VARIOUS CERTIFICATES OF INSURANCE AND CORRESPONDENCE (2)
II
TO:
FROM:
COPIES:
SUBJECT:
DATE:
1
I
CITY OF CLEARWATER
Interdepartment Correspondence Sheet
Assistant City Hanaser
Elizabeth S. Haeseker,
Sue Lukin, Assistant CitJ' Clerk
Various Insuranoe Certiticates & Lease Agreement w/Bead Start
September 8, 1982
We are enclosing berewith two oopies each of the following
insurance certificate.:
v.t)Dperial Cart1n8
&.fells Brothers
We are also enolosing two copies of Lease wi tb Head Start Pre-Sohool
Program and one copy of their insurance oertificate. Mr. MoFate has
a copy ot this insuranoe certifioate.
One copy is for your files and the other is tor departmental staff
follow-up.
Iss
Encl.
>~ ,
COMPANIES AFFORDING COVERAGES
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
COMPANY
LETTER
A
B
C
o
E
National Indenmi ty Company
COMPANY
LeTTER
NAME AND ADDRESS OF INSURED
COMPANY
LETTER
Head S tart Child Development &
Family Service
12351 - 134th Avenue North
Largo, Florida 33540
COMPANY
LETTER
COMPANY
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time, 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,
COMPANY
LETTER
TYPE OF INSURANCf
POLICY NUMBER
POLICY
ex PIRATION DA [f
limits of liability in Thousands ( 0 )
EACH
OCCURRENCE
GENERAL LIABILITY
$ 300
A
D COMPREHENSIVE FORM
[XjPREMISES-OPERATIONS GLA 196622
D EXPLOSION AND COLLAPSE
HAZARD
D UNDERGROUND HAZARD
D PRODUCTS/COMPLETED
OPERATIONS HAZARD
D CONTRACTUAL INSURANCE
D BROAD FORM PROPERTY
DAMAGE
D INDEPENDENT CONTRACTORS
D PERSONAL INJURY
BODILY INJUPY
11/7 /82
PROPERTY DAMAGE 100
$
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
PERSONAL INJURY
AUTOMOBILE LIABILITY
DCOMPREHENSI\lE FORM
DOWNED
D H I RED
D NON,OWNED
80DILY INJURY
I EAC H PERSON)
$
$
BODILY INJURY
lEACH ACCIDENT)
PROPI RTY DAMAGE
BODilY INJURY AND
rROPERTY DAMAGE
COMBINED
EXCESS LIABILITY
D UMBRELLA, FORM
D OTHER THAN UMBRELLA
FORM
BODILY INJURY AND
PROPERTY DAM/\.CE
C'OMB!NED
WORKERS' COMPENSATION
uUand
EMPLOYERS' LIABILITY
OTHER
DFSCRIPTION OF OPERATIONSfLOCATIONSNEHICLES
ACORD 25 (1,79)
SCHOOL:
701 North Missouri Avenue, Clearwater, FL
Cancellation: Should any of the above described policies ~e c3nce!led before Ire eXpiration date thereof, the Issuing com-
pany will endeavor to mail _ days WI'!tten notice to tr,e oelow named cel'tlficate holder. but failure to
mall such notice shall Impose DO obligation or liability of any kind upon the company,
'.-.
NAME AND ADDRESS O. CERTIFICA TE HOLDER'
'RECEIVED
DATE ISSUED:
12/21/81
City of Clearwater
P. O. Box 4748
Clearwater, FL 33518
DEe 24 1981
.DTY (;' F.RK
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
COMPANIES AFFORDING COVERAGES
COMPANY
LEITER
A
B
C
D
E
National Indemnity Company
COMPANY
LEPER
Hea~ Start Child Development &
Family Service
12351 - l34th Avenue North
Largo, Florida 33540
COMPANY
!,EHER
COMPANY
LETTER
OSC
1.8
1980
CITY CLERK
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time, 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.
- I
TYPE OF INSURANCf I
GENERAL LIABILiTY!
COMPANY
LETTER
POLICY NUMBeR
" ,. 1 Limits of Liability in Thousands"(OOO)--'
IX" I H~C;,(I)NY D f,T [ 1---'--, -------. ~ , ,EACTi,---'i-:;G-G;l'G~~-I:--
-i OCCURR[N(_~[ .."
---~---"- -----,._- -.-----
P"c," "I"" ''''Y ! 300 $
: ' . :,. I .. _ u ,. ,
!
11/7 /81
i
i
~'-----t..~.- ----.
['0',11 Y INJUR) AND
PROP, Rl Y DAMAGE $
._~~:~~
A
[J COMPREHFN:'IV[ !URM
D PflEMISES-OPLRM!ONS
D EXf'LOSION AND COLLJ,PSE
HAZARD
D UNDERGROUND HAZARD
D PRODUCTS/COMPLLHI'
OPERATIONS HAZARfl
D CONTRACTUAL INSURANCE
D BROAD FORM PROPERTY
DAMAGE
D INDEPENDENT CONTRf,CTORS
D PeRSONAL INJURY
GLA 189875
I"lH\;PCRTY DAMAGE
$ 100
$
P","SONAL INJURY
$
AUTOMOBILE LIABILITY
D COMPREHENSIVE
DOWNED
D HIRED
o NON,OWNED
FOflM
HODILY INJURY
IIACH PERSON)
BODILY INJURY
(EACH ACCIDENT)
PfKlPERTY DAMAGE
GODIL Y INJURY AND
I'ROPERTY DAMAGE
COMBINED
$
$
EXCESS LIABILITY
o UMBRELLA FORM
o OTHER THAN UMBRELLA
FORM
LJODILY INJURY AND
PROPE RTY DAMAGE
COMR:NED
WORKERS' COMPENSATION
------- --------al1d----
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES
School: 701 North Missouri Avenue, Cleanvater, Florida
Cancellation: Should any of the above described poliCies be cancelled before the eXpiration date thereof, the issuing com.
pany will endeavor to mail _ days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company,
NAME AND ADDRESS OF CERTIFICA IE HOLDER
City Clerk's Office
City of Clearwater
P.O. Box 4748
L__~~~:~a~~r, FL 33518
CA TE ISSUED'
12/16/00
~
UFE&CASUALTY
FIRE ~"' 1
POLICY _
6tJ The ~tna Casualty and Surety Company
Hartford, Connecticut 06156, A Stock Insurance Company I 1.- ~ r;
o The Standard Fire Insurdce Company '- ..
Hartford, Connecticut 06151, A Stock Insurance Company
-
DECLARATIONS
NAMED ~
INSURED
AND
ADDRESS
Head Start Child Development & Family Service
12351 - 134th Avenue North
Largo, Florida 33540
Policy Term Policy Number
3 Years 23 FP 257701
Policy t'eriod:
11-3-80 11-3-83
Inception Expiration
(Show Number and Street or RFD, City, County, State, and Zip Code)
It is important that the written portions of all policies covering the same property read exactly alike. If they do not, they should be made uniform at once.
Insurance is provided against only those perils and for only those coverages indicated below by a premium charge and against other perils and for other
coverages only when endorsed hereon or added hereto.
Amount Rate
.....,
$ 7,000. $ .630
$ .288
$ .011
$
Prepaid Term
Premium Due
At Inception
Annual Payment
Due Under Def.
Premo Pay. Plan
PERIL(S) Insured Against and Coverage(s)
Provided (Insert Nom. 01 Each)
$
195. Total Premium
For Poli Term under D. P. P. P.
Amount Fire or Fire Per Cent of
and Extended Cov- Co-Insurance
era e or Other Peril Applicable
$ 7,000. 80%
$
$
$
$
T otal(s) $
$
$
$
$
$
44.
20.
1.
Fire and Lightning
Extended Coverage
V&MM
65.
Item
No.
DESCRIPTION AND LOCATION OF PROPERTY COVERED
(Show cOllllnldlon, type 01 rool and occupancy 01 bullcllng(s) covered or
conlalnlng". property covered. II occupied 01 a dwelling dale nUIBber ollamilles.)
1.
On the frame, one-story, approved roof building occupied as a
Pre-School, located 701 North Missouri Avenue, Clearwater,
Pinellas, Florida.
