CERTIFICATE OF LIABILITY INSURANCE (2)
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DATE (MM/DDIYY)
09/27/01
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.
COMPANIES AFFORDING COVERAGE
PRODUCER
Greg Roe Insurance, Inc.
9851 state Road 54
New Port Richey FL 34655
Alvina Davis A062355
Phone No. 727-376-0030 Fax No. 727-376-2262
INSURED
COMPANY
A
Nonprofits Ins. Association
COMPANY
B
Underwriters at Lloyd's
Foundation Village
Neighborhood Family Center,Inc
Family Center, Inc.
918 Woodlawn st.
Clearwater FL 33756
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMlDDIYY) DATE (MM/DDIYY)
LIMITS
GENERAL LIABILITY
A COMMERCIAL GENERAL LIABILITY NIA180 9399
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
10/01/01
10/01/02
GENERAL AGGREGATE $ 3 , 000 ,000
PRODUCTS. COMP/OP AGG $ 1, 000 , 000
PERSONAL & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 100 , 000
MED EXP (Anyone person) $ 5 , 000
AUTOMOBILE LIABILITY
A ANY AUTO NIA1809399
ALL OWNED AUTOS
X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
10/01/01
10/01/02
COMBINED SINGLE LIMIT $ 500 , 000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO
RECEI ED
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COIVlPENSA TION AND
EMPLOYERS' LIABILITY
OCT 0 1 .001
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
EL DISEASE - POLICY LIMIT
EL DISEASE - EA EMPLOYEE
A Sexual/Prof Liab
B Building Covg
NIA1809399
190539
10/01/01
02/22/01
10/01/02
02/22/02
Sxl/Prof
Bldg Covg
1,000,000
303,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
HOLDER IS ADDITIONAL INSURED ~IAaILITY FOR BLDG LOCATED 918 WOODLAWN DR
CLEARWATER FL 33756, EFF 12/01/99 (OWNER OF BLDG)
CITYCLR
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
CITY OF CLEARWATER
ATTN: MR. SCHROEDER
PO BOX 4748
CLEARWATER FL 33758 4748
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