CERTIFICATE OF LIABILITY INSURANCE (51)
A CORaM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
12/27/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Wells Fargo Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P.O. Box 31666 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa, FL 33631-3666
727-796-6666 INSURERS AFFORDING COVERAGE
INSURED INSURER A: WESTFIELD INSURANCE COMPANY
Tampa Bay Systems Sales, Inc.
dba Tampa Bay Trane INSURER B: CONTINENTAL CASUALTY CO.
POBox 18547 INSURER c: FFVA MUTUAL INSURANCE CO.
~ampa FL 33679 INSURER 0:
INSURER E:
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.
I~~ TYPE OF INSURANCE POLICY NUMBER ~~~~rJ~5~T~~~ Pgk!fEY(~rXJ~~T.:$~
.A. GENERAL lIABIl.ITY O.~~,~1 940402 I 12/31/07
C-----
X COMMERCIAL GENERAL LIABILITY
= =:J CLAIMS MADE W OCCUR
~ BLANKET AI
~ BKTWAIVER
GEN'L AGGREGATE LIMIT APPLIES PER:
n POLICY !Xl j~g;- !Xl LOC
LIMITS
P/::l1/08
EACH OCCURRENCE
1800000
FIRE DAMAGE (Anyone fire)
150000
MED EXP (Anyone person)
10000
PERSONAL & ADV INJURY
1000000
GENERAL AGGREGATE
2000000
PRODUCTS - COMP/OP AGG
2000000
A AUTOMOBILE LIABILITY CMM1946402
I--
c1<- ANY AUTO
ALL OWNED AUTOS
I--
I-- SCHEDULED AUTOS
~ HIRED AUTOS
~ NON-OWNED AUTOS
I--
GARAGE LIABILITY
R ANY AUTO
B EXCESS LIABILITY 2090856223
Q OCCUR D CLAIMS MADE
12/31/07
12/31/08
COMBINED SINGLE LIMIT $
(Ea accident)
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
(Per accident)
AUTO ONLY - EA ACCIDENT $
1000000
OTHER THAN
AUTO ONLY:
EA ACC $
AGG $
12/31/07
12/31/08
EACH OCCURRENCE
AGGREGATE
7000000
7000000
$
c~i~;.~..~.,;; ';';;s'-L --;;'C8400019477--- - -"0' 10a~~----'/0' ';'9-xr~~I::'w~~
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
.....
500000
500000
500000
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
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FL STATE MANDATES 10 DAYS CANC NOTICE FOR NONPAYMENT OF PREMIUM
CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
',.)";
,',,/<-, n:-n"l'
.~, -'"C ~.~
I
ACORD 25-S (7/97)
47- 79
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 DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRE4ENTATIVES. ^
AUT~~1~JL
\ @ ACORD CORPORATION 1988
CITY OF CLEARWATER
112 S. OSCEOLA AVENUE
CLEARWATER, FL 33756
IMPORT ANT
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 25-8 (7/97)