CERTIFICATE OF LIABILITY INSURANCE (4)
ACORDN
CERTIFICATE OF LIABILITY INSURANC~~~lWE DA~E~~~~D;~)l
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.
PRODUCER
Lupfer-Frakes Insurance
222 Church Street
Kissimmee FL 34741
Phone: 407-847-2841
INSURERS AFFORDING COVERAGE
INSURED
Head ~tart Child Development
& Fam1ly Services, Inc.
6698 68th Ave.
Pinellas Park FL 33781-5063
INSURER A:.
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
Firemans Fund Child Care
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.
I~f~ TYPE OF INSURANCE POLICY NUMBER ~9~lfJ EFE~S]1VE POLl1~IEXPIRAT}~N LIMITS
DATE MMlDDlYvj' DATE MMlDDIYY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
I---
A ~ COMMERCIAL GENERAL LIABILITY MXG80787643 01/01/02 01/01/03 FIRE DAMAGE (Anyone fire) $ 100000
"-- =:J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ *5000
X Multicover PERSONAL & ADV INJURY $1000000
I---
GENERAL AGGREGATE $2000000
I---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $2000000
n n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
I--- $ 500000
A ~ ANY AUTO MXG80787643 01/01/02 01/01/03 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
>--- $
SCHEDULED AUTOS (Per person)
>--- "
HIRED AUTOS BODILY INJURY
f-- $
NON.OWNED AUTOS (Per accident)
>---
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
R ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
tJ OCCUR o CLAIMS MADE AGGREGATE $
$
q DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I TORY L1MrrS I 10J~'
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
. .. -, .- -. . -_.----.- - -- .-. - - - .E.L. DI~,i::ASE.EA EMPLOYi::E$ -
E.L. DISEASE. POLICY LIMIT $
OTHER
.A
DESCRIPTION OF OPERA TIONSIlOCA TIONSlVEHICLESlEXCLUSlONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS ~ '~
Additional Insured Endorsement applies in favor of City of Clearwater for
the following location: ~ ~ 0~
701 N. Missouri, Clearwater, FL ~ /~ ~
** 10 days for Non-Payment of Premium ~~Q ~. ()
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION ~~, ~
CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED B~~THE EXPIRATIO~
DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~AYS WRITTEN
NOTICE TO THE CERTIRCATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Risk Management Department
P. O. Box 4748 REPRESENTATIVES.
Clearwater FL 34618-4748 AUTHORIZED REPRESENTATIVE \ J...) LV11.J PAl 0--tZ>
I
ACORD 25-S (7/97) o ~ G l ~AL..' C l TL1.. o LGf2 (( @AC~D CORPORATION 1988
C~: 6::<.~ ~~(~6; (2.(S~