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CERTIFICATE OF LIABILITY INSURANCE (3) ACORDm CERTIFICATE OF LIABILITY INSURANC~~~!~ T DA~E~~~~ro~ THIS CERTIFICATE IS ISSUED AS A MATTER 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. PRODUCER Wallace Welch & willingham Inc 300 First Avenue South, 5th Fl P.O. Box 33020 St. Petersburg FL 33733 Phone: 727-522-7777 Fax:727-521-2902 INSURERS AFFORDING COVERAGE INSURED. Directions for Mental Health 1437 South Belcher Rd Clearwater FL 33764 INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: Mental Hlth Risk Retention Grp zenith Insurance Company COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Ir'f~ TYPE OF INSURANCE POLICY NUMBER !:gflf~.':r.f~mYl: PP.L.!IiV:.':N.'lRAWN LIMITS DATE MMlDD DATE '(f\lM/DDIYY GENERAL LIABILITY EACH OCCURRENCE $1,000,000 - A X COMMERCIAL GENERAL LIABILITY CCLOO1206 01/15/03 01/15/04 FIRE DAMAGE (Anyone fire) $ 300,000 X I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ 5,000 ~ Non-Owned Auto PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $3,000,000 I n PRO- nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ ANY AUTO (Ea accident) - ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) - HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Per accident) - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ::::J OCCUR D CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I f~R,?'LlMY;:sl IUE~- B EMPLOYERS' LIABILITY WC26013 05/01/02 05/01/03 $ 100,000 E.L. EACH ACCIDENT ~ --" -- _. . ~ - -. - ----- .- --- .. ~ ELoISEP.sE - EA EMPLOYEE $100;00o---~- E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONSlLOCATlONSNEHICLESlEXCLUSlONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS . CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CLWTRPO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO~ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ..1L DAYS WRITTEN Clearwater Police Dept. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Attn: Janet Skinner IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 645 pierce Street Clearwater FL 33756 REPRESENTATIVES. I AUTH~~~./ ACORD 25-S 7/97 / c @ ACORD CORPORATION 1988