1JJJ
Subject to Form No(s). attached hereto. (Insert form number(s) and edition date(s))
Countersignature Date 11/3/80
AgencyatSt.Petersburg, FL
AGENT
IN CONSIDERATION OF THE PROVISIONS AND STIPULATIONS HEREIN OR ADDED HERETO AND OF the premium above specified, The Stock
Insurance Company indicated above by lBI, herein called "This Company," for the term of yean specified above from inception date shown above At Noon
(Standard Time) to expiration date shown above At Noon (Standard Time) at location of property involved{ to an amount not exceeding the amount(s) above
specified, does insure the insured named above and legal representatives, to the extent of the actual cash value of the property at the time of loss, but not
exceeding the amount which it would cost to repair or replace the property with material of like kind and quality within Q reasonable time after such loss,
without allowance for any increased cost of repair or reconstruction by reason of any ordinance or law regulating construction or repair, and without com-
pensation for loss resulting from interruption of business or manufacture, nor in any event for more than the interest of the insured, ,against all DIRECT LOSS
BY FIRE, LIGHTNING AND BY REMOVAL FROM PREMISES ENDANGERED BY THE PERILS INSURED AGAINST IN TMIS POLICY, EXCEPT AS
HEREINAFTER PROVIDED, to the property described herein while located or contained as described in this policy, or pro rata for five days at each proper
place to which any of the property shall necessarily be removed for preservation from the perils insured against in this policy, but not elsewhere.
Assignment of this policy shall not be valid except with the written consent of this Company.
This policy is made and accepted subject to the foregoing provisions and stipulations and those hereinafter stated, which are hereby made a part of this policy,
together with such other provisions, stipulations and agreements as may be added hereto, as provided in this policy.
STANDARD FIRE INSURANCE POLICY for Alabama, Alaska, Arizono, Arkansas, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho,
Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Michigan Mississippi, Montano, Nebraska, Nevado, New Hampshire, New Jersey, New Mexico, New
York. North Carolino, North Dakota, Ohio, Oklahomo, Oregon, Pennsylvanio, Rhode Island, South Carolina, South Dakota, Tennessee, Utah, Vermont, Virginia, Washington,
West Virginia, Wisconsin, Wyoming,
') 20-0)
') 3-75
Page 1
Printed in U,S,A,
1 concealment, I nls entire POliCY snail De VOid IT, wnetner lS4 relating to tne Interests and obligations of suclfrnottgagee may
2 fraud, before or after a loss, the insured has wil- 85 be added hereto by agreement in writing.
3 fully concealed or misrepresented any ma- 86 Pro rata liability. This Company shall not be liable for a greater
4 terial fa~ or cwcumstance concling this insurance or the 87 , I' propor!.ion of" any I~ss than the amount
5 subject thereof, or the interest of t insured therein, or in case 88 hereby Insured hall bear-to the whole Insurance covering the
6 of any fraud or false swearing by e insured relating thereto. 89 property agains the peril involved, whether collectible or not.
7 Uninsurable This policy shall not cover accounts, bills, 90 Requirements in The insured shall give immediate written
8 and currency, deeds, evidences of debt, money or 91 case loss occurs. notice to this Company of any loss, protect
9 excepted property. securities; nor, unless specifically named 92 the property from further damage, forthwith
10 hereon in writing. bullion or manuscr~pts. 93 separate the damaged and undamaged personal property, put
, 11 Perils not This Company shall not be liable for loss by 94 it in the best possible order, furnish a complete inventory of
12 included. fire or other perils insured against in this 95 the destroyed, damaged and undamaged property, showing in
13 policy caused, directly or indirectly, by: (a) 96 detail quantities, costs, actual cash value and amount of loss
14 enemy attack by armed forces, including action taken by mili- 97 claimedj and within sixty days after the loss, unless such time
15 tary, naval or air forces in resisting an actual or an immediately 98 is extended in writing by this Company, the insured shall render
16 impending enemy attack; (b) invasion; (c) insurrection; (d) 99 to this Company a proof of loss, signed and sworn to by the
<n 17 rebellion; (e) revolution; (f) civil war; (g) usurped power; (h) 100 insured, stating the knowledge and belief of the insured as to
] ~ 18 order of any civil authority except acts of destruction at the time i101 the following: the time and origin of the loss, the interest of the
> co 19 of and for the purpose of preventing the spread of fire, provided 102 insured and of all others in the property, the actual cash value of
~ . ~ 20 that such fire did not originate from any of the perils excluded 103 each item thereof and the amount of loss thereto, all encum-
-0 0 ~ 21 by this policy, (i) neglect of the insured to use all reasonable 104 brances thereon, all other contracts of insurance, whether valid
~ ~-E 22 means to save and preserve the property at and after a loss, or 105 or not, covering any of said property, any changes in the title,
-0 >: 23 when the property is endangered by fire in neighboring prem- 106 use, occupation, location, possession or exposures of said prop-
~ ~ S 24 ises; (j) nor shall this Company be liable for I05S by theft. 107 erty since the issuing of this policy, by whom and for what
OJ .~-o 25 Other Insurance. Other insurance may be prohibited or the 108 purpose any building herein described and the several parts
-0 '0 ~ 26 amount of insurance may be limited by en- 109 thereof were occupied at the time of loss and whether or not it
~';1 27 dorsement attached hereto. 110 then stood on leased ground, and shall furnish a copy of all the
....~u 28 Conditions suspending or restricting insurance. Unless other- 111 descriptions and schedules in all policies and, if required, verified
~ ~~ 29 wise provided in writing added hereto this Company shall not 112 plans and specifications of any building, fixtures or machinery
~ {i: ~ 30 be liable for loss occurring 113 destroyed or damaged, The insured, as often as may be reason-
~ ~"~ ~ ~~ ~~~I~~i~n~~~e~:~a~1 ~~di~~~~~~~ ~l any means within the. con- g~ ~~~p~en~u~l~dth~r~~~~~~~b~\ ~on/~~og::t~O~e~~~ig~::~~b~a, ~hni~
~ <n> f 33 (b) while a described building, whether intended for occupancy 116 submit to examinations under oath by any person named by this
:: ,~~ ~. 34 by owner or tenant, is vacant or unoccupied beyond a period of 117 Company, and subscribe the same; and, as often as may be
C ~ ill (;'. 35 sixty consecutive days; or 118 reasonably required, shall produce for examination all books of
e~ :- ~ 36 (c) as a result of explosion or riot, unless fire ensues, and in 119 account, bills, invoices and other vouchers; or certified copies
~ 0.-0 S ~ 37 that event for loss by fire on Iy. 120 thereof if origi na Is be lost, at such reasonable ti me and place as
co ~ ~ -0 ~ 38 Other perils Any other peril to be insured against or sub- 121 may be designated by this Company or its representative, and
~ e:.o ~-2 39 or subjects. ject of insurance to be covered in this_ policy 122 shall permit extracts and copies thereof to be made.
~ ~ ~ ~: 40 shall be by endorsement in writing hereon or 123 Appraisal. In case the insured and this Company shall
o :v C: {is 41 added hereto. 124 fail to agree as to the actual cash value or
-0 E~ ~~~ 42 Added provisions. The extent of the application of insurance 125 the amount of loss, then, on the written demand of either, each
~ i?-~ co ~ 43 under this policy and of the contribution to 126 shall select a competent and disinterested appraiser and notify
<Xl ,,~c ~.:; 44 be made by this Company in case of loss, and any other pro- 127 the other of the appraiser selected within twenty days of such
'" -E~,B~ u 45 vision or agreement not inconsistent with the provisions of this 128 demand, The appraisers shall first select a competent and dis-
~ '0, (l)~ ";; 2: 46 policy, may be provided for in writing added hereto, but no pro- 129 interested umpire; and failing for fifteen days to agree upon
C :~S ~~ 47 vision may be waived except such as by the terms of this policy 130 such umpire, then, on request of the insured or this Company,
~ C ~"g 48 is subject to change. 131 such umpire shall be selected by a judge of a court of record in
-0 ,,~- ~::i1i 49 Waiver No permission affecting this insurance shall 132 the state in which the property covered is located, The ap-
~ ~~.:;:;; ~ 50 provisions. exist, or waiver of any provision be valid, 133 praisers shall then appraise the loss, stating separately actual
-0 Cc ~ ~ C. 51 unless granted herein or expressed in writing 134 cash value and loss to each item; and, failing to agree, shall
~ .- ~ ro~" 52 added hereto. No provision, stipulation or forfeiture Shall be 135 submit their differences, only, to the umpire. An award in writ-
~:.~OJN ~~ 53 held to be waived by any requirement or proceeding on the part 136 ing, so itemized, of any two when filed with this Company shall
~ ~c~~ C-o 54 of this Company relating to appraisal or to any examination 137 determine the amount of actual cash value and loss. Each
<n c ~ t::~~ 55 provided for herein. 138 appraiser shall be paid by the party selecting him and the ex-
'E ~ QJ:~~-E 56 Cancellation This policy shall be cancelled at any time 139 penses of appraisal and umpire shall be paid by the parties
~ ~~ <n~- ~:J 57 of. policy. at the request of the insured, in which case 140 equally.
