CERTIFICATE OF PROPERTY INSURANCE
From:BOVS & GIRLS CLUB
7275485583
02/28/2008 08:53
11821 P.002/003
I
DUCER 1-727-797-4190
rthur J. Gallagher Riek Management Service., Inc.
,~_. . ,,',. ~""'-""'l.'....,'
DATE (MMlDDlVYlg
03/27/08 !;;
THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
2600 McCo~ick Drive
Suite 300
Clearwater, F~ 33759
COMPANY
A Bssex Iasurance Campany
COMPANY
B
INSURED
Boys aI1d IUds Clubs of
the SUDcoast, lac.
5111 66th Street North
Suite 200
St. Petersburg, FL 33709
COMPANY
C
COMPANY
D
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THIS IS TO CERTIFY THAT THE POUCIES 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.
CO
LlR
TYPE OF INSURANCE
POLICY NUMBER
I'OUCY EFFEC;1M! POLICY EllP~TION
DATE (IIIIIDIl/YY) DATE (MMlDDIVY)
10/16/07 10/16/08
COVERED PROPERTY
LIMITS
A
X PROPERTY
CAUSES OF LOSS
BASIC
BROAD
SPECIAL
EARTHQUAKE
, FLOOD
BSPP0494
BUILDING
PERSONAL PROPERTY $
BUSINESS INCOME $
EXlRA EXPENSE S
BLANKET BUILDING $
BLANKET PERS PROP $
BLANKET8LDG & PP s
X Sill AT'lACBIrD $
S
INLAND MARINE
TYPE OF POLICY
BOILER & MACHINERY
$
$
S
$
$
$
S
$
$
CAUSES OF LOSS
NAMED PERILS
OTHER
CRIME
TYPE OF POLICY
OTHER
$
s
$
LOCATION OF PREMISElIJJ:IESCRIP110N OF PROPERTY
SPECIAL CONDfTlON8/OTHER COVERAGES
~~gf,iiTEiQJJg~R~Wi'r . 'i.'~~'"" ,.~;
,.' .~,.._,~ r'-':""'~"'''"'"'''\m-'tt~'L~~~~il\;l~~'~~~~~i,'ii''~!l.~it.'''"''"r,
~':..,l!ON:~j~~~
aHOULD ANY OF THE ABOVE DEBCRlBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT,
BUT FAll.URE TO MAIL SUCH NOTICE 8HALLIMP08E NO OBLIGATION OR LIABILITY
OF ANY KIND UPOIII THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AlITHORIZEDREPRESENTATlVE ~
l~ii1t., , ',",~' ~lli .",...,,!iml "', "...~1J~!i~i:ll....~i4JJQ"~'I.~"~~
City of Clea~ater
Pa:ks sad Recreatio~ Department
S. II'yrtle.Avenue
Cle.~.te:, FL 33756
ICQli.J.i~1~R"4i'i11~1~:;~,.
8221932
~
From:BOVS & GIRLS CLUB
7275465563
02/28/2008 08:53
r
SUPPLEMENT TO CERTIFICATE OF INSURANCE
. NAME OF INSURED; Boys sDd Girls Clubs of
the .SUDcosBt. Inc.
Additional DescriDtion of OoerationslRemarks from Pace 1 :
LocationB.
11 5111 66th Street Rorth Ste 200
Business Per: $30.000 BDP Media.
2. 1011 22Ddlltreet
Business Per: $564.000
$15.000 BDP EX Bxp: $10,000 Deductible, $5.000
$5.000
BDP Media: $10.000 BDP BX Bxp: $109.000 Deductible. $5,000
3. 111 W Lime Street
Business Per:$45,OOO BDP .edis:$12.000 EDP EX Bxp:$5.000 BLDG:$500.000 Deductible:$5.000
4. 7790 61st Street Rorth - A
BUBiD888 Per: $10,000 BDP, $25,000 BLDG: $862,000.000 Deductible: '5.000
5: 7790 618t Street Rorth - B
1N8iDeS8 Per. $5,000 BliP Medial $2,000 Btolle... $93.500 DeducUble: $5,000
Addilionallnformation:
11921 P.003/003
DATE
Oi/27/0B