CERTIFICATE OF LIABILITY INSURANCE (65)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY)
10/11/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Suncoast Insurance Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA Tj:
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 22668 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33622-2668
81~0 . INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Phoenix Insurance Company 25623
GriiTIail Crawford, Inc. INSURER B: Travelers Casualty and Surety Co 19038
1511 N Westshore Blvd INSURER C: Hudson Insurance Company 25054
Suite 1.115 INSURER D:
Tampa, FL 33607 INSURER E:
Client#. 6108
GRIMCRA3
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 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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER P.PAIfe~:~8~IE Pg~f.r,~~~N LIMITS
A ~NERAL LIABILITY 6805280L540PHX07 10/14/07 10/14/08 EACH OCCURRENCE $2.000.000
X. OMMERCIAl GENERAl LIABILITY DAMAGE IO RENTED $2.000.000
- CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $5.000
PERSONAl & ADV INJURY $2.000.000
-
GENERAL AGGREGATE $4 000.000
-
~'L AGGREAE ~:~ APnS PER: PRODUCTS - COMP/OP AGG $4.000.000
POLICY JECT LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
AI'lY AUTO RECEI lED (Ea accident)
~
ALL OWNED AUTOS
- BODILY INJURY $
SCHEDULED AUTOS (Per person) '.
~ CC::' 1 ~S 007
HIRED AUTOS
~ BODILY INJURY $
NON-OWNED AUTOS (Per accident)
,. - .~ FIe/At RtC:O:
f ~ l):3 AND
- ~, PROPERTY DAMAGE
LE ';/SI M.'JI= 0'.' .( 1-,r:nT (Per accident) $
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
:=JESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
==J DEqUCTIBLE $
$
RETENTION $ - $
B WORKERS COMPENSATION AND UB6100Y759 OS/22/07 OS/22/08 X I T"/,~VS~,~r.~;, I IOJ~-
EMPLOYERS' LIABILITY $1 000 000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $1,000000
If yes, describe under $1,000 000
SPECiAl PROVISIONS below E.L. DISEASE - POLICY LIMIT
C OTHER Professional AEE7137102 OS/29/07 OS/29/08 $1,000,000 per claim
Liability $2,000,000 ann I aggr.
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Professional liability is written on a claims made and reported basis.
RE: Engineer of Record - Mike Crawford
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL --3.0- DAYS WRITTEN
Engineer Dept; Attn: Susan Chase NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Suite 220 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
PO Box 4748 REPRESENTATIVES.
Clearwater, FL 33758-4748 A~ZED REPRE~TlVE
. ~ QJ... .4), ~
ACORD 25 (2001/08) 1 of 2
#M153283
BPK
@l ACORD CORPORATION 1988