OJ,~ ~~'<n~ ~ 58 this Company shall upon demand and. sur- 141 Company's It s11all be optional with this Company to
-E:<n:~ i: ~,,-5 59 render of this policy, refund the excess of paid premium above 142 options. take all, or any part, of the property at the
~-S.:g~~~'O 60 !he customary short rates for the ex~ired time. This, ~ol- 143. . agreed or appraised value, and also to re-
~-o (;>-~c - 61 ICY may be cancelled at any time by'" thiS COlJ1pany by giVing 144 paIr, rebUild or replace the propertydestr()yed or damaged With
~ ~ i: [:- .-~ 62 to the insured a five days' written notice of cancellation with 145 other of like kind and quality within a reasonable time, on giv-
e ~~~ <n'~ ~ 63 or without tender of the excess of paid premium above the pro 146 ing notice of its intention so to do within th irty days after the
o.{i>-~~~e: 64 rata premium for the expired time, which excess, ,if not ten- 147 receipt of the proof of loss hereintequired.
~ ~ 1<( i: >'= 65 dered, shall be refunded on demand. Notice of cancellation shall 148 Abandonment. There can be no abandonment to this Com-
e: co~o ~~: 66 state that said excess premium (if not tendered) will be re- 149 pany of any property.
~:v'~~>-."'~ 67 funded on demand. 150 When loss The amount of loss for which this Company
:v::~g I '<n C 68 Mortgagee If loss hereunder is made payable, in whole 151 payable. may be liable shall be payable sixty days
E~>Z~'E ~ 69 interests and or in part, to a designated mortgagee not 152. after proof of loss, as herein provided, is
i? ~,,<ia: ~" 70 obligations. named herein as the insured, such interest in 153 received by this Company and ascertainment of the loss is made
"~g~o <D~ 71 this policy may be cancelled by giving to such 154 either by agreement between the insured and this Company ex-
-E <n>o~t'= Z 72 mortgagee a ten days' written notice of can- 155 pressed in writing or by the filing with this Company of an
-'=~;::a:z' I: 73 cellation. 156 award as herein provided.
[~~5;;;(:l.:g 74 If the insured fails to render proof of loss such mortgagee, upon 157 Suit. No suit or action on this policy for the recov-
~ ~W:I:~~ (; 75 notice, shall render proof of loss in the form herein specified 158 ery of any claim shall be sustainable in any
~ c.~:;:u~ i: 76 wit.hin sixty (60) da~s thereafter. and shall. be subject to the pro- 159 court of law or equity ~nless. all the requirements of this P?li<;y
<(~~o~~~ 77 viSions hereof relating to appraisal and time of payment and of 160 shall have been complied With, and unless commenced Within
"" ~ Z >- 78 bringing suit. If this Company shall claim that no liability ex- 161 twelve months next after inception of the loss.
79 isted as to the mortgagor or owner, it shall, to the extent of pay- 162 Subrogation. This Company may require from the insured
80 ment of loss to the mortgagee, be subrogated to all the mort- 163 an assignment of all right of recovery against
81 gagee's rights of recovery, but without impairing mortgagee's 164 any party for loss to the extent that payment therefor is made
82 right to sue; or it may payoff the mortgage debt and require 165 by this Company.
83 an assignment thereof and of the mortgage. Other provisions
In Witness Whereof, this Company has executed and attested these presents; but this policy shall not be valid unless countersigned
by the duly authorized Agent of this Company at the agency hereinbefore mentioned.
\))~
'0
CD
OJ
C
C
<n
-E
C
o
E
OJ
>
"
Z
LI.IQ..'"
......z:
Cuo
"'>e-
en......
.r
I
I
i~..
<m
FLORIDA AMENDATORY ENDORSEMENT
CF 01 02
(Ed. 10 79)
I. The fOllowing provision is added when the Coinsurance Clause applies.
Coinsurance Contract: The rate charged in this policy is based upon use of a coinsurance clause attached hereto with the consent of the Insured,
II. The Deductible Clause, if any, in this policy is replaced by the fOllowing as respects those perils specifically named below:
A. No deductible is applicable to the perils of fire, lightning or removal.
B. When this pOlicy is extended to include the Extended Coverage or Vandalism or Malicious Mischief perils, the fOllowing deductibles shall apply:
The sum of $100 shall be deducted from the amount of loss to property in anyone occurrence resulting from the perils of Windstorm or Hail.
The sum of $50 shall be deducted from the amount of loss to property in anyone occurrence resulting from the perils of Smoke, Explosion, Riot, Riot
Attending a Strike or Civil Commotion, Aircraft or Vehicles, or Vandalism or Malicious Mischief.
This deductible shall apply separately to each building (including personal property therein), separately to personal property in each building if no
coverage is provided on the containing building and separately to personal property in the open (including within vehicles), The aggregate amount of
this deductible in anyone occurrence shall not exceed $1,000.
This deductible shall not apply to insurance covering Business Interruption, Tuition Fees, Extra Expense, Rent or Rental Value or Leasehold Interest.
This deductible shall not supersede any other deductible of more than $100.
III. The fOllowing clause is applicable to all propertie~ located in the Counties of Broward, Dade, Martin and Palm Beach and in all areas east of the west
bank of the Inter-Coastal Waterway in the Counfies of Indian River andSt. Lucie when this po/ityis extended to include-the Extended Coverage peril of Wind-
storm:
Windstorm Exterior Paint and Waterproofing Clause: It is hereby stipulated that coverage under this policy does not include damage caused in any manner
by windstorm to paint or waterproOfing material, applied to the exterior of the buildings or structures covered hereunder. The value of paint or water-
proofing material shall not be considered in the determination of the amount of deductible and the actual cash value when applying the Coinsurance Clause,
when loss is caused by windstorm.
CF 01 02 (Ed. 10 79)
<m
..
~ ..
1
c
IL 00 02
(Ed. 01 77)
EFFECTIVE TIME ENDORSEMENT
The time of inception and the time of expiration of this policy and of any schedule or endorsement attached shall be 12:01 a.m. standard time.
To the extent that coverage in this policy replaces coverage in other policies terminating noon standard time on the inception date of this policy,
coverage under this policy shall not become effective until such other coverage has terminated.
IL 00 02 (Ed. 01 77)
.r
I
I
"
!~ ..,
$
GENERAL PROPERTY FORM
CF 00 11
(Ed, 05 77)
Insurance applies only to item(s) specifically described in this policy for which an amount of insurance is shown and, unless otherwise provided, all
provisions and stipulations of this form and pOlicy shall apply separately to each such item.
When the insurance under this policy covers "Building(s)", "Personal Property of the Insured", or "Personal Property of Others" such insurance shall
cover in accordance with the following description(s) of coverage,
COVERAGE A-BUILDING(S): Building(s) or structure(s) shall include at- This coverage shall alsp include Tenant's Improvements and Betterments,
tached additions and extensions; fixtures, machinery and equipment con- when not otherwise specifically covered, Tenant's Improvements and Bet-
stiluting a permanent part of and pertaining to the service of the building; terments means the named Insured's use interest in fixtures, alterations,
yard fixtures; personal property of the named Insured used for the mainte- installations or additions comprising a part of the buildings occupied but
nance or service of the described building(s), inClUding fire extinguishing not owned by the named Insured and made or acquired at the expense of the
apparatus, outdoor furniture. floor coverings and appliances for refrigerat- named Insured exclusive of rent paid by the named Insured, but which are
ing, ventilating, cooking, dishwashing and laundering (but not including not legally subject to removal by the named Insured,
other personal property in apartments or rooms furnished by the named , ,
Insured as landlord); all while at the described locations, COVERAGE C-PERSONAL PROPERTY OF OTHERS: This Insurance shall
cover for the account of the owner(s) (other than the named Insured)
COVERAGE B-PERSONAL PROPERTY OF THE INSURED: Personal property personal property belonging to others in the care, custody or control of the
of the Insured means only bUSiness personal property, owned br the named named Insured, while (1) in or on the described buildings, or (2) in the open
Insured usual to the occupancy of the named Insured, Including bullion, (including within vehicles) on or within 100 feet of the described premises,
manuscripts, furniture, fixtures, equipment and supplies, not otherwise
covered under this policy, and shall also include the named Insured's loss shall be adjusted with the named Insured for the account of the
interest in personal property owned by others to the extent of the value of owner(s) of the property, except the right to adjust such loss with the
labor, materials and charges furnished, performed or incurred by the owner(s) is reserved to this Company and the receipt(s) of theowner(s) in
named Insured; all while (1) in or on the described buildinfs, or (2) in the satisfaction thereof shall be in full satisfaction of any claim by the named
open (including within vehicles) on or within 100 feet 0 the described Insured for which payment(s) has been made, This coverage shall not
premises, otherwise benefit the named Insured nor any carrier or other bailee,
DEBRIS REMOVAL: This insurance covers expense incurred in the removal of debris of the property covered, which mGY be occasioned by loss caused by any
of the perils insured against in this policy,
The total liability under this poliCy for both loss to property and debris removal expense shall not exceed the amount of insurance applying under this policy
to the property covered.
