CERTIFICATE OF LIABILITY INSURANCE (5)
CERTIFICATE OF LIABILITY INSURANC~oN8t~~
ACORD~
DATE (MMlDDIYY)
01/16/03
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
The Connelly Insurance Group
630 Chestnut Street
P.O. Box 2456
Clearwater FL 33757-2456
Phone: 727-461-6044 Fax:727-442-7695
INSURERS AFFORDING COVERAGE
The Long Center
1501 N. Belcher Road, Ste. 225
Clearwater FL 34625
INSURER A:
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
General Insurance Company
SAFECO Insurance Company
Auto Owners
INSURED
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 ~'r~~~r;~7-l.}YE Pd'.k+~~rl;?<Pl~?N LIMITS
DATE MMlDDIYY
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
f-- 10/15/02 10/15/03
A X COMMERCIAL GENERAL LIABILITY CP7771258 FIRE DAMAGE (Anyone fire) $ 200,000
I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $10,000
PERSONAL & ADV INJURY $1,000,000
-
GENERAL AGGREGATE $3,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $3,000,000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
f-- $1,000,000
C X ANY AUTO 43-064-690-00 10/15/02 10/15/03 (Ea accident)
f--
ALL OWNED AUTOS BODILY INJURY
f-- $
SCHEDULED AUTOS (Per person)
f---
HIRED.AUTOS BODILY INJURY
f-- (Per accident) $
NON-OWNED AUTOS
f---
X Comp $100 ded PROPERTY DAMAGE
f-- $
X ColI $250 ded (Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $5,000,000
B ~ OCCUR D CLAIMS MADE OL7771258 10/15/02 10/15/03 AGGREGATE $5,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND I TORY L1MrrS I IUER-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
E.L. DISEASE. EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSlVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITRE-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRA nON
City Recreation & Parks Dept. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ...3.L DAYS WRITTEN
Municipal Services Building NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Attn: Debbie IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
100 South Myrtle Avenue
Clearwter FL 33756 REPRESENTATIVES.
AUTHORIZEn b?~ ~
I ~
. -
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ACORD 25-S (7/97)
@ACORDCORPORATION 1988