CERTIFICATE OF LIABILITY INSURANCE (66)
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 CERTIFICATE
P.O. Box 22668 . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, .EL. 33622-2668
81~-5200 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Phoenix Insurance Company 25623
Grimail Crawford, Inc. INSURER B: Travelers Casualty and Surety Co 19038
1511 N Westshore Blvd INSURER c: Hudson Insurance Company 25054
Suite 1115 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.
II~l: ~~! TYPE OF INSURANCE POLICY NUMBER ~..t~~:~~~8~ Pgl'fl,~~~~N LIMITS
A GENERAL LIABILITY 6805280L540PHX07 10/14/07 10/14/08 EACH OCCURRENCE $2 000 000
- DAMAGE TO RENTED
x.. COMMERCIAL GENERAL LIABILITY $2 000 000
- =:J CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $5 000
PERSONAL & ADV INJURY $2 000 000
-
GENERAL AGGREGATE $4 000 000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $4 000 000
I POLICY n ~~gT n LOG
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I-- $
ANY AUTO ~CE,vr.:r (Ea accident)
I-- R.
ALL OWNED AUTOS
I-- '" I."." BODILY INJURY $
SCHEDULED AUTOS (Per person)
r- ;~ , --.
HIRED AUTOS ~2 1"':"","'.1
r- c.' L~"i BODILY INJURY $
NON-OWNED AUTOS (Per accident)
" r-
()f:FiC:/: . h.~:(~~(~/1<i_. ': ,. PROPERTY DAMAGE $
" , ' (Per accident)
~ i.~ -
~RAGE LIABILITY LL \::;1 hJ LI"' ! I V I: "'1-: 'I ;'" ,) l . AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA UABIUTY EACH OCCURRENCE $
:=J OCCUR 0 CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ --- $
B WORKERS COMPENSATION AND UB6100Y759 OS/22/07 OS/22/08 X I T~~J,[~!.~;, I IOJ~-
EMPLOYERS' LIABILITY $1.000,000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE $1,000.000
~~E~I~tS~~~~~1~~s be~ EL DISEASE - POLICY LIMIT $1,000.000
C OTHER Professional AEE7137102 05129/07 OS/29/08 $1,000,000 per claim
Liability $2,000,000 ann I aggr.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I 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.lL. 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 ~ED REPR~TIVE
. ~ Ola.A -
ACORD 25 (2001/08) 1 of 2
#M153283
BPK
@ ACORD CORPORATION 1988
_:_.'~.'-_"'___..o._:,..,'.;,-,:.,';:':_;,,-'~":'r.,'--'