This Company shall not be liable for a greater proportion of such debris removal expense than the amount of insurance under this policy bears to the whole
amount of insurance covering the property against the peril causing the loss, whether or not other insurance covers such expense,
SECTION I-PROPERTY COVERED
A. THIS POLICY DOES NOT COVER:
1. Animals and pets;
2, Aircraft; watercraft, including motors, equipment and accessories
(except rowboats and canoes while out of water and on the described
prem i ses);
3. Growing crops and lawns;
4. Personal property while waterborne;
5. Property which is more specifically covered in whole or in part by
this or any other contract of insurance, except for the amount of loss
which is in excess of the amount due from such more specific
insurance;
6. Personal property in which parties other than the named Insured
also have an insurable interest, when the named Insured's interest in
said property is otherwise covered by insurance,
B. THIS POLICY DOES NOT COVER THE FOLLOWING PROPERTY UNLESS
SPECIFICALLY DESCRIBED ON THE FIRST PAGE OF THIS POLICY OR BY
ENDORSEMENT:
1. Vehicles designed for use on public thoroughfares;
THE ABOVE EXCLUSIONS SHALL NOT APPLY TO THE FOLLOWING PROPERTY WHEN HELD FOR SALE OR SOLD BUT NOT DELIVERED:
1. Animals and pets;
2, Watercraft,including motors, equipment and accessories, while not afloat;
3, Outdoor trees, shrubs and plants,
SECTION II-PROPERTY NOT COVERED
2. Outdoor signs, whether or not attached to a building or structure;
3, Outdoor trees, shrubs and plants, except as provided in Section
III-Extensions of Coverage;
4. Outdoor swimming pools; fences; piers, wharves and docks; beach
or diving platforms or appurtenances; retaining walls not constitut-
Ing a part of buildings; walks, roadways and other paved surfaces.
C. THIS POLICY DOES NOT COVER THE FOLLOWING PROPERTY WHEN SEC-
TION IV-COINSURANCE CLAUSE APPLIES, UNLESS ADDED BY ENDORSE"
MENT:
1. Cost of excavations, grading or filling;
2, Foundations of buildings, machinery, boilers or engines which
foundations are below the undersurface of the lowest basement floor,
or where there is no basement, below the surface of the ground;
3, Pilings, piers, pipes, flues and drains which are underground;
4, Pilings which are below the low water mark,
When the named Insured elects to apply the fallowing Extensions of Coverage:
A, The liability of this Company for loss in anyone occurrence, including loss under these Extensions, shall not exceed the amount of insurance applicable
to the coverage(s) being extended. except as provided under Extension No, 1.
B, This company shall not be liable for a greater proportion of any loss than would have been the case if all fire insurance policies covering the described
property had contained an identical Extension of Coverage and the same election were made under all such policies.
C, When there is other insurance, whether collectible or not, this Company shall not be liable for more than its pro rata share of the amounts set forth in
these Extensions of Coverage,
1. PERSONAL PROPERTY OF OTHERS: The named Insured may apply at loss shall be adjusted with the named Insured for the account of the
each location up to 2%, but not exceeding $2,000, of the amount of owner(s) ~f the property, ~xcept that the right to a~just such loss with the
insurance for Coverage B-Personal Property of the Insured at such loca- owner(s) !S reserved to thiS Company a.nd th~ receJpt(s) o~ the owner(s) In
tion as an additional amount of insurance to cover for the account of the satisfactIOn thereof shall be In full satisfactIOn of any claim by the named
' , , , , Insured for which payment(s) has been made, ThiS ExtenSion of Coverage
owner(s) (other than the named Insured), direct loss by a penl Insured shall not otherwise benefit the named Insured nor any carrier or other
against to personal property Similar to that covered by thiS POliCY, belong- bailee,
ing to others in the care, custody or control of the named Insured, while
(1) in or on the described buildings, or (2) in the open (including within
vehicles) on or within 100 feet of the described premises,
SECTION III-EXTENSIONS OF COVERAGE
(THIS SECTION IS APPLICABLE ONLY WHEN 80% OR HIGHER COINSURANCE CLAUSE APPLIES)
2. OFF-PREMISES: The named Insured may apply up to 2%, but not
exceeding $5,000, of the sum of the amount(s) of insurance for Coverage
A-Building(s) and Coverage B-Personal Property of the Insured at a
CF 0011 (Ed, 0577)
Page 1 of 4
described location, to cover direct loss by a peril insured against to such
property, other than merchandise or stock (raw, in process, or finished),
owned by the named Insured, while such property is temporarily removed
for purposes of cleaning, repairin'g, reconstruction or restoration,
This Extension of Coverage shall: (a) not apply to property in transit nor to
property on any premises owned, leased, operated or controlled by the
named Insured; (b) not apply except as excess over the amount due from
any other insurance covering the property, whether collectible or not;
(c) not directly or indirectly benefit any carrier or other bailee,
.-S~.---NEW[V- JC-QU1R-ElrPROl'EllTY:-' --' ---- - ------""--.,"~- - --- -----
A, The named Insured may apply up to 10%, but not exceeding
$25,000, of the amount of insurance for Coverage A-Building(s} to
cover direct loss by a peril insured against to the following described
property:
(l) New buildings and new structures being constructed on the
described premises and intended for similar occupancy. This
coverage shall cease 30 days from the date construction begins
or on the date the values of new construction are reported to
this Company, or on the expiration date of the policy, whichever
occurs first.
(2) Buildings acquired by the named Insured at any location,
elsewhere than at the described premises, within the fifty
states of the United States of America and the District of
Columbia and used by him for similar occupancies or warehouse
purposes. This coverage shall cease 30 days from the date of
such acquisition or on the date values of the buildings are
reported to this Company, or on the expiration date of the
policy, whichever occurs first.
B, The named Insured may apply up to 10%, but not exceeding
$10,000, of the amount of insurance for Coverage B-Personal Prop-
erty of the Insured to cover direct loss in anyone occurrence by a peril
insured against to such property at any location (except fairs and
exhibitions) acquired by the named Insured, elsewhere than at the
described premises, within the fifty states of the United States of
America and the District of Columbia, This coverage shall cease 30
daysfromJhedate.of such acquisitlon oron the date vaJuesat such
locations are reported to this Company, or on the expiration date of
the policy, whichever occurs first.
Additional premium shall be due and payable for values so reported from
the date construction begins or the property is acquired.
4. PERSONAL EFFECTS: The named Insured may apply up to 5%, but not
exceeding $500, of the amount of insurance for Coverage B-Personal
Property of the Insured to cover direct loss by a peril insured against to
personal effects while located on the described premises, belonging to the
___l1-ameG-_Il1-sured, -of-fiGer-s.-par-tMrS-M--em P IQY99S th9r9Qf ,---ami-limited.. to--
$100 on personal effects owned by anyone individual. This Extension of
Coverage does not apply if the loss is covered by any other insurance,
whether collectible or not, or which would have been covered by such other
insurance in the absence of this policy, At the option of this Company, loss
under this Extension of Coverage may be adjusted with and payable to the
named Insured,
5. VALUABLE PAPERS AND RECORDS: The named Insured may apply up to
5%, but not exceeding $500, of the amount of insurance for Coverage B-
Personal Property of the Insured at a described location to cover direct loss
by a peril insured against under this policy to valuable papers and records.
