CERTIFICATE OF LIABILITY INSURANCE
Client#. 2242
BRIGHOUS
,ACORD", CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIVYYY)
12/20/2007
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
BWD Group LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
BWD Plaza, P.O. Box 9050 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
113 South Service Road
Jericho, NY 11753 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: American Home Assurance Company
Bright House Networks, LLC. INSURER B: St. Paul Fire & Marine Insurance Co.
700 Carillon Pkwy., Suite 6 INSURER c:
St. Petersburg, FL 33716 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~:~ ~~~~ TYPE OF INSURANCE POLICY NUMBER P~+~~ri:~~I~\E
A ~ERAL LIABILITY 1595685 01/01/08
X COMMERCIAL GENERAL LIABILITY
=:=J CLAIMS MADE [i] OCCUR
COVERAGES
p~~fJ I~~ICC~~N
01/01/09
EACH OCCURRENCE
DAMAGE TO RENTED
MED EXP (Anyone person)
A
~
f--
~'L AGGRE~E LIMIT AP~S PER:
I POLICY I I j~8T I I LOG
~TOMOBILE LIABILITY
1L ANY AUTO
RERSO/IIAL & ADV INJURY
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
Per Loc Aaa
01/01/08 01/01/09
RECF:i IFy
1607250
COMBINED SINGLE LIMIT
(Ea accident)
-
ALL OWNED AUTOS
BODILY INJURY
(Per person)
_ SCHEDULED AUTOS
X HIRED AUTOS
-'--
1L NON-OWNED AUTOS
-
,..- '",
:... __v,.
"1~7
J'J.
BODILY INJURY
(Per accident)
c ., :~~CC )r'.C' ~ ~ ':1
l ':" rq " ,,\,,011< \...,...; LY\:j~ l
PROPERTY DAMAGE
(Per accident)
~AGE LIABILITY
I ANY AUTO
AUTO ONLY - EA ACCIDENT $
EA ACC $
OTHER THAN
AUTO ONLY:
B
01/01/09
EACH OCCURRENCE
AGGREGATE
01/01/08
EXCESs/UMBRELLA LIABILITY Q K06501595
llJ OCCUR D CLAIMS MADE
"I DEDUCTIBLE
"Xl RETENTION $ 10.000
LIMITS
$2000000
$1 000 000
$EXCLUDED
$2 000 000
$20,000.000
$2 000 000
4 000 000
$2,000,000
$
$
$
AGG $
$5.000.000
$5.000.000
$
$
$
A WORKERS COMPENSATION AND
"'_ ,EMPLOY_E.RS' LIABI,LI-rv.><
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
5144928,29,30,31
--. ..,~. - -'-
X I T~gJ;r~J,~;, I IOJ~'
". 'E.L. EI\6H-AGGIBEN....- . ....$1.000.000.,.
E.L. DISEASE - EA EMPLOYEE $1,000,000
EL DISEASE - POLICY LIMIT $1,000.000
01/01/08
01/01/09
-. .....
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Re: 2530 Drew Street, Clearwater, FL 34625
Certificate holder is included as additional insured.
CERTIFICATE HOLDER
CANCELLATION
City of Clearwater
112 South Oscala Ave.
Clearwater, FL 34616
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ---3.0...- DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
~~
JONEE @) ACORD CORPORATION 1988
ACORD 25 (2001/08) 1 of 2
#M57732
\
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
-- >--
ACORD 25-5 (2001/08) 2 of 2
#M57732