CERTIFICATE OF LIABILITY INSURANCE
MRY 11 2000 15:51 FR RCORDIR INC
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ACORD", CERTIFICATE' OF LIABILITY INSURANC
727 791 1871 TO 95624086
P. 01/02
Acordia SE, Central Fla Divsn
P.O. Box 31666
Tampa, FL 33631-3666
727-796-6666
DATI! IMMIDDIYYI
05/11/00
Tl-IIS 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 COVERACE AFFORDED BV THE POLICIES DELOW.
PRQIlUCER
INSUIID)
Carlouel Homeowners Assoc.
P. O. BOX 3442
CLEARVVATER FL 33767
INSUR~R A:
INSURER B:
INSURER C:
INSURER 0:
INSURER f:
INSURERS AFFORDING COVERAGE
AUTO-OWNERS INSURANCE COMPANY
COVERAGES
THE POLICIES OF INSURANCE LISTED BElOw HAVE BEEN ISSUED TO TH~ INSURED NAMED ABOVE FOR Tlit; POLICY PERIOO INOICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERllFlCATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SU8JECT TO All THE TERMS. EXCLUSIONS AND CONomONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
11N'.l' TYI"E OF INSURANl:E POUCV NUMBER POLICY EFFECTIVE ~l:Y EXl'lRAT10N LIMITS
A ~~RAL UABIUTV 2045061400 5/09/00 5/09/01 EACH OCCURRD.lCE . 1nnoooo
..K. COMMERCIAL GENERAL \.IABIUTY ~IRE DAMAGE IAnv one fI,el . 50000
- :=J CUlIMS MADE W OCCUR MEO EXP IAny on8 pe,oen) . 5000
PERSONAL 80 ADV INJURY . 1000000
GENERAl. AGGREGATE . 1000000
r:r AGGREn LIMIT APn PER: "AODUCT! - COMPlOp Allll .
X ~OllCY ~~9;. LOe
~TOMODlUi LlAllLITY COMBINED SINGLE LIMIT .
ANY AlITO lio '4;llldontl
-
- ALL OWNEO AUTOS BODILY INJURV
(plf Il8reonl .
- SCHEDULED AUTOS
- HIRED AUTOS BODILV INJURV
.
NON.OWNED AUTOS (Por occldentl
-
PROplRTY DAMAGE .
1"8' .eeid<lnt)
GARAGE UAllllJT1l AUTO ONl'r - EA ACCIDiNT .
R'ANY AUTO OTHER THAN EA ACC .
AlITO QNL V; AGG .
EXCESS L1A811.llY ~CH OCCURRENCE .
~'OCCUR 0 CLAIMS MADE AGGREGATE .
.
R DEDUCTIBLE .
IlETENfION . .
WORIUiMS COMPENSATION AND 1_~!;:.~r~T.:!:.1 IO[,t'"
EMpLOYEIlti. LlAIIILlTV
e.\.. EACH ACCIDENT .
E.l. DI$~$E . Ell EMPLOYEE .
E.\.. DISEASE. POLICY LIMIT .
OTHElI
DiSCRll'TlON OF OPERAT10NI/lOCAT10N8NEHll:LESlEXC~ ADDED IIY ENDOMEMEHTI8PEcIAI. PIlOVlSIONS
ATTN: SUSAN STEPHENSON. FAX '727-582-4086
PROPERTY LOCATION: 1 CARLOUEL. SUBOIVISION, CLEARWATER, FLORIDA
CERTIFICATE HOLDER I X I AODmONAL INIUIlED: '....UflER tnTml. CANCELLA TIQN
CITY OF CLEARVVATER attoULD MY OP ~ AII011i llEIl:IUlED I'OUCIU all CANCELLfll -OIlE THE I!Kl'lRATION
RISK MANAGEMENT DEPARTMENT DATE 11lE1l!Ol'. THE lUUWo INIIUIlER WILL EIiIIlEAvOII TO MAlL ......1.Q.. DA1'8 WlllTTEN
NOTICE TO THE CBmFICATI! HOUlIIl NAME!) TO THE LEFT. aUT fAILURE TO 00 GO 'HALL
P.O. BOX 4748 lMl'OH NO CIIlIGA TlON 011 UA8n.lTY OF AMY lUNO UPON l~ INSURER, IT$ AClEtfTI OR
CLEARVVATER, FL 33758 IlEPREBENT A T1YES.
!.nzm -5Im':{f )d t1/vP.-vV
I ,A_ A_
ACORD 2&.S 17197} 7.27 -p e ACORD CORPORATION 19B8
MAY 11 2000 15:51 FR ACORDIA INC
727 791 1871 TO 95624086
P.02/02
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policyliesl must be endorsed. A statement
on this certifioate does not confer rights to the certificate holder in lieu of such endorsementlsl.
If SUBROGATION IS WAIVED, subject to tho terms and conditions of the policy. certain policies may
roquire an endorsement. A statement on this certificate does not clmfer rights to tho certificeto
holder in lieu of such endorsementls).
DISCLAIMER
The Certificuto of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurerlsl, authorized representative or producor, and the certificate holder. nor does it
affirmatively or negatively amttnd, extend or alter the coverage afforded by the policies Iistod thereon.
ACORD 25-8 17/971
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