CERTIFICATE OF INSURANCE (5)
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CITY OF CLEARWATER
Interdepartment Correspondence Sheet
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TO: Cyndie Goudeau, City Clerk
FROM: Ream Wilson, Director Parks and Recreation
DATE: March 6, 1986
SUBJECT: Clearwater High School Band Boosters
COPIES: E. Haeseker
Attached is a copy of the Certificate of Insurance which is
required for the Clearwater High School Band Boosters to park
automobiles at Jack Russell Stadium during the Philadelphia
Phillies spring training season. This Proof of Insurance
has been reviewed by Bob Ellis and is found to be in compli-
ance with the recently executed agreement between the City
and the Boosters.
Please contact me if you have any questions.
Attachment
RW/ev
RECEIVED
MAR 7 1986
CITY CLERK
THIS CERTIFICATE IS ISSUED AS A MATTER OF INfORIoAATlON ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AfFORDED BY THE POLICIES 8ELOW.
West Coast Insurors
P.O. Box 10340
St. Petersburg, Florida 33733
COMPANIES AFFORDING COVERAGE
COMPANY A
LETIER Insurance company of North America
COMPANY B
LETIER
INSURED
Clearwater High Ban Boosters
c/o Sharon Bagley
2225 Jaffa Place
Clearwater, Florida 33546
COMPANY C
LETIER
COMPANY D
LETIER
COMPANY E
LETIEA
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THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEAIODINDICATED.
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 POLIca;S Dt:SCRIaEP titRElN IS SUjjJECT TO ALL THE TERMS. EXCLUSIONS, AI~D CONDI.
TIONS OF SUCH POUCIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EffECTIVf
DATE IMMlIlIl/YY)
POLICY EXPIRATION
DATE (MMlOOIYYl
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
GO 63 eo 73 6
8/8/85
8/8/86
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV, PASS,)
ALL OWNED AUTOS (OTHER THAN)
PRIV, PASS,
HIRED AUTOS
NON.OWNEO AUTOS
GARAGE lIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS
RE: Booster Parking, Clearwater Phillie's games
ADDITIONAL INSURED:
City of Clearwater
Robert Ellis, Risk Man?0ement
P.O. Box 4748
ClearwatQr, Florid~
LIABILITY LIMITS IN THOUSANDS
EACH AGGREGATE
OCCURRENCE
aoolL Y 300
INJURY $ $
PROPERT'( 100
DAMAGE $ $
61 & PO $ $
COM6INED
PERSONAL INJURY $
800IL y
IUJUIlY $
(1'[11 PERSON!
OOOiL t
INJUllt $
II'[R AWULtlli
PROPERT'(
DAMAGE $
BI & PO
COMBINED $
61 & PD $ $
COMBINED
STATUTORY
$ (EACH ACCIDENT)
$ (DISEASE.POLlCY lIMIl
$ (DISEASE .EACH EMPLO