This Extension of Coverage covers only the cost of research and other
expense necessarily incurred by the named Insured to reproduce, replace,
or restore such valuable papers and records consisting of books of account,
manuscripts, abstracts, drawings, card index systems, film, tape, disc,
drum, cell and other magnetic recording or storage media for electronic
data processing, and other records, all the property of the named Insured
at such location(s),
6. OUTDOOR TREES, SHRUBS AND PLANTS: The named Insured may apply
up to 5%, but not exceeding $1,000, of the sum of the amount(s) of
insurance for Coverage A-Building(s} and Coverage B-Personal Property
of the Insured to cover outdoor trees, shrubs and plants at the location(s}
described in this policy against direct loss in anyone occurrence by the
perils of fire, lightning, explosion, riot, civil commotion or aircraft, but
only to the extent such perilS are insured against. This Company shall not
be liable for more than $250 on anyone tree, shrub or plant, including
debris removaL expense. -- - - ~
SECTION IV-COINSURANCE CLAUSE
(THIS CLAUSE VOID UNLESS A PERCENTAGE IS SPECIFIED IN THE APPROPRIATE SPACE ON THE FIRST PAGE OF THIS POLICY OR BY ENDORSEMEttT)
This Company shall not be liable for a greater proportion of any loss to the
property covered than the amount of insurance under this policy for such
property bears to the amount produced by multiplying the actual cash value
of such property at the time of the loss by the coinsurance percentage
applicable (specified on the first page of this policy, or by endorsement),
In the event that the aggregate claim for any loss is both less than $10,000
and less than 5% of the total amount of insurance applicable to the
property involved at the time such loss occurs, no special inventory or
appraisement of the undamaged property shall be required, providing that
nothing herein shall be construed to waive the application of the first
paragraph of this clause,
The value of property covered under Extensions of Coverage, and the cost of
the removal of debris, shall not be considered in the determination of
actual cash value when applying the Coinsurance Clause,
SECTION V-DEDUCTIBLE CLAUSE
The sum of $100 shall be deducted from the amount of loss to property in
anyone occurrence resulting from any of the perilS insured against. This
deductible shall apply separately to each building (including personal
property therein), separately to personal property in each building if no
coverage is provided on the containing building and separately to personal
property in the open (including within vehicles). The aggregate amount of
this deductible in anyone occurrence shall not exceed $1,000,
This deductible shall not apply to insurance covering Business Interrup-
tion, Tuition Fees, Extra Expense, Additional Living Expense, Rent or Rental
Value or Leasehold Interest.
SECTION VI-PERILS INSURED AGAINST
This poliCY insures against all direct loss caused by:
,. FIRE OR LIGHTNING,
2. REMOVAL, meaning loss by removal of the property covered hereunder
from premises endangered by the perils insured against, and the amount of
insurance applies pro rata for 5 days at each proper place to which such
property shall necessarily be removed for preservation from the perilS
insured against.
This policy is extended to insure against direct loss by
Windstorm, Hail, Smoke, Explosion, Riot, Riot Attending
A Strike, Civil Commotion, Aircraft And Vehicles as
hereinafter provided, only when premium for EX-
TENDED COVERAGE Is shown on the first page of this
polley or by endorsement.
3. WINDSTORM OR HAIL, excluding loss caused directly or indirectly by
frost or cold weather, or ice (other than hail), snow or sleet, whether driven
by wind or not.
A, This Company shall not be liable for loss to the interior of the
building(s) or the property covered therein caused:
(1) by rain, SIlOW, sand or dust, whether driven by wind or not,
unless the building(s} covered or containing the property cov-
ered shall first sustain an actual damage to roof or walls by the
direct action of wind or hail and then shall be liable for loss to
the interior of the building(s} or the property covered therein as
may be caused by rain, snow, sand or dust entering the build-
ing(s) through openings in the roof or walls made by direct
action of wind or hail; or (2) by water from sprinkler equipment
CF 00 11 (Ed, 0577)
.,!
,I
or from other piping, unless such equipment or piping be
damaged as a direct result of wind or hail.
B, This Company shall not be liable for Windstorm or Hail damage to
the following property:
(1) Windmills, wind pumps or their towers;
(2) Crop silos or their contents;
(3) Metal smokestacks; or
(4) When outside of buildings,
(a) Grain, hay, straw or other crops,
(b) Trees, shrubs or plants,
(c) Awnings of fabric or slat construction, canopies of
fabric or slat construction, including their supports,
(d) Radio or television antennas, including their lead-in
wiring, masts or towers,
4. SMOKE. meaning sudden and accidental damage from smoke, other
than smoke from agricultural smudging or industrial operations,
5. EXPLOSION, including direct loss resulting from the explosion of accu-
mulated gases or unconsumed fuel within the firebox (or combustion
chamber) of any fired vessel or within the flues or passages which conduct
the gases of combustion therefrom,
A, This Company shall not be liable for loss by explosion of steam
boilers, steam pipes, steam turbines or steam engines, if owned by,
leased by or operated under the control of the Insured,
B. The following are not explosions within the intent or meaning of
these provisions:
Page 2 of 4
I
.'
SECTION VII-EXCLUSIONS
I. 'LECTRICAl APPARATUS, Th', Com"" 'h," ,,' b.lI.hI. t" '"' I." S. POW" ""U"" ThI, C.m,,", ,h,,, ,,' b. lI,hI. ,,, '0" 0"'"
ffi" It", fro m '"' ., ,,',' 00 I '" j"" " """b '"" ,. """'00' 'PP' I,""" "'''''' " '"" '''''' by tho ",."" Ii" ., '0." " .th" "Ii Illy "Nk.
''''00', fin"" " .Ie, '. 00" ,,' by .,,,,,, 00 I '" "'"', .rt If' 0" II, .'"" - foe" i, h.' '0 th. ,,,,,' bo' '''ml", If 'h. '"''''' ,Ii," ',"" ",,, ,."
"., "" ,." fi" " '" ",,' "., os, '""", '"' 'h" thl, C.m"" ,h," b. 'rom th. ,,,,,"'" ,com' ",. If , ,"iI '"",,' '" i os, """ " th.
II ,hi. ,,, "" it, ,ro ,orti" ., ,,,' "',,' b, th. '""i". fi". '''''m", ,"ml ''', th " C.m,,", ,h." b. II' hi. I" "" '" "',ort ,,, .,
loss caused by the ensuing peri/.
2. .um,. CLAUS! (Not '''''''hI. " 'ew 'Plij, Th. .", "fi,," '" 'hi, 1. WAf an. ~hI, 0'''" ,,,II,, '0 ," ,,,ii, ,,",,' '.'ios' h.""",,,
poll 0' " '"'''''moot, · ""h.' h."" " "ot '" ,,, ,., ,. '"' '0" ,,' .."" I"' ,"ii, 0' fi", lI.h '"'"' '"' "m...1 .hI oh ". ofh".,,, ,,,_
'm b"" '"' I." ""Ii" " "",I", co "'Ii" " co" '''Ii" ""', m'",- .Id., t" " 'hi, poli,,). ThI, Com"" ,h,,, ,,' b. h, hi. ,,, I", ",,'"
tion, all whether controlled or uncontrolled, and loss by nuclear reaction or directly or indirectly by:
'"' ,." co""," " ,," '''Ii.. """m' ",Ii" " ,,' '" ''"'" ,. bo '"' " A. hos'iI. PI ."11 k. "Ii" '" lim. 0' '"'' " .", '"" ''',' "Ii"
'of '","ffi' '.. 'os, by th" 'olio, " "Id "'''"m,"", .h"h" '",h I." " hi"'""" "mb'Ii",,, ,.t"",. .","" '" "'''', 'm,,",,",
be direct or indirect, proximate or remote, or be in whole or in part caused or expected attack,
b,. ,,",,"" ,., ", " '"'' ",., b, "fi ffi" " '"' .th" ,,,ii, ,",,,,, (l) b, '"' ...,," m,"' " ""'"'' 'OW" (" loc. " ,. ,,,,.)..
""",, b, th" ,. h 0' " "Id '"'''''moo t" ho...", "bj,,' '0 'h. " b, '"' "th", Iy m,'"""" " "i". m iI.it,., ".." " ,Ie
foregoing and all provisions of this policy, direct loss by "fire" resulting forces; or
'rom ,"',." ''''''" " ""0"" "".Ii" " ""o"li" o"',m,,,,,,, " (~ by m'h'"" ",,' " ,', '"'''' "
insured against by this pOlicy.
