181- Metropolitan Systems
ACORDTII CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY)
3/20/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Wells Fargo Ins Services Southeast, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Po Box 31666 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Tampa FL 33631-3666 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(727) 796-6666
INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Zenith Insurance Company 13269
Metropolitan Systems Inc eta1 INSURER B: Westfield Insurance Co 24112
3014 Horatio Street INSURER C:
Tampa FL 33609 INSURER D:
I INSURER E:
COIl ~ Ie:;: i
Cert ID 39581
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COVERAGES
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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 r:P..~~ TVPF POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
IT"
GENERAL LIABILITY EACH OCCURRENCE $ 1 000 000
c-'- ~~~~~~J9E~~~~nce'
B X COMMERCIAL GENERAL LIABILITY CMM1686631 7/1/2008 7/1/2009 $ 150,000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 10,000
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2,000,000
-
~'L AGGREAE LIMIT APnS PER: PRODUCTS - COMP/OP AGG $ 2,000,000
POLICY ~~R;: LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
B ....!... ANY AUTO CMM1686631 7/1/2008 7/1/2009 (Ea accident) 1,000,000
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
....!... SCHEDULED AUTOS
....!... HIRED AUTOS BODILY INJURY
$
....!... NON-OWNED AUTOS (Per accident)
- PROPERTY DAMAGE $
(Per accident)
~RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $ 4,000,000
B ~ OCCUR D CLAIMS MADE CMM1686631 7/1/2008 7/1/2009 AGGREGATE $ 4,000,000
$
R DEDUCTIBLE $
RETENTION $ $
A WORKERS COMPENSATION AND Z831250616 3/3/2008 3/3/2009 X I T~~~T~Jg'i::.l IOJ~-
EMPLOYERS' LIABILITY 1,000,000
ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 1,000,000
~~~cl~tS~W'6~~~gNS below E.L. DISEASE - POLICY LIMIT $ 1,000,000
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
FL statute mandates 10 days notice of cancellation for nonpayment of premium. CERTICICATE HOLDER IS
ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA nON
CITY OF SANFORD DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 2L DAYS WRITTEN
ATTN: CITY CLERK NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
P.O. BOX 1778 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
SANFORD FL 32711 AUTHORIZED REPRESENTATIVE ~;L
I
ACORD 25 (2001/08)
@ACORD CORPORATION 1988
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3/20/2009
IMPORTANT
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 (2001/08)
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