CERTIFICATE OF LIABILITY INSURANCE (3)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
" ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Greg Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
New Port Richey FL 34655 COMPANIES AFFORDING COVERAGE
Alvina Davis A062355
Phone No. 727-376-0030 FexNo.727-376-2262
INSURED
COMPANY
A Nonprofits Ins. Association
Foundation Village
Neighborhood Family Center,Inc
Family Center, Inc.
918 Woodlawn St.
Clearwater FL 33756
COMPANY
B Underwriters at Lloyd's
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 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIOr~ LIMITS
LTR DATE IMMIDDIYYI DATE IMMIDDIVYI
GENERAL LIABILITY GENERAL AGGREGATE $3,000,000
A X COMMERCIAL GENERAL LIABILITY NIA1810230 10/01/02 10/01/03 PRODUCTS - COMP/OP AGG $3,000,000
CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
FIRE DAMAGE (Anyone fire) $100,000
MED EXP (Anyone person) $ 5,000
AUTOMOBILE LIABILITY
10/01/02 10/01/03 COMBINED SINGLE LIMIT $1,000,000
A ANY AUTO NIA1810230
ALL OWNED AUTOS BODILY INJURY
X SCHEOULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per eccident)
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
$
THE PROPRIETOR/ INCL EL DISEASE - POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE. EA EMPLOYEE $
OTHER
A Sexual/Prof Liab NIA1810230 10/01/02 10/01/03 Sxl/Prof 1,000,000
B Building Covg 190539 02/22/02 02/22/03 Bldg Covg 303,000
DESCRIPTION OF OPERATlONSILOCATIONSNEHICLESISPECIAL ITEMS
HOLDER IS ADDITIONAL INSURED I,IQILITY FOR BLDG LOCATED 918 WOODLAWN DR
CLEARWATER FL 33756, EFF 12/01/99 (OWNER OF BLDG)
SEP 3 0 2002
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CITY OF CLEARWATER
ATTN: MR. SCHROEDER
PO BOX 4748
CLEARWATER FL 33758 4748
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CITYCLR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAlL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAlWRE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRES
Alvina Da
tuVo.
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