(3) by an a~ent of any such government, power, authority or
forces, it being understood that any discharge, explosion or use
of any weapon of war employing nuclear fission or fusion shall
be conclusively presumed to be such a hostile or warlike action
by such a government, power, authority or forces;
B, insurrection, rebellion, revolution, civil war, usurped power, or
action taken by governmental authority in hindering, combating or
defending against such an Occurrence,
8. WATER EXCLUSION: This Company shall not be liable for loss caused
by, resulting from, contributed to or aggravated by any of the fOllowing:
A, flood, surface water, waves, tidal water or tidal wave, overflow of
streams or other bodies of water, or spray from any of the foregoing,
all whether driven by wind or not;
B, water which backs up through sewers or drains;
C. water below the surface of the ground including that which exerts
pressure on or flows, seeps or leaks through sidewalks, driveways,
foundations, walls, basement or other floors, or through doors,
windo'ws, or any other opening in such sidewalks, driveways, founda-
tions, walls or floors;
unless fire or explosion as insured against ensues, and then this Company
shall be liable for only its proportion of loss caused by the ensuing fire or
explosion,
..
,/
J
(1) Shock waves caused by aircraft, generally known as "sonic
boom",
(2) Electric arcing,
(3) Rupture or bursting of rotating or moving parts of maChinery
caused by centrifugal force or mechanical breakdown,
(4) Water hammer,
(5) Rupture or bursting of water pipes,
(6) Rupture or bursting due to expansion or swelling of the
contents of any building or structure, caused by or resulting
from water,
(7) Rupture, bursting or operation of pressure relief devices,
6. RIOT, RIOT AnENDINGASTRIKE OR CIVIL COMMOTION, including direct
loss by acts of striking employees of the owner or tenant(s) of the described
building(s) while occupied by said striking employees and shall also
include direct loss from pillage and looting occurring during and at the
immediate place of a riot, riot attending a strike or civil commotion. This
Company shall not be liable for loss resulting from damage to or destruc-
tion of property due to change in temperature or humidity or interruption of
operations whether or not such loss is covered by this policy as to other
perils,
7. AIRCRAFT DR VEHICLES, meaning only direct loss resulting from actual
physical contact of an aircraft or a vehicle with the property covered or with
the building(s) containing the property covered, except that loss by aircraft
includes direct ioss by objects falling therefrom,
This Company shall not be liable for loss:
A, by any vehicle owned or operated by an Insured or by any tenant of
the described premises;
B, by any vehicle to fences, driveways, walks, or when outside of
buildings, to trees, shrubs or plants;
C. to any aircraft or vehicle including its contents other than stocks
of aircraft or vehicles in process of manufacture or for sale.
3. NUCLEAR CLAUSE (Applicable in New York): This policy does not Cover
loss or damage caused by nuclear reaction or nuclear radiation or radioac-
tive contamination, all whether directly or indirectly resulting from an
insured peril under this pOlicy.
4. NUCLEAR EXCLUSION (Not applicable in New York): (This clause
applies to all perils insured against hereunder except the perils of fire and
lightning, which are otlrerwise provided for in the Nuclear clause above):
loss by nuclear reaction or nuclear radiation or radioactive contamination,
all whether controlled or uncontrolled, or due to any act or condition
incident to any of the foregoing, is not insured against by this pOlicy,
whether such loss be direct or indirect, proximate or remote, or be in whole
or in part caused by, contributed to, or aggravated by any of the perils
insured against by this pOlicy; and nuclear reaction or nuclear radiation or
radioactive contamination, all whether controlled or unControlled, is not
"explosion" or "smoke",
5. ORDINANCE OR LAW: This ,Company shall not be liable for loss, includ-
ing debris removal expense, occasioned directly or indirectly by enforce-
ment of any ordinance or law regulating the use, construction, repair or
demolition of property, unless such liability is otherwise specifically
assumed by endorsement.
I
The word "vehicles" means vehicles running on land or tracks but not
aircraft. The word "aircraft" shall include self-propelled missiles and
spacecraft,
This polley Is extended to Insure against direct loss by
Vandalism or MalicIous Mischief as hereinafter pro-
vIded, only when premium for VANDALISM AND MALI-
CIOUS MISCHIEF Is shown on the first page of thIs
pOlicy or by endorsement.
8. VANDALISM DR MALICIOUS MISCHIEF, meaning only the willful and
malicious damage to or destruction of the property covered.
This Company shall not be liable for loss-
A, to glass (other than glass building blocks) constituting part of a
building, structure or an outside sign;
B, by pilferage, theft, burglary or larceny, except that this Company
shall be liable for willful damage to the building(s) covered caused by
burglars in gaining entrance to or exit from the building(s) or any part
of the building(s);
C. by explosion of steam boilers, steam pipes, steam turbines or
steam engines, if owned by, leased by, or operated under the control
of the namedlnsured; or by rupture or bursting of rotating or moving
-parts of macliinery caused by centrifugal force Or mechanica'lbreak_
down;
0, from depreciation or deterioration;
f. resulting from change in temperature or humidity;
F. if the described building(s) had been vacant or unoccupied beyond
a period of 30 consecutive days immediately preceding the loss,
whether or not such period commenced p'rior to the inception date of
insurance against these perils; but a bUilding in process of construc-
tion shall not be deemed vacant or unoccupied, nor shall the unoccu-
pancy provision be applicable to private dwelling property, (The words
"vacant" and "unoccupied" are defined in Section IX, paragraph 8,)
SECTION VIII-VALUATION
The following bases are established for valuation of property:
t. All property at actual cash value, except as provided below or by
endorsement.
2. The value of all stock actually sold but not delivered shall be the price
at which it was sold, less all diScounts and unincurred expenses.
3. Tenant's Improvements and Betterments:
CF 00 11 (Ed, 05 77)
A. If repaired or replaced at the expense of the named Insured within
a reasonable time after loss, the actual cash value of the damaged or
destroyed improvement$ and betterments,
B. If not repaired or replaced within a reasonable time after loss,
that proportion of the original cOst at time of installation of the
damaged or destroyed property which the unexpired term of the lease
or rental agreement, whether written or oral, in effect at the time of
loss bears to the periods from the dates such improvements or
betterments were made to the expiration date of the lease,
C, If repaired or replaced at the expense of others for the use of the
named Insured, there shall be no liability hereunder.
4. Valuable Papers and Records:
A, Books of account, manuscripts, abstracts, drawings, card index
systems and other records (except film, tape, disc, drum, cell and
other magnetic recording or storage media for electronic data pro-
cessing) for not exceeding the cost of blank books, cards or other
blank material plus the cost of labor incurred by the named Insured
for transcribing or copying such records,
B, Film, tape, disc, drum, cell and other magnetic recording or
storage media for electronic data processing for not exceeding the
cost of such media in unexposed or blank form.
SECT-ION IX_O"THERuPROVISIONS-
,. APPORTIONMENT: This Company shall not be liable for a greater pro-
portion of any loss less the amount of the deductible, if any, from any peril
or perils included in this policy than (Al the amount of insurance under this
policy bears to the whole amount of fire insurance covering the property, or
which would have covered the property except for the existence of this
insurance, whether collectible or not, and whether or not such other fire
insurance covers against the additional peril or perils insured against
hereunder, nor (B) for a greater proportion of any loss less the amount of
the deductible, if any, than the amount hereby insured bears to all
insurance, whether collectible or not, covering in any manner such loss, or
which would have covered such loss except for the existence of this
insurance; except if any type of insurance other than fire extended to cover
additional perils or windstorm insurance applies to any loss to which this
insurance also applies, or would have applied to any such loss except for
the existence of this insurance, the limit of liability of each type of
insurance for such loss, hereby designated as "joint loss", shall first be
determined as if it were the only insurance, and this type of insurance shall
be liable for no greater proportion of joint loss than the limit of its liability
for such loss bears to the sum of all such limits, The liability of this
Company (under this policy) for such joint loss shall be limited to its
proportionate part of the aggregate limit of this and all other insurance of
the same type, The words "joint loss", as used in the foregoing, mean that
portion of the loss in excess of the highest deductible, if any, to which this
policy and other types of insurance above referred to both apply,
2. CONTROL OF PROPERTY: This insurance shall not be prejudiced by any
act or neglect of any person (other than the named Insured), when such act
or neglect is not within the control of the named Insured,
3. DIVISIBLE CONTRACT CLAUSE: If this policy covers two or more build-
ings or the contents of two or more buildings, the breach of any condition of
the policy in anyone or more of the buildings covered or containing the
property covered shall not prejudice the right to recover for loss occurring
In any building covered or containing the property covered, where at the
time of loss a breach of condition does not exist.
