CERTIFICATE OF LIABILITY INSURANCE
e:6'
~ORl)_ CERTIFICAtE OF L1ABILI~ ~~~~...~ SUED AS A~=GOF INFOA::~";';;
- - ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Rogers" Associates :Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
POBox 1747 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Palm Barbor FL 34682 COMPANIES AFFORDING COVERAGE
1------------ --- ---- -----.--
COMPANY
_.___._ roo_A. ___.b..erican St. a_.te__s Insurance. __C_ 0 ___.__
!'f:!one~~13=286_=--.~~2__ F~No8J.,1-":1.86-=-1-684__ _ + _ _
i COMPANY
B
~K-
LA s, t- ,(,{
INSURED
,- .------- --- --------- -- - -
Clearwater High Band Boosters
POBox 4279
Clearwater FL 34618-4279
i COMPANY
. C
~._-
I COM PAN
o
u
-_. --. --- -- .-- -'...---.--
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAve BEEN REDUCED BY PAID CLAIMS.
-------. --r- .---- .----.------;- r---------;----------.---.------
I POLICY EFfECTIVE . POLICY EXPIRATION !
TYPE OF INSURANCE , POLICY NUMBER DATE IMMIDDIYYI DATE IMM/DDIYYI lIMITS
CO I
LTR,
I OEIIBIAL LIABILITY
A rxl COMMERCIAL GENERAL LIABILITY I
P i CLAIMS MADE i _x-I OCCUR!
1---4 OWNER'S & CONTRACTOR'S PROT 1
I I
ri -------q
I AUTOMOIIIlE LIA8lI.ITY
~
: j ANY AUTO
r--l
i-~ ALL OWNED AUTOS
LJ SCHEDUlED AUTOS
: i HIllED AUTOS
i -I NON-OWNED AUTOS
I'
1----1--------1
I
01CD4549l730
06/20/97
06/20/98
I G~E~~A~~GATE __ ~.!..10~00~0 ___
I_PRODl:'CTS~~!~A~; $ 1000000
IPE~,!NAL_&~DV IN~~~~__~t 500000--,-
I EACH OCCURRENCE It 500000
j !~~E-~AM~GE (AIIV one l~el t 50000 _-=
MED EXP IAny ..... pellDnl I. 5000
! COMBINED SINGLE LIMIT : $
~---_. .-.-----------~.----h
r BODILY II\UUAY : $
j (Per .-->, i
---------_.__._---~------
[' BODILY INJURY ,
IPer ",:e:,elenll
----,-_.. ---+---.----
I
I PROPERTY DAMAGE I .
I
, GARAGE LIA8IUTY
~i ANI' AUTO
r u---,
I
~- -----
~~UTO ~~IDENT ! .
I ?THER THAN AUTO ONLY: I
, EACH ACCIDENT j $
i .------ ------,- --_____
, AGGREGA TE $
I~~<:~_OCCLJRRE~~ ___ i $
I AGGRfGA TE i $
1--,- ---.- ~----"---r------
, $
i EXCESS LIABILITY
1---/ UMBRellA FORM
,
I OTHER THAN UMBRELLA FOAM
I WORI:ERS COMPENSATION ANO
EMPlOYERS" LIABILITY
I THE PROPRIETORI
I PAIITNERS/EXECUTIVE
I OFFICERS ARE:
i OTHER
i
i INCL
i EXCL
I I WC STATU- .OTH-I
1_ : TORY lIMIT~~E1i+-_______
i El EACH ACCIDENT ! $
, ------.--- -----1-_____--
i E~ OISEASE - POLICY LIMIT -t!--_________
i EL DISEASE EA EMPLOYEE I $
DESCRIPTION OF OPERATlONSILOCATIONSNEHICLESISPEC'AL ITEMS
City of C1.arwater is an Additional :Insured under the ter.ms & conditions of
the Liability Policy with respects to the parking activity for the Philidel-
hia Phill sames.
CERTIFICATE HOLDER CANCELLA TION
CTYCLE2
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WIlL ENDEAVOR TO MAlL
J:.L. OAYS WRrTTEN NOTICI; TO THE CERTIFICATE HOLDEfl NAMED TO THE LEFT.
BUT FAILURE TO MAIl SUCH NOTICE SHALL IMPOSE NO O8lIGATION OR LIABIlITY
City of Clearwater
Parks " Recreational Dept.
P.O. Box 4748
Clearwater FL 34618
~ ~PORATION 1988
ACORD 25-S (1195)
~~