CERTIFICATE OF LIABILITY INSURANCE
!~~
ACORDN CERTIFICATF OF LIABILITY INSUR~~C~PID LL T DATE(MM/DDfYY)
~CAL-1 12/16/99
PRODUCER -- THIS CERTIFICATE IS IS~ ":ED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
R. H. Nicholson & Co. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
2106-G Gallows Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Vienna VA 22182-3910
Phone: 703-883-1800 Fax: 703-448-3347 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Travelers Insurance CO.
INSURER B:
Alcalde & FaS Ltd. INSURER C
2111 Wilson lvd. #850 INSURER 0:
Arlington VA 22201
I 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.
INSR TYPE OF INSURANCE POLICY NUMBER b~f!fiM~b~~E P8l+~~~~~~~N LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
-
A ~ COMMERCIAL GENERAL LIABILITY I-660-197L4884-TIL-99 07/01/99 07/01/00 FIRE DAMAGE (Anyone fire) $ 50000
- :=J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
PERSONAL & ADV INJURY $ 1000000
e.-
GENERAL AGGREGATE $ 2000000
f---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2000000
II nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
e--- $ 500000
A ~ ANY AUTO I-650-197L4884-TIA 07/01/99 07/01/00 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
~ $
SCHEDULED AUTOS (Per person)
~ ~
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
==l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $ 1000000
A ~ OCCUR D CLAIMS MADE ISM-CUP-197L488-4-IND-99 07/01/99 07/01/00 AGGREGATE $ 1000000
$
~ DEDUCTIBLE $
X RETENTION $ 10000 $
WORKERS COMPENSATION AND X I TORY L1Mris I IOJ~-
ER
A EMPLOYERS' LIABILITY I-UB-197L488-4-99 07/01/99 07/01/00
E.L. EACH ACCIDENT $
EL DISEASE - EA EMPLOYEE $ --
-- -- --. --~ -. ----- - -E:tc-D13EA3E - POLICY LiMt'f- T- --
OTHER
A Property Section I-660-197L4884-TIL-99 07/01/99 07/01/00
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYO-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
City of Clearwater LEFT, BUT FAILURE TO DO :tj-~ IMPOS~~EGATION OR LIABILITY OF
112 South Osceola Ave A"fI' KIN~N THE,jNSUR R, IT AGENTS 0 RESENTATIVE~
Clearwater FL 33756
I ~~~. /I~
ACORD 25-S (7/97) (/ U ACORD CORPORATION 1988