CERTIFICATE OF LIABILITY INSURANCE (3)
7/ 1113/05 12:43
f727 442 7695
Brown I Brown
C:C', ~ i.-I~
SSMITH'" Julie
2/2
I'RODUCI!It
Brown , Brown Insurance
17'7'7 US Highway 19 ., Ste 660
P.O. Box 2456
Clearwater FL 33157-2456
Phon.: 72'7-461-604" I'ax: 727-""2-76Sl5
INllURED
ONLY AND CONFERS NO RIGHTS UPON THE CERnFlCATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR
ALTER THE COVERAGE AfFORDED BY THE POLICIES BELOW.
DATI IMM/IIbIYYYYI
ACORD.
CERTIFICATE OF LIABILITY INSURANCE
05
WSURERS AFFORDfNQ COVERAGE
Clearw.ter GoU Associates Ine
Jer~ lIc)ustol1
18'7!r~t Drive
Clearwater F.L 33765
NllA:IlI '"
INSUlEIt 8:
IlSlIlBl c.
MIRRa:
NJURER Ie
aAFBCO ID~naraaee
IPVA ...,..a1 1......_ COIIIpaaJ'
ADtr.ican Bcon
HAle #I
247..0
19690
COVERAGES
THe POLICIES OF INSURANCE USTID BELOW toMW BEEN ISSUED TO THE INSURED NM.tED A80VE FOR TH: POLICY PERIOD INDICATED. NOTWITHSTANDING
AHV R1EQl.JlRlWENT. TERM OR CONDITION OF AHV CONTRACT OR OTHER DOClMENT lllITH RESPECT TO WHICH THS CERTIFICATe MAl( Be ISSUED OR
MAY PeRTAIN, 'niE lN8UWICIi AFFORDED IV THE PClLIClI'S DE8("MIO HIiRIj!IN IS ---=T TO ALL THE TEAMS. EXCW8IONI N<<J CXlNDIT1ON8 OF SUCH
~lCles. AGGREGATE l.1MITS SHOWN MAY HIM! BEEN ReDUCeD IV PAID CLAIMS.
~.=- ~ . . .,--,---- ". -- .--...... .._.._~~. ,..-.-- lIClWYii"lIlriiiif ~- ..' ,........-----------....--- -......-........-
LTR IRD 1'1'''._ ~Y- lJMITI
~UMILITY EACH OCCuRReNce s 1000000
A ][ ~ COMMERCIfoL G!NERAL I.NII.ITY 02CE0795781 06/1"1/0" 06/17/05 '~~~~I s 200000
- ::J' Cl.QISw.ne [!] OCCUl hIED ElG' (Any CIIlI psntlll) s 10000
~ Li.quor Li.8bili ty PE!IlliOIW. & I'DlIi'lJURY $ ~OOOOOO
OENERA\, AlJGIIIl:GI.IE S 2000000
Gel'L o\OCReGATE UMll APPI..ES PER- PRODUCTS. COW'IOP AGG S 2000000
I f'OUCY n ~ n lOC
~1~QUfY COM8INEO SINOI.E IMlT S 1000000
C e!.. Nf'( Al1TO 02CBO?78'l510 06/28/0" 06/28/05 (Ea -/den)
,ou. OWNI;D AIITOS BOD1!. Y 1NJ1IRY
.-.-- $
SCHEOOLED AUTOS (Per person)
'--
~ H~ AlITOS ROOIL v 1N.'lR'V
$
~ NOf4.0WNE0 AIIros {POt aecIIInl
'-- F'ROI"l!RTY DMWlE ,$
(per~nll
_ LIMILITY AUTO ~Y - EA IlCCIlIl!NT S
R ~ AUIO OTHER TtWI €AACC $
,l,UTO 0Nl.v, AGO $
IllCftlINMeRaLA LIMlIJTY EACH OCCURREtJCf S
~ OCCUR 0 c..-s IIWlI! AGGReGATf! $
$
=i OEOuCTISlE $
RETENTION $ $
=:-- IT~J:r~ I IO~
B _. LMIItLI1'I' 16105 0'J/17/01 03/17/05 El. EACH ACClOENt S 100000
..w I'RClPIlETCRlPARTNF.RiElCECl!T1V!
OFF/CERlME"lIlER EXCUJDEO? e 1.. OEEASI! - €A ENPl.O\Il!E S 100000
ryea._\IIllleI E.I..l:lIII!ASE- POUCYLMT $ 500000
specL'L.p~ I!eIOW
0_
____...IIfIIMrWMIUlOA~IVIItlCUI/IlrCLUIlOIItADTllOIY~/......._
City ofCleaxwater is listed as Additional. InsU%ed.
CERnACATEHOlDER ~LAnoN
CITOF-8 --.oM,.. 'TIIIl__1IIlIOIIIIIO _.. -.u.IO __1MI1llI'IIUm0ll
DMII_.~___1III.I.__1'O__
30 DAYlWNTTII!
Cit:y of C1ea.rwater
PO 80x 41..8
C1earwaber FL 33758
IIImOII TO'lMIIIIImFIIlMa ___ 1'01111 LVI'.IUT '~1'O DO 10 lHALI.
M'OIIIIO taIM1lOIl OIl UllIIUfY OF My KIlD UFOIl1lll_1UIIIR.1T8 MeNTlI Oft
_H~
All'TIlOll
ACORD ~5 2001/08)