CERTIFICATE OF LIABILITY INSURANCE
, 4130/02 14:36
(727 442 7695
Conne 11 Y Ios
LIsa Pope-+Kalherlne
2/2
ACORD. CERTIFICATE OF LIABILITY INSURANCE OPID LPI DATE (MM'Do.YY)
PALMP-2 04/30/02
I'RODUCER THS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
The Connel.ly Insurance Group ONLY AND COtEERS NO RIGHTS UPON THE CERTIFICATE
630 Chestnut Street - HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 2456 AI.. TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Cl.earwater FL 33757-2456
Phone: 727-461-6044 Fax: 727-442-7695 t1SURERS AFFORDING COVERAGE
MUllED INSURER '" Scottsdale Insurance Co.
INSUR5l B Fireman's Fund Insurance Co.
Pa1m Pavil.ion of Cl.earwater INSURER C Progressive Insurance Company
Ken Hamil.ton
10 Bay Espl.anade INSURER D: Hartford Ins. Co. of the S. E .
Cl.earwater FL 33767
I INSJ~E
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAIoIIED ABOVE FOR THE POLICY PERlODIi'DICATED. NOTWITHSTANDING
ANY REQUREMENT, TERM OR CONDITION OF ANY CONTRAcT OR OTHER DOCUMENT WITH RESPECT TO WHCH THIS CERTIFICATE MAY BE ISSUED OR
MAYPERTAlN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SLBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAD CLAIMS,
INSR TYPE OF INSURANCE ~~C;:,,~~ POUCY EXPIRAnON
LlR POUCY NUMBER DATE IMNlDDlYYj UMrn
GENERAL LWIIUTY EACH OCCURRENCE $1,000,000
-
A X CCNMEROAL GENERAL UAIlUT" BCSOOO1307 04/05/02 04/05/03 FRE DMlAGE (My ene nre) $100,000
I CLAMS 'llADE ~ OC:UR M::O EXP (Arr( 0'" pe"o,) $ EXCLUDED
PER9:l1\W.. &NY' INJUFU $1,000,000
G::NERAl AGGREGi',TE $ 2, 000,000
-
G::N'l AGGREGATE .JMIT APPLES PER PRODUCTS - CO'olPIOP AGO $1,000,000
~ I ,PRO- n.oc
PO.JCY JECT
AUTOMOBILE UAIlIUTY COMBINED SNGLE UMIT
- $1,000,000
C ...!... ANY AUTO CA065726247 04/05/02 04/05/03 (fa aCCident)
ALL OWNED ,'.uTCS BODILY INJURY
- $
SCHEOOLEO .AUTOS (Fer ~erson)
-
HIllED AUTOS BOOIL Y INJURY
- $
NO'i-ONNEO AUTOS (Fer ;;CClcent:
-
- PROFER-V ~E $
(Fer c:ccicent:
DARACELWlIUTY AUTO O~Y - EAACCIDENT $
R ANY AUTO OTHER T-iAN E.4 AC: $
AUTOO~Y: AGG $
EXCESB UABIUTY EACH OCCURRENCE S 2,000,000
B t!:J OCCUR o CUWS MArE nZ96826573 04/05/02 04/05/03 AGGREG'TE $ 2, 000,000
$
~ DEDUCTIBLE S
X RETENTION 5 0 $
__ CDM~ENSAnON AMI I ~'1~,rC~~s I 10 H-
ER
E.-.uJYERB' UAIlIUTY 04/01/02 04/01/03
EL EACH ACCu::eNT $ 500,000
E L CISE.\SE - EA EMPLOYE!: $ 500,000
E L CISE.\SE - POUCY UhllT $ 500,000
OTHER
Dl!BClUI'nOB OF oPERAnoNa'l..OCAnoNIlYEHICU!IJEICWIIONI ADDED BY ENDORSEMEliTiBPECIAL PRDVlSIO~B
RE: Building 12 - 332 s. Gul.fview Blvd., Clearwater Beach, FL. and
Buil.dinql3-330 S.Gulfview Blvd., Cl.earwater; $50,000. Buil.ding coverage "
$10,000. Contents. All. property coverage based on Repl.acemen t Cost basis.
Certificate Holder is included as Additional. Insured.
CERTIFICATE HOLDER I Y I ADDmONAl. 1~IURlD; INSURlR LETTER: A CANCELLATION
CITYO-1 IIIOULD ANY OF THI MOllE DESCRllED ~OUCII8 IE CANCEU5D BEFORE THE ElPRAnON
City of Cl.eazwater DATE THEREDF, THE ISSUI~O IBSl.flER wu. INDEAVOR TO MAl. ~ DAYS WRITTEN
FAX I 462-6957 NOllCE TO THE CERTlFlCAlE HOLDER NAMED TO THE U!FT, Bur FAlLUU! TO DO 10 IHALL
Attn: Catherine Yell.in
25 Causeway Bl.vd. IMPOSE ..0 OBUOAnOtt OR UASIUTY OF ANY K"'D UPON THE INSURER,. ITS AGENTS OR
Cl.earwater FL 33767 REPREBENTAnw:S.
AUTM~ -,. ~ /~
I V-.-
ACORD 25~ (7/97)
o ACORD CORPORATION 1988
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