CERTIFICATE OF LIABILITY INSURANCE (11)
'If 5/22/07 13;57
f727 442 7695
Brown &. Brown
AdrLane Blnder-t-Nr. Ayer
2/2
ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID A8T 11I\'1& (l\IIIU\Il:IIIiYY1V)
Q1EJl:N-!l 05122/0"1
PRDIlUllEIl THIS CERTFlCATE IS ISSUED AS A MATTER OF INFORMATION
Brown" Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIfICATE
17'15'1 us Highwal' 19 N, Ste 660 HOLDER. THIS CERTIRCATE DOES NOT AMEND. EXTEND OR
P.O. Box 2456 ALTER THe COVeRAGe AFroMDED BY THE POLICIES BELOW.
C~earwater FL 33'157-2456
Phone; 727-461-6044 Fax; 727-442-7695 INSURERS AFFORDING COVERAGE NAlC#
---....-..-
IN&URED I16UAfRI'( lial;t€""" :1:.... Ct>. <oS! t:b.. 8.8. 38261
Nl.flfR e:
Wi~~a Carson Hea1th -'lc:
Qe$o~ ce~~, XnQ.
1108 N. M[J{ Avenue ~RD:
C1.arw.~~ F.L 33755
_RE:
COVERAGES
THe POLICIES Of INSURANCE LISTED eaow HAVE BEEN ISSUED TO TK;; ~ INEtl AElOW FOR 1tE POUCY PERIOD INDICAlED. NOTVIIllHSTANOlNG
AN( REQUlREMEN'1'. law OR cONDITION OF ANt CONTRACT OR 0Ttei DOCllIloEH1' WITH FlI:!9Pt:CT TO \\HCH THIS CERTFlCATE MAY BE ISSlll"D OR
MAY PERlAIN, THE NURANCE AFFORDED BY 1tE POUClES DESCRIlBJ HEREJIlIS SUBJECT TO ALL THE Tt!RM$, EXCLUSIONS AND CONDITIONS OF SUCH
POLIOeS. AGGReGATE UMIT$ Sl-lO\IIIN ~y ttAVE ~ ReouceD S"f P.tIIO CU\IlIS.
III&R C:~ -- ='~ "="~~ LJlIlII'IS
lTll 'lYPE OF 1_
~e/W.lIA8lLI'IV EACH oCc~AAeNCf $1,000,000
A ~ plAL.llSNEIRAl. UlSUTY ZlS&IRQ7532 05{02/07 05/02/08 PREMSS E. _eel $ 300 000
I-- ClJlMl w.oe ~ OCCUR rcol:!'PV'IIVlllle~J $ 10,000
- PE!!3ONAL & MJV IMJURY S 1.000,000
.
- G&BlAl..oGGREGtIYE $ 2,000 000
~~t,AGGReClA1t UMIY APPL.II!& n PRQOUCTS . CQt.lPlCl',lGG S 2,000,000
n ppo-
POLICY JECT l.CC
~MOlIU UAIlllJl'Y CO_o.91~GLE U~IT $ 1,000,000
A MY PJ/IO 21SJWaQ'7532 05/02/07 05/02{08 (e..a:_~
-
- AU. QwJEO"~YOS IODIL Y IT>llIlRY
S
5C'll!al.Ji..SD .l.lJTOS RE( ~EIVED (I'(!I !lefBOO!
-
~ !tIEl AU10S SODlLV INJURY
S
.!... NON. OWNeD AlITQ$ (Per attlll.nIJ
A.lJG 2 ~ 2007 PROPERTY DNAAGE S
(PSf8_
_ LIABIUTY ECORDS AN AuTO. or.,v. EA~OOEIlIl 8
H'"' OlJTO )FFICIAL EA ACe s
;EGISLATI\ E SRVCS DEF f OTtEl~ T_
AUTO CtlL Y, ...s~ $
EXCE~UABILITY EACt1 OCCuRRENCe $
o OCClJR 0 CLAlWSIAACE AGGRI!GAle $
s
HD~_' J
RElErfTlCI< S S
_ COIIl1PENIlATION AHIl IT;;'V'U~TS I IU~~
EMPIDVERS' WlIlIUlY
Nf( PRllPRlE1CIRIPARTNERlMClITMi h.. EACH ACCIce.T s
efFie_lEI< Iil/CWDED'I EJ.. DISEASE. EAENPI..O\'EE J
. ~9, IlEIltrioe unaer
8f'liClALP~S_ EJ..IllSEAllE. PClUCY lJIIT S
-
~UF_ /L.Ol:A1IlIN&/YBlCLBI/EllCLII8IlllI8ADDED BYEIIl_ /----
c.c~:i.aat;.a. Rol.der is ~ as AdditionaJ. Insured as res~ots to
General. r.iabiliq only.
CERTIFICATE HOLDER CANCELLATION
CITYC-2 ~ NlVI"""" _. ~ PGUCISlllllliCANcliJJiD88U1MlNRIX_..
DAlE 1IlEREOF. THE ,_e ..IURER..... ENDEAYoR 10 MllII..
30 OAts WRITIU
NOTICe 'TO TIle. GII!ID'I'ICATl! HOlD_ NAMl!D 1'0 THI! U!PT. I!IUI' PAIL~ TO DG so IIR1AI.1.
City of C1earwater
POBox 4748
Clearwater FL 33758-47'8
~ 110 OBUCAnON OR UAB&STY Of' AllY _ UPON 1HE IIIIlURBI, ITI AllEN11l OR
ACORD 25 (2001108)
t..
~
ClACORO CORPORAOON 1888