4. INSPECTION OF PROPERTY AND OPERATIONS: This Company and any
person or organization making inspections on the Company's behalf shall
be permitted but not obligated to inspect the named Insured's property and
operations at any time. Neither the right of this Company and any person or
organization to make such inspections nor the making thereof nor any
report thereon shall constitute an undertaking, on behalf of or for the
benefit of the named Insured or others, to determine or warrant that such
property or operations are safe or healthful, or are in compliance with any
law, rule or regulation,
5. LIBERALIZATION: If during the period that insurance is in force under
this policy, or within 45 days prior to the inception date thereof. on behalf
of this Company there be adopted or filed with and approved or accepted by
the insurance supervisory authorities, all in conformity with law, any
changes in the form attached to this policy by which this form of insurance
could be extended or broadened without increased premium charge by
endorsement or substitution of form, then such extended or broadened
insurance shall inure to the benefit of the named Insured hereunder as
though such endorsement or substitution of form had been made,
&. LOSS CLAUSE: Any loss hereunder shall not reduce the amount of this
policy. '
7. MORTGAGE CLAUSE (Not applicable in Minnesota): (Applies only to
building items and is effective only when poliCY is made payable to a
named mortgagee or trustee,)
Loss or damage, if any, under this policy, shall be payable to the mort-
gagee (or trustee), named on the first page of this policy, as interest may
appear, under all present or future mortgages upon the property herein
described in which the aforesaid may have an interest as mortgagee (or
trustee) in order of precedence of said mortgages, and this insurance, as to
the interest of the mortgagee (or trustee) only therein, shall not be invali-
dated by any act or neglect of the mortgagor or owner of the within
described property, nor by any foreclosure or other proceedings or notice of
sale relating to the property, nor by any change in the title or ownership of
the property, nor by the occupation of the premises for purposes more
hazardous than are permitted by this policy, provided, that in case the
mortgagor or owner shall neglect to pay any premium due under this policy,
the mortgagee (or trustee) shall, on demand pay the same,
CF 00 11 (Ed, 05 77l
,
I
Provided, also, that the mortgagee (or trustee) shall notify this Company of
any change of ownership or occupany or increase of hazard which shall
come to the knowledge of said mortgagee (or trustee) and, unless permitted
by this policy, it shall be noted thereon and the mortgagee (or trustee)
shall, on demand, pay the premium for such increased hazard for the term
of the use thereof; otherwise this policy shall be null and void,
This Company reserves the right to cancel this poliCY at any time as
provided by its terms, but in such case this policy shall continue in force
for the benefit only of the mortgagee (or trustee) for 10 days after notice to
the mortgagee (or trustee) of such cancellation and shall then cease, and
this Company shall have the right, on like notice, to cancel this agfeement.
Whenever this Company shall pay the mortgagee (or trustee) any sum for
loss under this policy and shall claim that, as to the mortgagor or owner,
no liability therefor existed, this Company shall, to the extent of such
payment, be thereupon legally subrogated to all the rights of the party to
whom such payment shall be made, under all securities held as collateral
to the mortgage debt, or may, at its option, pay to the mortgagee (or
trustee) the whole principal due or to grow due on the mortgage with
interest, and shall thereupon receive a full assignment and transfer of the
mort~age and of all such other securities; but no subrogation shall impair
the right of the mortgagee (or trustee) to recover the full amount of said
mortgagee's (or trustee's) claim.
8. PERMITS AND USE: Except as otherwise provided, permission is
gra nted:
A, to make additions, alterations and repairs, This poliCY insofar as
it covers building(s) or structure(s), is extended to cover additions,
alterations and repairs, when not otherwise covered by insurance,
including temporary structures constructed on site, materials, equip-
ment and supplies therefor on or within 100 feet of the described
premises; and this policy, insofar as it covers contents, is extended
to cover in such additions. This provision does not waive or modify any
of the conditions of the Automatic Sprinkler Clause, if any, attached
to this policy;
B, for such unoccupancy as is usual or incidental to the described
occupancy; but vacancy is limited to the 60 day period permitted by
the poliCY conditions ("Vacant" or "Vacancy" means containing no
contents pertaining to operations or activities customary to occu-
pancy of the building. "Unoccupied" or "Unoccupancy" means con-
taining contents pertaining to occupancy of the building while opera-
tions or other customary activities are sus-pendeC>>;
C. in the event of loss hereunder, to make reasonable repairs,
temporary or permanent, provided such repairs are confined solely to
the protection of the property from further damage, and provided
further that the named Insured shall keep an accurate record of such
repair expenditures, The cost of any such repairs directly attributable
to damage by any peril insured hereunder shall be included in
determining the amount of loss hereunder. Nothing herein contained
is intended to modify the policy requirements applicable in case loss
occurs, and in particular the reqUirement that, in case loss occurs,
the named Insured shall protect the property from further damage.
9. PROTECTIVE SAFEGUARDS: It is a condition of this insurance that the
insured shall maintain so far as is within his control such protective
safeguards as are set forth by endorsement hereto,
Failure to maintain such protective safeguards shall suspend this insur-
ance, onty as respects the location or situation affected, for the time of
such discontinuance.
10. PROVISIONS APPLICABLE ONLY WHEN THIS POLICY COVERS BUSINESS
INTERRUPTION, TUITION FEES, EXTRA EXPENSE, ADDITIONAL LIVING EX-
PENSE, RENT OR RENTAL VALUE, LEASEHOLD INTEREST OR OTHER CONSE-
QUENTIAL LOSS: The term "direct", as applied to loss, means loss, as
limited and conditioned in this policy, resulting from direct loss to
described property from the peril(s) insured against. If the business of the
owner or tenantls) of the described building(s) is interrupted by a strike at
the described location, this Company shall not be liable for any loss due to
interference by any person(s) with rebuilding, repairing or replacing the
property damaged or destroyed or with the resumption or continuation of
business,
11. SUBROGATION: This insurance shall not be invalidated should the
named Insured waive in writing prior to a losS any or all right of recovery
against any party for loss occurring to the property described,
Page 4 of 4
I
--
- - -
1
cl T Y 0 F C LEA R W ATE R
Interdep.rtment Correspondence Sheet
TO:
Lucille Williams, City Clerk
FROM:
Joseph R. McFate, Community Development
coordin.to'.- Me
COPIES:
SUBJECT:
Head Start Facility - 701 North Missouri Avenue
DATE:
November 21, 1979
r
'I"'~
~RECEIVEQ'
....,
NOV 26 1979
,CITy ,C~,
Attached, for your records, is the Certificate of Insurance for the above
stated facility.
snl
Attachment
~j
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
COMPANIES AFFORDING COVERAGES
Head Start Child Development &
Family Service
12351 - l34th Avenue North
Largo, Florida 33540
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LETTER
National Indemni ty Company
NAME AND ADDRESS OF INSURED
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. 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.
