CERTIFICATE OF LIABILITY INSURANCE (5)
05/1 2 . ~Q/ ~ "~--ti\o.mQac~ _
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ACORDm CERTIFICAtE OFLIABILITV INSURA ~CE U bATE (UM/DDIYV)
, - 05/18/2001
PRODUCER THIS OERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MITCHELL AGENCY INe ONLY AND CONFERs NO RIGHTS UPON THE CERTIFICATE
14290 WALSINGHAM RD HOLDER. THIS OERTlFICATE DOES NOT AMEND, EXTEND OR
LARGO FL 33774 ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW.
727-595-252' INSURERS AFFORDING COVERAGE
INSURED Pickels Plus Too, Inc. INSURER A: Old Dclminion Insut'ilnce COIllPan\'
320 Cleveland Street INSURER B:
Clell""ate1' Fl 33759 INSUREA C:
INSURER D:
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE1 LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABovE FOR THE POLIcy PERIOD INDICATED. NOiWlTHSTANDING
ANY AEaUIREMENT, TEJ:lM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THiS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCe AFFORDED BY TI-IE POLICIES DESCRIBED HEREIN IS SUBJECT To ALL THE TERMS. EXCLUSIONs AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAJMS.
II~':: lYPE OF INSURANCE PoLICY NUMBER ~~CVIU~ Pgkl~v J.Xr.t~~N LIMITS
~NEAAL LIABILITY EACH OCCURRE:NCE $ 500,00
X COMMERCIAL GENERAL UABIUlY FIRE DAMAGE (Arly one fire) $ 50,00
l CLAIMS MADE W OCCUR ME:O ex;> (Anyone person) $ 5.00
A BPQ15254 04/24/2001 04/24/2002 PERSONAL & ADV INJURY S 1.000,00
I--
G~NERALAOGREGATE $ 1,000,00
~'LAOORnE UMI'T nS PER: PAODUC'IS - COMP/OP AGG $ 1 000,00
POUCY ~~ LOC
~TOM08ILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO tea aoddent)
-
- ALL OWNED AUTos BODILY INJURY
$
SCHEDULED AUroS (per p..,",on)
-
I-- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (per accident)
I--
PFlOPERTY DAMAGE $
(per BGCldent)
~I'lAGE LIABILITY AUTO ONLy - EA ACCIDENT $
ANY AUTO OTHEH THAN Ell. ACC &I
AUTO ONLY: AGG $
OESS LIABILllY EACH OCCURRENCE &I
OCCUR 0 ClAlMS MADE AC3GAEGATE $
S
q DEDUCTIBLE $
RETENTION $ $
WORKERS COMPI!NSATlON AND I ~s;r~WR I IOJ~-
EMPLOVEfls' L1ABIUTY EL EACH ACCIDENT $
e.L DISEASE - EA EMPLOYEE 1&
EL DISEAse - POLICY UMIT $
OTHER
DESCIIl1'110N OF OPERATtONeILOCATlONS/VEHICLESJEXQ.USIONS ADDED BY ENDORSEMENT/SPEClAL PROVISIONS
OERTIFICATE HOLDER I X 1 ADDlnONAL lNSIIFlEDj INSURER LEtreIl: A CANCELLATION
City of Clea~ter SHOULD ANY OF THE ABOVE DEsCftlBED POLlCI~ BE CANCEllED BEFORE THE EXPIAATION
P.O. Box 4748 DATE THEFlEOF. THE ISSUING lMoURER WILL ENb..AVOR TO MAIL ~ DAVS WRITTEN
Clean/ate!' Fl 33758-4748 NOTlCETO THE CEiRTIFlCATE HOlDER NAMED TO ,...... LEFT, BUT FAIL.uRE TO DO SO S"ALL
Attn: Parks and Recreation Dept. IMPOl;I! NO OBLIGATION OR liABILITY OF AtfY KIND UPON T1iE INSURER, l'l<i A<rlENTS OR
REP ... - ~
AUTHORIl:~~EN",,\:~ ~~ '~.A'
I - - -~
ACORD 25.8 (7/97) I @ACORD CORPORATION 1988
81 001 0'3 50
7275'366'382
MITCHELL AGENCY INC
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