CERTIFICATE OF LIABILITY INSURANCE
~., -
ACORDm CERTIFICATE OF LIABILITY INSURANCE CSR sc I DATE (MM/DDIYYYV)
YOUNG-8 10/03/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. ,Box 7910 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-7910
Phone: 727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Progressive Commercial 10193
INSURER B: Markel Insurance Company
Young Women's Christian Assn INSURER c: Zenith Insurance Company
Of Tampa BaA
655 Second venue South INSURER 0:
St. Petersburg FL 33701
INSURER E:
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.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER POLICn, EFFEC.I~~ P6'k~CEY(~~bRt~~N LIMITS
DATE MM/DDIYY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
-
B X COMMERCIAL GENERAL LIABILITY 3602SS2583991 10/01/05 10/01/06 PREMISES (Ea oc~~~nce) $ 100000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 3000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000
I 'nPRO- n Emp Ben. 1000000/3
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $ 1,000,000
A X ANY AUTO 047436123 10/22/05 10/22/06 (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
f-- $
NON-OWNED AUTOS (Per accident)
f--
f-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
B tJ OCCUR D CLAIMS MADE 4602SS2581610 10/01/05 10/01/06 AGGREGATE $ 1,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND X I TORY LIMITS I IUJ~-
C EMPl.OYERS' LIABILITY Z049904501 06/24/05 OS/24/06 $ 500000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ,",CCIDENT
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 500000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is listed as an additional insured.
*30 Days Cancellation applies to Worker's Compensation Policies, 10 Days
Cancellation for all other policies - Applies to Florida Employees Only.
CERTIFICATE HOLDER
CANCELLATION
CITYC-1
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
ESE NT A TIVES.
RIZED REPR
City of Clearwater
City Attorneys Office
P.O. Box 4738
Clearwater FL 33758-4738
PORATlON 1988
ACORD 25 (2001/08)
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