CERTIFICATE OF LIABILITY INSURANCE (9)
~-
~:!-
Client#: 3206
AUDESHA3
ACORDTM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DD/YV)
07/25/05
THIS CERTIFICATE IS ISSUED 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.
PRODUCER
Suncoast Insurance Associates
P.O. Box 22668
Tampa, FL 33622-2668
813289-5200
INSURERS AFFORDING COVERAGE
Aude, Shand & Williams, Inc
19353 U.S. Hwy 19 N
Ste 101
Clearwater, FL 33764
COVERAGES
INSURER A: United States Fidelity & Guaranty
INSURER B: Fidelity & Guaranty Ins CO
INSURER C: St Paul Fire & Marine
INSURED
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~f~ TYPE OF INSURANCE POLICY NUMBER P~~!f:,~'J~gJ.X~ P~';.';X 1~!:J~reN LIMITS
A GENERAL LIABILITY BK01430766 107/22/05 07/22/06 EACH OCCURRENCE $1 000000
-
.x. COMM ERCIAL GENERAL L1AB ILlTY FIRE DAMAGE (Anyone fire) $300 000
- ~ CLAIMS MADE [i] OCCUR MED EXP (Anyone person) $10000
- PERSONAL & ADV INJURY $1,000,000
- GENERAL AGGREGATE $2,000,000
~'L AGGREril L1M IT APPlS PER: PRODUCTS -COMP/OP AGG $2,000,000
POLICY X p'~g: LOC "
B AUTOMOBILE LIABILITY " BA01444272 08/07/05 08/07/06
- COMBINED SINGLE LIMIT $1,000,000
~ ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
X HIRED AUTOS BODILY INJURY
- $
~ NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Par accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
A EXCESS LIABILITY BK01430766 07/22/05 07/22/06 EACH OCCURRENCE $1 000.000
=:!J OCCUR D CLAIMS MADE AGGREGATE $1 000.000
$
l DEDUCTIBLE $
R"TEN-l'ION ,$ -. ~ ~ ,'" ,~-- -', --', ' ," - --'~ __"H __ , ' ' - -- 'C ,- " $ - - - ',"
C WORKERS COMPENSATION AND WVA7723704 09/01/05 09/01/06 X IT"Xs.:mm!.'~ I 10J~-
EMPLOYERS' LIABILITY $500,000
E.L. EACH ACCIDENT
E.L. DISEASE, EA EMPL OYEE $500,000
E.L. DISEASE - POLICY LIMIT $500,000
C OTHER QP03807021 07/20/05 07/20/06 $2,000,000 per claim
Professional $2,000,000 aggregate
Liability
DESCRIPTION OF OPERATIONSlLOCA TlONSlVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Professional Liability is claims made and reported.
City of Clearwater is an additional insured w/respect to General Liability
and Auto Liability. Waiver of Subrogation is included except for Workers
Compensation.
CERTIFICATE HOLDER I I ADDmONALINSURED'INSURERLETTER: CANCELLATION
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30.....- DAYS WRITTEN
AUn: City Clerk NOTICE TOTH E CERTIFICATE HOLDER NAMED TOTHELEFT, BUT FAILURE TODOSOSHALL
P.O. Box 4748 1M POSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
Clearwater, FL 33758-4748 REPRESENTATIVES.
....UTHORIZED REPRESENTATIVE
I ~ h\. ~(b..L a.-
ACORD 25-5 (7/97)1 of 2
#M108505
KEB
IS) ACORD CORPORATION 1988