CERTIFICATE OF INSURANCE
~.~OOUCER
I$SUE DA TE \MM/O~/Y Y I
2/09/88
SHAFER-BROWN INS INC
POBOX 1328
CLEARWATER FL 34617
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~, -FEB 1 6- 928
AS A MATTER OF INFORMATION ONLY
AND CONFERS NO RIGHTS PON THE CERTIFICATE HOLDER. THIS
c.ERTIFICA~E DOES NOT AMEND, EXTEND OR ALTER THE COVER.
AG'E- AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
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COMPANY A CINCINNATI INS CO
LETTER
COMPANY B CINCINNATI INS CO
.' 'CETIER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
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INSURED
PINELLAS YOUTH FOOTBALL .CON IN
POBOX 71
LARGO FL 34294
VERAG~:I~~i~7~]1~~!l~~Jt~ti;~~~~d-~':~~~!1'~ ~::;t~~; t~-~ :f~ i~5~;'(lt::~:' ~'~*-'f :i~~ !~:-: :~~~;.:-:;;:'~l:.~;:~~~~~~~~~~~"~~~~~ _ -4, _ ~ ~-
THIS IS TO CERTIFY THAT POLICIES OF rr,SURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED. NOr,vITHST-"NDING ,o,NY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH
RESPECT TO WHICH THIS CERTIFIC,o,TE 'AAY 3E ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED
HEREIN IS SUBJECT TO ALL THE -;-:;:RMS. EXCLUSIONS. AND CONDITIONS OF SUCH POLICIES.
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ANY AUTO
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE IMM/DD/YYI DATE lMM/DD/YYI
LIABILITY LIMITS IN THOUSANDS
..:TYPE OF INSURANCE
r:.A"':H
C C~'~Q~""C;:
AGGREGATE
~ENERAL LIABILITY IAGL2984527
COMPREHENSIVE FORM ;
I I
IX JPREMISES/OPERATIONS I
r-jUNDERGROUNO I
I EXPLOSION & COLLAPSE MA;:ARD I
~PRODUCTS'CDMPLETED OPERATIO"S
ICONTRACTUAL
INDEPENDENT CONTRACTORS
IBROAD FORM PROPERTY DAMAGE
IPERSONAL INJURY
3/01/88
3/01/89
BODI L Y
INJURY
PROPERTY I
DAMAGE
BI & PO I
COMBINED 150 0
PERSONAL INJURY
AUTOMOBILE LIABILITY
AGL2984527
3/01/88
3/01/89
BODI L Y
INJURY
IPER
PERSONI
BODILY
INJURY
IPER
ACCIDENT!
ALL OWNED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
C-L- :
Esrl
l< . W ( L-S 0 ,./.
5. 5.,.. e.rl"r-l <::,vs c-'
D . fleJ"nt-.5 e""/ 3 psis.
PROPERTY
DAMAGE
BI & PO
COMBINED
UMBRELLA FORM
BI & PO
COMBINED
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY
iEACH ACCIDENTI
!DISEASE.POLICY LIMIT)
OTHER
:JESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
.JR COUGARS FOR
SPORTS COMPLEX
,~ .
=ITY OF CLEARWATER
~TTN: LARRY OOWD
:J 0 BOX 4748
=LEARWATER FL34618
SHOULD
BEFORE:: THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY
WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO
THE CERTIFICATE HOLDER NAME.D TO THE LEFT, BUT FAILURE TO
'.1AIL SUCH NOTICE SHALL IMP()"C- NO OBLiGATION OR LIABILITY OF
'::'NY KIND UPON THE CO~~V'rS AGENTS REPRESENTATIVES.
'>'UTHORIZED REPRESENTAT
STEPHEN 0 BROWN
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