CERTIFICATE OF LIABILITY INSURANCE
ACORD.. CERTIFICAT 10.- OF LIABILITY INSURAN\. OP ID C9 DATE (MMlDD/YYYY)
- AB:IL:I-1 01/09/04
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Hockman Lackey :Insurance, :Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3438 Colwell Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Tampa FL 33614
Phone: 813-636-4000 Fax:813-281-1086 INSURERS AFFORDING COVERAGE NAlC#
INSURED INSURER A: National :Insurance Co/NO
INSURER B: Nationwide Mutual/BM
Abilities :Inc of Florida INSURER C: General :Ins Co of America/Ne
2735 Whitne; Road INSURER 0:
Clearwater L 33760
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.
LTR NSRI TYPE OF INSURANCE POLICY NUMBER ~ DATE lMMID~ LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
I---
A X COMMERCIAL GENERAL LIABILITY 25CCOO171401 11/07/03 11/07/04 PREMISES (Ea occurencel $200,000
I CLAIMS MADE [!J OCCUR MED EXP (Anyone person) $ EXCLUDED
PERSONAL & AOV INJURY $ 1,000,000
-
GENERAL AGGREGATE $3,000.000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $3,000,000
Xl . n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1, 000,000
B ANY AUTO 7332583001 09/30/03 09/30/04 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
f--- $
~ SCHEDULED AUTOS (Per person)
-.!.. HIRED AUTOS BODILY INJURY
$
~ 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 $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $2,000,000
C ~ OCCUR D CLAIMS MADE 01XS13744810 12/01/03 11/07/04 AGGREGATE $2,000,000
$
==1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORYLIMITS I IVE~-
EMPLOYERS' LIABILITY
,!I.NY PRCPR!ETCP,,'P ART~EPv'E)<EC :.:r:\/E ' E.L. E/,CH A,CCIDENT ' S
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYE~ $
g~~~~Jls~cfNs below E.L. DISEASE. POLICY LIMIT $
OTHER
C Professional Liab LP7739054 11/07/03 11/07/04 Per Claim $1,000,000
Aggregate $3,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
.-.. , .-. -~.
CERTIFICATE HOLDER
City of Clearwater
Economic Development &
Housing
112 S. Osceola Ave
Clearwater FL 33756
CANCELLATION
C:ITYCLR SHOULD ANY OF THE ABOVE DESCRIBED POUCIES 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
M'OSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTA11VES.
AUTHORIZED ~
'CORD 25 (2001/08)
Ron Hockman
.,.,.
@ACORD CORPORATION 1988