CERTIFICATE OF LIABILITY INSURANCE (5)
~ 06/~0/2004 12:12 FAX 727 725 3663
CARLISLE FIELDS & CO.
14l 002
~kcr:iRD..
CERTIFICATE OF LIABILITY INSURANCE
OP ID R DATE (MM/DDIYYYYI
COMMa-! 06 30 04
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. TliIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
PRODUCER
Carlisle Fields & Company, Ine
P.O. BOX 7910
Clearwater FL 33758-7910
Phone:727-797-0441 Fax:727-725-3663
INSURED
community pride Child Care
Center o~ Clearwater, Ine.
1235 Holt Ave.
C1sarwater ~L 33756
INSURERS AFFORDING COVERAGE
I~U~A: Cincinnati Insurance
INSURER B:
INSURER C;
INSURER D:
INSUt<ER E;
NAIC#
01:<109
COVERAGES
THE: F'OUCLliS OF INSURANce ~I$TED BELOW HAVE aeEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTINITflSTANDING
ANY ReOUIREMENT, rERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPE;CT TO WHICH THIS Cl;RTIFICATE MAY BE ISSUED OR
MAY PERTAIN, THE INSURANCE AFFORDED BY THE po~ICIES DeSCRIBE:O HEREIN IS SUBJECT TO ALL THe TERMS, EXCLUSIONS AND CONDITIONS OF SU~
POLICIES. AGGREGATF. LIMITS SHOWN MAY HAVE BEEN ReOUCCD BY PAID CLAIMS.
LTft N$RC TYrE OF INSURANCE poLICY NUMeI!R rjA'YE iMMI~~~E DA-fE 'MMlOD~~N LIMITS
~ERAl.I.IABILITY EACH OCCURRENCE; $ 300,000
A -.!.. COMMERCIA~ GENERAL LIAl:llL11Y CPP0658641 06/30/04 06/30/05 PREMISES Y~~~el $J.OO,OOO
=:J CLAIMS MADE [!] OCCUR MED ExF' (Any one person) $ 5,000
-
PERSONIIl & J>ot)V INJURY $300,000
-
GENeRAL AGGREGArE $
-
GEN'\. AGGREGATE LIMIT APPLIES PE:t<: PROOUCTS.COM~OPAGG 5600,000
~ POLICY n r~8T n LOC
~OMOBII.E L,IABllITY COMBINED SINGLE LIMli 5300,000
A ANY AUTO CPP0658641 06/30/04 06/30/05 (Ea accld9l11)
-
- ALL OWNED AuTOS BOalL Y INJURY
(Par per.on) S
SCHEDULEO AUTOS
-
..!... HIRED AUTOS BODILY INJURY
$
..!..- NON.OWNED Au1'OS (Pel accldenll
PROPeRTY DAMAGE S
(Per accident)
lRAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AuTO ONLY; AGG $
EXCESS/UMBRELLA LIABILITY eACH OCCURRENCE S .
:J OCCUR 0 CLAIMS MADE AGGREGATE; $
$
=1 DEDUCTIBLE S
RETENTION $ $
WORKERS COMPENSATION AND ITORYLIMITS I IV~lt
EMPLOYER.S' LIABILITY E,\., 5ACH ACCIDENT $
ANY PROPRIE;TORlPAt<TNERleXECUTIVE
OFFICeRlMEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE $
.t yes, dll.~rlbe under E.L. DISEASE - t"OLICY LIMIT $
SPECIAL PROVISIONS below
OTHER
OESCR.IPTION OF opERATIONS I LOCATION$I VEHICLES I EXCLUSIONS ADDED BY ENDORSI!MENT I SPECIAL PRO\IISIONS
.
City of Clearwater
Real Bstat@ Serviees Manager
Earl Barrett
P.O. Box 4748
Clearwater FL 33758-4748
CANCELLATION
C:I'1'YC -1 sHOlJt.O ANV OF THE ABovE peSCltlBED POLICIE$ liE CANCELLEO SE::FORE THE EXPIRATION
DATE THEREOF, THE ISSUlNG INSURER WILL ENDeAVOR TO MAIL ~ PAYS WRrrUN
NoTICE TO THE CERTIFICATE:: HOLDER NAMEg TO THE LEFT. BUT fAlLU~ TO DO so SHALL
IIIIPOSE:: NO OBUGATION OR UABIUfY OF ANY KIND UPON THe INSURER, ITS AGENTS OR
RI::Pfi:ESENT A 'I'1VES.
AUTHORIUO REF'
PORATION 1988
CERTIFICATE HOLDER
ACORD 25 (2001/08)