CERTIFICATE OF LIABILITY INSURANCE (2)
ACORD,.
CERTIFICAT'- OF LIABILITY INSUR
C~PID LL
~CAL-1 07/13/00
THIS CERTIFICATE IS IS UED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
DATE (MM/DDfYY)
PRODUCER
R. H. Nicholson & Co.
2106-G Gallows Road
Vienna VA 22182-3910
Phone:703-883-1800 Fax: 703-448-3347
INSURERS AFFORDING COVERAGE
INSURED
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Travelers Insurance Co.
Alcalde & Fay Ltd.
2111 Wilson Blvd. #850
Arlington VA 22201
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!frM~b~~E P8l+~~~~~~~N LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
e---
A ~ COMMERCIAL GENERAL LIABILITY I-660-197L4884-TIL-00 07/01/00 07/01/01 FIRE DAMAGE (Anyone fire) $ 50,000
~ :=J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
I nPRO- n
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $500,000
A ~ ANY AUTO I-650-197L884-TIA 07/01/00 07/01/01 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
.. HIRED AUTOS
- tJUDIL Y INJURY $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $ 1,000,000
A ~ OCCUR D CLAIMS MADE ISM-CUP-197L488-4-IND-OO 07/01/00 07/01/01 AGGREGATE $1,000,000
$
~ DEDUCTIBLE $
X RETENTION $ 10000 $
WORKERS COMPENSATION AND X I TORY LIMITS I IOlH-
ER
A EMPLOYERS' LIABILITY I-UB-197L488-4-00 07/01/00 07/01/01 EL EACH ACCIDENT $ 100,000
----- .-- "--,------" ---------- .- ------.---,.. --.- ----.'- - --._--- '-- -._---- ----"- r;:,L DISEi^SE; E^ ''''PL0YEE $--1-~rO-O-O-
E.L. DISEASE - POLICY LIMIT $ 500,000
OTHER
A Property Section I-660-197L4884-TIL-99 07/01/00 07/01/01 BPP $451,943
r:-:~~' " Special $250 Oed.
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SP~'RfV1SIO~S " " '. ..;
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CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: C....,f'l:, ~.1oI'f" .1 '.'1/:1.
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 T~ZO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF
112 South Osceola Ave A,WY KI~PON THE I UR~, ITS"'GE~R REPRESENTATIVES,
Clearwater FL 33756
12r~)J Q{~//
I SR/~
ACORD 25-S (7/97) {/ ./ .. ACORD CORPORATION 1988