CERTIFICATE OF LIABILITY INSURANCE (47)
A CORDT,~,~i'~~Jlrnf(lit€~ TEQF:i~l~j;i~JT~~I~~JJRANeE:;~I~~ DATECMM/DD/YY)
10/05/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER nF INFORMATION ONLY
Aon Risk services, Inc. of Tennessee
501 corporate Centre Drive AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
Suite 300 CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE
Frankl i n TN 37067 USA COVERAGE AFFORDED BY THE POLICIES BELOW.
PHONE. (866) 283-7124 FAX- (866) 430-1035 INSURERS AFFORDING COVERAGE
INSURED INSURER A: XL Specialty Insurance Co
ARCADIS U.S. , Inc. INSURER B: Greenwich Insurance company
formerly ARCADIS G&M, Inc.
630 pl aza Dr. Ste 200 lNSURER c:
Highlands Ranch CO 80129-2379 USA
INSURER D:
INSURER E:
ed~~~ESii!f:'hlllyeemficateisnot:inletldl!aJ:lililloeciW:all:endorserl1l!i1fi~lll'l'iiera<9l!ii::lerms conditions and~clusions:'of theJi>hli6iesJshown; "rtj:;JY5I~ ~ay:App:1 y
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.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM\DDlYY) DA TE(MM\DDlYY) LIMITS
B GENERAL LIABILITY GEcOOl076105 01/01/07 01/01/08 EACH OCCURRENCE $1,000,000
- Genera 1 L i abil ity
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE( Anyone fIre) $1,000,000
- CLAIMS MADE 0 OCCUR
MED EXP (Anyone person) $10,000
-
X contractual PERSONAL & ADV INJURY $1,000,000
-
- GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG
~ POLICY [8] PRO- [] $2,000,000
JECT LOC
B AUTOMOBILE LIABILITY AEC001075805 01/01/07 01/01/08 COMBINED SINGLE LIMlT
- Auto (A OS ) (Ea acciLient) $1,000,000
X ANY AUTO
B - AECOOl719S03 01/01/07 01/01/08
ALL OWNED AUTOS Mass Auto BODILY INJURY
- ( Per person)
SCHEDULED AUTOS
-
X HIRED AUTOS BODILY INJURY
X NON OWNED AUTOS (Per accident)
-
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
1 ANY AUTO OTHER THAN EA ACC
AUTO ONLY:
AGG
B EXCESS LIABILITY UEC00107590S 01/01/07 01/01708 EACH OCCURRENCE $1,000,000
~ OCCUR D Umbrella
CL/liMS ~LWE AGGREGATE $1,000,000
cc c' _ ---~
~ DEDUCTIBLE
X RETENTION $10,000
A WORKERS COMPENSATION AND RWD943516301 01/01/07 01/01/08 X I~c STATU-I I?TH-
EMPLOYERS' LIABILITY workers compensation TORY LIMITS ER
A RWR943516701 01/01/07 01/01/08 E.L. EACH ACClDENT $1,000,000
State of Wisconsin E.L. DISEASE-POLICY LIMIT $1,000,000
E.L. DISEASE-EA EMPLOYEE $1,000,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHlCLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Evidence of Insurance.
Cancellation provision shown herein is subject to shorter or longer time peri ods depending on the jurisdiction of,
and reason for, the cancellation.
CERTIFICATE HOLDER . .. .'. .....i ." .iCANCEtLA TION .i i, .iii'" --;-C:;~~ .. . , .i',
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
Attn: Kathy Bedini Ccity cl e rk) DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
P.O. Box 4748 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
clearwater FL 33758-4748 USA BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KlND UPON THE COMPANY, ITS AGENTS OR REPRESE'lT A TIVES.
AUTHORIZED REPRESENTATIVE ....<<- ~S~. -9~",_ <>6 '7_",__
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