The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (2) A COROTM CERTIFICATE OF LIABILITY INSURANCE DATE IMM/DDIYY) 10/03/03 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 ACaRDIA EAST - TAMPA BAY P.O. Box 31666 Tampa, FL 33631-3666 727-796-6666 INSURERS AFFORDING COVERAGE INSURED INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: ZURICH-AMERICAN-09593 ZENITH INSURANCE CO-DB PACT, Inc., Performing Arts Center Foundation, Inc. 1111 McMullen Booth Road Clearwater FL 33759 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..~gY EFFECTIVE Pgk!fEY'~~!~~J.J~~ LIMITS A ~NERAL LIABILITY CP0278060500 10/01/03 10/01/04 EACH OCCURRENCE $ 1000000 X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100000 ~ CLAIMS MADE W OCCUR M ED EXP (Anyone person) $ 10000 f-- f-- PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 f-- n'L AGGREn LIMIT AP~ PER: PRODUCTS - COMP/OP AGG $ 2000000 POLICY ~~RT X LOC A ~TOMOBILE LIABILITY CP0278060500 10/01103 10/01/04 COMBINED SINGLE LIMIT (Ea accident) $ 1000000 f-- ANY AUTO f-- ALL OWNED AUTOS BODILY INJURY $ ~ SCHEDULED AUTOS (Per person) ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) f-- PROPERTY DAMAGE $ (Per accident) RAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ A EXCESS LIABILITY UMB9376789 10/01/03 10/01/04 EACH OCCURRENCE $ 10000000 tijOCCUR 0 CLAIMS MADE AGGREGATE $ 10000000 $ R DEDUCTIBLE $ RETENTION $ $ B WORKERS COMPENSATION AND _ Z83f;l.Q94210__ ,.J/OJJQ3 '. l/O,JL04 _ x~~~SlliU- I IOTH- -~ ,- .. -- . Y ITS ,ElL, EMpLOYERS'I.IAB1LlTY-- - E.L. EACH ACCIDENT $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CITY IS ADDITIONAL INSURED AS OWNER/LESSOR OF PREMISES o t<--l6:. (!):. ~ Cfu... 2J.< <:!..- C!.. ~ Kt S K ( p,~~~> * 1 0 DAYS NOTICE OF CANCELLATION APPLIES FOR NON PAYMENT, * CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN ATTN: LEO SCHRADER, RISK MGMT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL POBOX 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR CLEARWATER FL 33758-4748 REPRESEJt[ATIVES, I AUTH A~~A I c.-,..... ~ ...." . - ACORD 25-S (7/97) 46- 64 @ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(sl, authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25-5 (7/97) :-.Aiii'ilij.:....::.~.~:EI.I~I.EII:I::::::I:I:::::::11I'I:I:III::::::II:I:IIII:I:I:~::::~:::':::::::::::.::::::::~::.:::::.::....,~:::~~::::,:::,:~::."'~ATE IMM/DDNYI ....><,<<.:::::.:::: .'.....,..,. ..... .........:.:..,,:;....:':/\.. .'.. ..........., ....... :i::.:.:.. .. ..:., :?: '.. "::::::::::.i'it:::::. :. .. :...:..:.} . .:.: :,..\.::\..:: :.. .:::))))))))):)::.<.,' 10/03/03 THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND PRIVILEGES AFFORDED UNDER THE POLICY. PRODUCER 727-796-6666 COMPANY Acordia Southeast, Inc. PO Box 31666 Tampa, FL 33631-3666 ZURICH AMERICAN CODE: 09-1 031 50 ~3~~g~ER 10 #: PER54440 INSURED SUB CODE: PACT, Inc., Performing Arts Center Foundation, Inc. 1111 McMullen Booth Road Clearwater FL 33759- EFFECTIVE DATE 10/01/03 EXPIRATION DATE 10/01/04 CONTINUED UNTIL TERMINATED IF CHECKED LOAN NUMBER POLICY NUMBER CP0278060500 THIS REPLACES PRIOR EVIDENCE DATED: 10/03/03 .......... ........... ................. .. ........ M6~~l,jtt~:]~l#.6,rt.MAjfI6tii.)))::::::::::::::::::::::::::::. .. .. ... ... .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .............................. ............................... . . . . . . . . . . . . . . . . . . . . . . . . . ................................... .................................. ................................... ..... ::::::::;:::;:::::;:::;:::::::::::::::::::::::::::::::::::::::::::::: . . . . . .. ............. ..................... ..................... ..................... ..................... ..................... . . . . . . . . . . . . . . . . . . . .................... .................... . . . . . . . . . . . . . . . . . . . . .................... ........................ ..... .................... ........................ ..... ............. .................. ................................................ .... ..... ...... . ..... ........... .......................... .............. .. ............................. ............,.......................... .. .. ..... .................................. .................................................................................................. ................................. .................................................................................................., .................................. LOCATION/DESCRIPTION 1111 MCMULLEN BOOTH RD (RUTH ECKERD HALL) CLEARWATER FL 34619 COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE BUILDING - ALL STRUCTURES BUILDING WIND & HAIL DEDUCTI8LE, MIN 25,000 CONTENTS - ALL STRUCTURES CONTENTS WIND & HAIL DEDUCTIBLE, MIN 25,000 24925000 5000 2% 1226000 5000 2% 5000 FLOOD 5000000 50000 SPECIAL FORM REPLACEMENT COST AGREED AMOUNT R~M.Afl(<.$.Ji.rwl.ij~i.ijg$~~I.:<<~ij~~ ... ... .. .. .............................................. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .............. .............. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ........................ .................... ........................ . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .................... ..................... ................. ................... ................... ................... ................... ................... ................... ................... ................... ................... ................... .... ................... ..................... .................... ..................... .................... ..................... .................... ..................... .................... ..................... CITY IS ADDITIONAL INSURED AS OWNER/LESSOR OF PREMISES ~0: ~~CC~~~ c.. (: (2-( S IL ( P AR-(L :; * 1 0 DAYS NOTICE OF CANCELLATION APPLIES FOR NON PAYMENT. * CITY OF CLEARWATER ATTN: LEO SCHRADER, RISK MGMT POBOX 4748 CLEARWATER FL 33758-4748 , . . . . . . , , , . , . . . . . . . . , , , , . . . . . I . ' , , ' , , , ' . ~A<<Q.~~:~1~l~/l:f$.k . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .............................. ............................. ....................... .................... .................. AUTHORIZED REPRESENTATIVE .. fNii~!JiJj~:.~;~A~~