TYPE OF INSURANCE
POLICY NUMBER
POLICY
EXPIRATION DATE
Limits of Liability in Thousands
EACH
OCCURRENCE
GENERAL LIABILITY
o COMPREHENSIVE FORM
A ~ PREMISES-OPERATIONS
o EXPLOSION AND COLLAPSE
HAZARD
o UNDERGROUND HAZARD
o PRODUCTS/COMPLETED
OPERATIONS HAZARD
o CONTRACTUAL INSURANCE
o BROAD FORM PROPERTY
DAMAGE
o INDEPENDENT CONTRACTORS
o PERSONAL INJURY
BODILY INJURY
300
100
GLA 160106
11/7/80
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
PERSONAL INJURY
$
AUTOMOBILE LIABILITY
o COMPREHENSIVE FORM
DOWNED
o HIRED
o NON-OWNED
EXCESS LIABILITY
BODILY INJURY
(EACH PERSON)
BODILY INJURY
(EACH ACCIDENT)
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
$
o UMBRELLA FORM
o OTHER THAN UMBRELLA
FORM
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
WORKERS' COMPENSATION
ana-----
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES
School - 701 North Missouri Avenue, Clearwater, Florida
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail - days written notice to the below named certificate holder. but failure to
mail such notice shall impose no obligation or liability of any kind upon the company,
NAME AND ADDRESS OF CERTIFICATE HOLDER'
Office of Community Relations
City of Clearwater
P. O. Box 4748
Clearwater, Florida 33518
11/15/79
DATE ISSUED:
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time.
limits of liability in Thousands (
oCCG~~~NCE AGGREGATE
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
COMPANIES AFFORDING COVERAGES
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LETTER
Employers Insurance of Wausau
NAME AND ADDRESS OF INSURED
Head Start Child DeveiLopment and
Family Service
12351 - 134th Avenue North
Largo, Florida 33540
APR 4 1979
CLERK
TYPE OF INSURANCE
POLICY
EXPIRATION DATE
POLICY NUMBER
GENERAL LIABILITY
D COMPREHENSIVE FORM
D PREMISES-OPERATIONS
D EXPLOSION .AND COLLAPSE
HAZARD
D UNDERGROUND HAZARD
D PRODUCTS/COMPLETED
OPERATIONS HAZARD
D CONTRACTUAL INSURANCE
D BROAD FORM PROPERTY
DAMAGE
D INDEPENDENT CONTRACTORS
D PERSONAL INJURY
BODILY INJURY
PROPERTY DAMAGE $
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
PERSONAL INJURY
AUTOMOBILE LIABILITY
D COMPREHENSIVE FORM
DOWNED
D HIRED
D NON-OWNED
BODILY INJURY
(EACH PERSON)
BODILY INJURY
(EACH OCCURRENCE)
$
$
EXCESS LIABILITY
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
D UMBRELLA FORM
D OTHER THAN UMBRELLA
FORM
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
WORKERS' COMPENSATION
A
--141000- 051034 _c___ -~~ ~---
and
EMPLOYERS' LIABILITY
OTHER
371/80-----
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES
All Operations
State of Florida
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail _ days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER:
4/3/79
Ci ty Cle rk
City of Clearwater
P.o. Box 4748
Clearwater, FLorida 33518
DATE ISSUED:
- ,.
,
clrv OF CLEARWATER
Interdepartment Correspondence Sheet
TO:
Sue Lamkin, City Clerk's Office
FROM:
Joseph R. ~cFate, Community Development Coordinator
COPIES:
SUBJECT:
Head Start Facility - 701 North Missouri Avenue
DATE:
November 21, 1978
~. <6) Y
-RECEIVED
NOV 22 1973
~~,{1t ~'R;S:'IL1!.
Attached, for your records, is an additional copy of the Certificate of Insurance
for the above mentioned facility.
v
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
NAME AND ADDRESS OF INSURED
Head Start Child Development & Family
Service
12351- 134th Avenue North
Largo, Florida 33540
COMPANIES AFFORDING COVERAGES
COMPANY
LE ITEr
A
B
C
o
E
National Indemnity Company
This is to certify that policies of insurance listed below have been Issued to the insured named above and are in force at this time.
limits of liability in ThousandsJOO~_.
occ fJ~(k~ NC EAGG REGATE
TYPE OF INSURANCE
POLICY NUMBER
A
GENERAL LIABILITY
~] COMPREHENSIVE FORM
pr,EMIS ES.--OPERA nONS
[J EXPLOSION AND COLLAPSE
HAZARD
o UNDERCROUND HAZARD
D PRODUCTS/COMPLETED
OPERATIONS HAZARD
o CONTRACTUAL INSURANCE
o BROAD FORM PROPERTY
DAMAGE
o INDEPENDENT CONTf<ACTORS I
o PERSONAL INJURY
GLA 148766
AUTOMOBILE LIABILITY
o COMPREHENSIVE
DOWNED
D HIRED
o NON OWNED
FOI1M
-l- EXCESS LIABILITY
o UMBRELLA FORM
-J 0 ClTHERTHAN UMBRELLA
FORM
-- - -
IWQRKERS'~~:PEN~A~~IQN
EMPLOYERS' LIABILITY
~------~----- --"
OTHER I
I
i
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
COMPANY
LETTER
COMP,'NY
I_E'Ttn
=Jr~P,\NY
LETTER
COMPANY
LETTER
F'OLlCY
IXf'IRATION DATE
11/7 /79
:------
BODILi INJURY 300
100
PROPERTY DAMAGE
BODilY iNJURY AND
PROPERTY DAMAGE
COMBINED
PEliSONAL INJURY
BODILY INJURY
(EAC H PERSON)
BODILY INJURY
(EACH OCCUrmENCE)
PROPERTY DAMAGE
BODILY INJUIiY AND
Pl10PERTY DAMAGE
,OM8INED
BODILY INJURYOND
PROF'ERTY DAMA(;E
COMBINED
School - 701 North Missouri Avenue, Claarwater, Florida
Cancellation: Should any of the above deSCribed policies be cancelled before the expiration date thereof. the Issuing com-
pany will endeavor to mail _ days written notice to the below named certificate holder. but failure to
mall such notice shall Impose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER:
Office of Community Relations
City of Clearwater
P.O. Box 4748
Clearwater, Florida 33518
(Attn: Joseph McFath)
I
I
DATE ISSUED
)
'7--~1 Y
clv OF CLEARWATER
Interdepartment Correspondence Sheet
TO:
Sue Lamkin, City Clerk's Office
Joseph R. HcFate, Community Development Departmen~
FROM:
COPIES:
SUBJECT:
Head Start Facility - 701 North llissouri Avenue
DATE:
November 14, 1978
Attached is the Certificate of Insurance showing the renewal of coverage for
the above mentioned facility. Please include in your file to show this
requirement has been met.
sn/
Attachment
West Coast Insurors, Inc.
P. O. Box 10340
St. Petersburg, Florida 33733
COMPANIES AFFORDING COVERAGES
-~_._._------._------_._---
Head Start Child Development & Family
Service
12351 - 134th Avenue North
Largo, Florida 33540
COMPANY A
LETTER
COMPANY B
L E TTE R
COMPANY C
~fTTER
COMPANY 0
LETTER
COMPANY E
LETTER
National Indemnity Company
NAME AND ADDRESS OF INSURFD
ThiS is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time.
w" " ""c'^,,, eo",,,",,,, ,,,,,~i~~' OM' lim;t, of li.billty ;ci.~~;:::l:J:,~~,:" " .
GENERAL LIABILITY [JOllILY INJUIlY $ 300 $
[J COMPREHENSiVE Fr)llM Renewal of
A XX] PREMISES--OPERATIONS GLA 123048 11/7/79 PROPERTY DAMAGE $ 100 $
o EXPLOSION ,~ND COLLAPSE
. HAZARD
o UNDERGROUND HAZARD
o PRODUCTS/COMPLETED
OPERATIONS HAZARD
o CONTRACTUAL INSURANCE
10 BROAD. FORM PROPERTY
DAMAGE
,0 INDEPENDENT CONTRACTORS
o PERSONAL INJURY
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
PERSONAL INJURY
AUTOMOBILE LIABILITY
o COMPREHENSIVE FORM
DOWNED
o HillED
[J NON.OWNED
t-
BODILY INJURY
I rEACH PERSON)
I BODILY INJURY
I[~CH OCCURRENCE)
f---,
PROPERTY DAMAGE
EXCESS LIABILITY
i---------1.
j 80[>11 Y INJURY ~ND
PROP, RTY DAMAGE
_ ___~ OMBiNI~~___
S) /\-'..J.L.)R1 _
BODILY INJURY AND
PROPERTY DAMAGE
::OMBINED
o UMBRELLA FORM
o Of HER THAN LIMB RELLA
FORM
WORKE'!S~COMPENS~ATIO.N~ __
and
EMPLOYERS' LIABILITY .
OTHER
I
I
-+--
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
School:
701 North Missouri Avenue, Clearwater, Florida
Cancellation: Should any of the above descnbed poliCies be cancelled before the eXpiration date thereof. the Issuing com-
pany Will endeavor to mail - days written notice to the below named certificate holder, but failure to
mail such notice shall Impose no obligation or liability of any kind upon the company,
.---~---~----------,--
FM~;;~:ES~~ C~~:::~O~;RRelations
i City of Clearwater
i ~i O. Box 4748
~earwater, Florida
33518
(Attn:
11/13/78