CERTIFICATE OF INSURANCE
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Issue Date: 02/16/2000 ?
CERTIFICATE OF INSURANCE
10: 527
Insured: Clearwater Housing Authority
Address: 210 Ewing Avenue
P,O, Box 960
Clearwater, FL 34617-4617
Coverages------------- --------___________
Type of Insurance Policy Number
General Liability 10-0249-2000-00-000-0
[X] Commercial General
Liability
[X] Occurance
[X] Owner's _
Contractor's Proto
[X] Broad Form CGL
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Effective Date: 04/01/2000
Expiration Date: 04/01/2003
Limits
Gen Aggregate: 2.000,000
Products / Comp Op: Included
Personal .Adv Inj: Included
Each Occurance: 1.000,000
Fire Damage: 50,000
Med Expense: Not Covered
Description: Proof of Insurance
Certificate Department of Housing and Urban Development
Holder: 451 7th Street, S.W.
Washington, DC 20410
Company: Housing Authority Risk Retention Group, Inc.
THIS IS TO CERTIFY THAT THE POLICIES LISTED ABOVE HAVE BEEN ISSUED TO THE INSURED NAMED
ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING ANY REQUIREMENTS, TERM OR
CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE
MA Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY
HAVE BEEN REDUCED BY CLAIMS PAID. 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 ABOVE.
Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will
endeavor to mail 90 days written notice to the certificate holder named above, but failure to mail such notice shall
impose no oblications or liability of any kind upon the company, its agents, or representatives.
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Policy Change No. 01-028-01-2000-12
Change Endorsement
Public Officials - Controlling Interest
Named Insured:
Policy Number:
Policy Effective Date:
Issue Date:
Clearwater Housing Authority
10-0249-2000-00-000-0
04/01/2000 - 04/01/2003
02/25/2000
Effective From: 04/01/2000 at the time of day the policy becomes effective.
Public Official's Errors and Omissions (Claims-Made)
The Insurance is Amended as follows:
We will extend coverage under that section to an additional insured shown in the
SCHEDULE PROVIDED THAT:
1. You provide us with evidence satisfactory to us that the duties performed by
the additional insured and the purpose of said non-profit organization(s) are in
direct furtherance of the duties and purpose of the named insured.
2. Your insured under the Policy when they act on their capacity as directors,
officers or commissioners of other non-profit organization(s) have the authority
to oversee and direct the activity of the non-profit organization. - -
Schedule:
Schedule: Partners in Self-Sufficiency
Description: Not Applicable
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HARRG ENDTt
Housing AUlhority Risk Relenllon Group Dale: 0212912000
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Policy Change No. 01-020-01-2000-2
. Additional Insureds - Non-Profit
Change Endorsement
Named Insured:
Policy Number:
Policy Effective Date:
Issue Date:
Clearwater Housing Authority
10-0249-2000-00-000-0
04/01/2000 - 04/01/2003
0212512000
Effective From: 04/01/2000 at the time of day the policy becomes effective.
General Liability
The Insurance is Amended as follows:
WHO IS AN INSURED is amended to include as an additional insured the Non-Profit
SHOWN IN THE SCHEDULE BUT ONLY WITH RESPECT TO LIABILITY ARISING
OUT OF THE
ownership, maintenance, or use of the premises shown in the Schedule.
.
. Schedule: Partners in Self-Sufficiency
Description: Partners in Self-Sufficiency as additional insured per Endorsement No.
02d-01
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HARRG ENOTl
Housing Authority Risk Relentlon Group O.te: 0212912000