CERTIFICATE OF INSURANCE
CERTIFICATE OF INSURANCE
Name of Insured
Clearwa
DESCRIPTIVE SCHEDULE _
Hi School Band Boosters Asso~. Inc.
Address of Insured
c/o Don Hacker, 540 So. Hercules Ave.
Clearwater, Florida 33516
Location Covered
r
Mailing Address (Slreet And Number, City, Slate, Zip Cade)
City of Clearwater
RFCfJr~D
Phii~~ 'i Phillip~
MAR 9 1978
Hpring 'I'r::lining
Operations Covered Use of parking fad 1 i tip!,! fnr
Games
THIS IS TO CERTIFY TO CERTIFICATE HOLDER:
"I
P. O. Box 4748
C~T':.t~proVided in Company initialed below:
rn A=AETNA INSURANCE COMPANY
o U=AETNA FIRE UNDERWRITERS INSURANCE CO.
D C=CENTURY INDEMNITY COMPANY
Clearwater, Florida 33518
Attn: R. G. Whitehead
City Clerk Effective 3/3/76
that on the above date the following described insurance policies, issued
subject to all the terms, conditions, limitatioIlS- and exclusions, thereoL
\..
~
Co Nome of Coveroge Policy Effective Expiration Limits of
Number Dote Date Liability
Workmen's Compensation Statutory
1:- .Public Liability-Bodily Injury (Not Auto) $ 300 ,000 each occurrence
.. Comprehensive CG 60 21 12 10/31/75 10/31/78
.Public Liability-Property Damage (Not Auto) $ 25 ,ODD each occurrence
t. " " "
A Comprehensive $ ,000 aggregate
(Explosion, Collapse, Underground Hazards S ,000 each occurrence
Not Covered Unless Otherwise Stated Herein) $ ,000 aggregate
Products-Completed Operations- $ ,000 each occurrence
Bodily Injury $ ,000 aggregate
Products-Completed Operation.. $ ,000 each occurrence
Property Domoge $ ,000 aggregate
Specific Contractual-Bodily Injury $ ,000 each occurrence
(Other Than Incidental Contracts As DefIned
In The Policy)
Specific Contractual-Property Damage $ ,000 each occurrence
(Other Than Incidental Contracts As Defined
In The Policy) $ ,000 aggregate
Automobile-Bodily Injury $ ,000 each person
$ .000 each occurrence
Automobile-Property Damage $ ,000 each occurrence
Burglary
. Plate Glass
by this Company, are in full force and effect,
~
IilIncludes coverage for the following incidental written agreements: (1) lease of premises, (2) easement agreement, except
· in connection with construction or demolition operations on or adjacent to a railroad, (3) undertaking to indemnify a
municipality required by municipal ordinance, except in connection with work for the municipality, (4) sidetrack agree-
ment, or (5) elevator maintenance agreement.
Should any of the above described policies be cancelled before the normal expiration date thereof, the Company
will endeavor to give written notice to the above Named Certificate-holder, but failure to give such notice shall im-
pose no obligation or liability of any kind upon the Company.
THIS CERTIFICATE OF INSURANCE NEITHER AFFIRMATIVELY NOR NEGATIVELY AMENDS, EXTENDS OR ALTERS THE COVERAGE AFFORDED BY THE POLICIES INDICATED
ON THIS CERTIFICATE UNDER POLICY NUMBER.
By
(Include One Duplicate
INSURORS, INC.
J L L
Authorized
py fO~POlicy listed hereon)
Agent
Form 600.840 3/73
fI2Il:-
In consideration of the premium for which this policy is written, it is
agreed that the CI1Y OF Clearwater FLORIDA is included as an
additional insured under the coverage provided by this policy for the
liability imposed upon it by law and aris ing out of the operations of
Clearwater High School Band Boosters Assoc., Inc.
. . . . II . . . . . . . . II /10 . Of COli . . . . . . . . . . . . . .. . II . '. . II . . . . . . . . . . . . . . . . . . . .
(name of licensee)
of ., . . . . . II II . II . . . .. .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
c/o Don Hacker, 540 So. Hercules Ave., Clearwater, Fla. 33516
(address of licensee)
The inclusion herein of the CITY OF CLEARWATER, _; FLORIDA as an
additional ins ured shall not operate to increase the limits of the com-
pany's liability. All other conditions of this policy and its endorse-
ments remain unchanged.
f
The CITY OF ST. PETERSBURG, FLORIDA shall be afforded the same
notice as the named insured in the event of the cancellation of this
policy by the company.
It is further agreed that this endorsement applies only with respect to
Division One (Premises - Operations) Coverages A and B FOR USE OF
PARKING FAC ILITIES FOR PHILADEPHIA PHILLIES SPINNG TRA NING GAMES.