CERTIFICATE OF LIABILITY INSURANCE (2)
~.AcnRD CERTIFICATE OF LIABILITY INSURANC~~~lWE I DATE (MMlDDIYY)
"'""---- ...:.....-- nI 12/11/01
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Lupfer-Frakes Insurance HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
222 Church Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Kissimmee FL 34741
Phone: 407-847-2841 INSURERS AFFORDING COVERAGE
INSURED INSURER A Firemans Fund Child Care
INSURER B:
Head ~tart Child Development INSURER C:
& F~ll Services, Inc.
6698 68 hAve. INSURER D:
Pinellas Park FL 33781-5063 ,
I " INSURER E:
COVERAGES
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, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TNSR
LTR
~NERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY MXG8 0 7 8 7 64 3
~ ~ CLAIMS MADE ~ OCCUR
~ Multicover
TYPE OF INSURANCE
POLICY EFFl;c;TlVE P.9.L!QY EXPlf!I!!I0N
DATE IMMlDDlYvi DATE'IMMlDDIYYI
POLICY NUMBER
EACH OCCURRENCE
01/01/02
01/01/03
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
PERSONAL & ADV INJURY
GEN'L AGGREGATE LIMIT APPLIES PER:
Ii POLICY n j~T n LOC
AUTOMOBILE LIABILITY
f--
A ...!. ANY AUTO MXG80787643
ALL OWNED AUTOS
-
_ SCHEDULED AUTOS
HIRED AUTOS
-
_ NON.OWNED AUTOS
GENERAL AGGREGATE
~.
PRODUCTS" COMP/OP AGG
01/01/02
COMBINED SINGLE LIMIT
01/01/03 (Eaaccidenf)
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
-
PROPERTY DAMAGE
(Per accident)
GARAGE LIABILITY
~ ANY AUTO
EXCESS LIABILITY
tJ OCCUR D CLAIMS MADE
RDEDUCTIBLE
RETENTION $
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AUTO ONLY - EA ACCIDENT $
EA ACC $
$
$
$
$
$
$
OTHER THAN
AUTO ONLY:
EACH OCCURRENCE
AGGREGATE
I TOR'Y'OMYisl ~
EL. EACH ACCIDENT $
EL. DISEASE. EA EMPLOYEE $
- ECDISEASE - POLICY1.II\IIIT" $
" .--"-
,.'" ..-
OTHER
DESCRIPTION OF OPERATIONSlLOCATlONSlVEHICLESlEXCLUSlONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Loc: 918 Palmetto St., Clearwater, FL (Sanderlin Center Playground). City of
Clearwater is additional insured for general liability.
LIMITS
$ 1000000
$ 100000
$ *5000
$ 1000000
$ 2000000
$ 2000000
$ 500000
$
$
$
--;c-
AGG
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
., ....nULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlO~
~ .Is 0LU'_L [I' D~tE~~,' F,THEISSUINGINSURERWILLENDEAVORTOMAIL ~DAYSWRITTEN
Ci ty of Clearwater I r l'IDTIJ;f ~THE CERTIACATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Public Works Admin t II
Attn: Earl Barrett I 'j DE"r' I 8 ",-, IMPQllE;~OpBLIGATIONORLlABILITYOFANYKINDUPONTHEINSURER,ITSAGENTS OR
P.o. Box 4748 W L ,'-J (U i!REP~bEN-fATlVES. (
Clearwater FL 33758-47411 :_______" ",', AUTHORIZED REPRESENTATIVE I "'~ ....J ~ l/l .1
I CfT'.' Of C'F ~,~;:;r r;-J 1 l' III 11 , (' \ II' ,A. S
ACORD 25-S (7/97) \"iUI{i'\~ hOi.U!!;!IL\ flr)!/ .J @ACO~ CORPORATION 1988