CERTIFICATE OF LIABILITY INSURANCE (9)
ACORDN
CERTIFICATE OF LIABILITY INSURANC~A8~~~ S DA~E~~~~70~
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
Brown & Brown Insurance
630. Chestnut Street
P.O. Box 2456
~learwater FL 33757-2456
Phone: 727-461-60.44 Fax:727-442-7695
INSURERS AFFORDING COVERAGE
INSURED
INSURER A: Landmark American Ins. CO.
INSURER B: Ace American Insurance
INSURER C: Amerisure Insurance
INSURER D:
INSURER E:
Head Start Child Development
& Family Services
6698 68th Avenue, North #D
Pinellas Park FL 33781-50.63
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 \NHICH 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 ~~f~MLb5'f.l.).YE P LIMITS
DATE (MM/DDIYY)
GENERAL LIABILITY EACH OCCURRENCE $1,0.0.0.,0.0.0.
-
B X COMMERCIAL GENERAL LIABILITY G2D4DD869 0.1/0.1/0.4 0.1/0.1/0.5 FIRE DAMAGE (Anyone fire) $ 10.0.,0.0.0.
.. '. .".CLAIMS.MADE. @OCCUR --- -. ._,._-----,-._,~_._---,--- .- ,,. ......'- r---'. - MED EXP (Any.ooe..per~_ $ 5,0.00. ' '..'" ..,
PERSONAL & ADV INJURY $ 1,0.0.0. , 0.0.0.
-
GENERAL AGGREGATE $2,0.0.0.,0.0.0.
-
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMP/OP AGG $2,0.0.0.,0.0.0.
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $5DDrDDD
B ~ ANY AUTO H08123D32 0.1/0.1/0.4 0.1/0.1/0.5 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON.OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY" EA ACCIDENT $
~ ANY AUTO 'fT; ~--- ---~-.- ... EA ACC $
IT: OTHER THAN
i r1 .. AUTO ONLY: AGG $
il') .-"- .,.--,-.- .._..~
EXCESS LIABILITY EACH OCCURRENCE $
=:J OCCUR D CLAIMS MADE ' ,
.~ I DEe 3 0 AGGREGATE $
Ul (~.:j .-I' $
L______... I
~ DEDUCTIBLE --.-_ J ! $
RETENTION $ C:-l C ( .. -i) $
WORKERS COMPENSATION AND t!H'iL \\'Uf '::.~, ',"_ ,:..,:. \~!(~~J ___i X I TO"R~'GMYTS I IUJ.H-
-..----....".. .. ER
C EMPLOYERS' LIABILITY WC122734 0.1/0.1/0.4 _0..!1 0.1 / O~. $1.0.00.00.
E.L. EACH ACCIDENT
. _.~.- -" - ... . I. .- ',--- ."...' ----. ------ f---..-.-
E.L. DISEASE. EA EMPLOYEE $ 10.0.0.0.0.
E.L DISEASE" POLICY LIMIT $ 50.0.0.0.0.
OTHER
A Property Section LHD332417 0.1/0.1/0.4 0.1/0.1/0.5 Per Policy
on File
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate holder is an additional insured for general liability only with
regard to 70.1 N. Missouri, Clearwater, FL
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: A CANCELLATION
CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
City of Clearwater NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
ATTN: Earl Barrett IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
P.O. Box 4748
Clearwater FL 33758-4748 REPRESENTATIVES.
1 AUTHOIT1:rRESENl:JE ~
ACORD 25-S 7/97 C-/ @ACORDCORPORATI N1
o 988