSURANCE POLICY DESCRIPTION LIMITS LTR DATE DATE OTHER FZ0701651 03/30/07 03/30/08 limit B Mise Liab cvg Fidelity Bond $10,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSNEIDCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS -'---'-~ -~._----,~_._-~,,------"---. --- - -'---"-~----~-"-'-- Certificate No : 570023421120