CERTIFICATE OF LIABILITY INSURANCE
ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
09/20/2007
PRODUCER (305) 822 -7800 FAX (305)827-0585 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Collinsworth, Alter, Fowler,Dowling ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOTAMEND, EXTEND OR
& French Group Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P. o. Box 9315
Miami Lakes, FL 33014-9315 INSURERS AFFORDING COVERAGE NAIC#
INSURED Post, Buckley. Schuh. & Jernlgan. Inc. INSURER A: Lloyds of London A XV
d/b/a PBS&i INSURER B:
2001 NW 107 Avenue INSURER c:
Miami. FL 33172-2507 INSURER D:
INSURER E:
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.
I~~: ~o,.'l;l TYPE OF INSURANCE POLICY NUMBER ~..u,.sY EFFECTIVE P~~!fJ EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
- DAMAGE TO RENTED
COMMERCIAL GENERAL LIABILITY $
. I CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $
PERSONA:L & ADV INJURY $
c-
GENERAL AGGREGATE $
-
GEN'L AGC..t:\EGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
I .nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- RECE/v $
ANY AUTO ED (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
I-- (Per person) $
SCHEDULED AUTOS O~T
I- /J I 02 20 07
HIRED AUTOS BODILY INJURY
I-- $
NON-OWNED AUTOS eFr (Per accident)
I-- '~IAl RECORD
LEG SAND PROPERTY DAMAGE $
,)LA riVE SRVC' ill=L11 (Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
~. OCCUR 0 CLAIMS MADE AGGREGATE $
$
~ DEDUCTjBLE $
RETENTION $ $
WORKERS COMPENSATION AND I WC STATU-: I 10J~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
.-
OFFICER/MEMBER EXCLUDED? . E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E. L. DISEASE - POLICY LIMIT $
p~TH~ . / LDUSA0700811 09/30/2007 09/30/2008 $1,000,000 Limits
ro esslonal
A Pollution Liability Ea Claim and Annual Aggregate
CLAIMS-MADE FORM 11/11/1961 Retrodate
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ef: City of Clearwater.
COVERAGES
CE
C
Clearwater, City of
Engineer of Record
100 S. Myrtle Avnue
Engineering - Suite 220
Clearwater, FL 33756
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 CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
.r~-{;Z~;/
Meade Collinsworth/ANNA
ACORD 25 (2001/08)
@ACORDCORPORATION 1988