CERTIFICATE OF LIABILITY INSURANCE (9)
...,
01/06/2005 01:05:24 PM
Karen Thorp
FAX SERVER
Page 2
PRODUCER
Aon Risk Services,
200 East Randolph
chicago IL 60601
Inc, of Illinois
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) DATE (MM/DD/YV
'.>)01/06/05
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,
COMPANIES AFFORDING COVERAGE
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PHONE. (866) 283-7122 FAX _ (847) 953-5390
INSURED
Manufactured Home communities, Inc.
2 North Riverside Plaza
Chicago IL 60606-2617 USA
COMP ANY
A
Firemans Fund Ins Co
COMPANY
B
Lexington Insurance Company
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COMP ANY
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COMP ANY
D
THIS IS TO CERTIFY THAT 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,
co
LIR
B GENERAL LIABILITY
TYP~ m'INSURANCE
POLICY NUMBER
02/28/04
LIMITS
N
02/28/05 \0
$10,000,000 00
00
RODUCTS - COMP/OP AGG $1,000,000 c:n
N
N
PERSONAL & ADV INJURY $1,000,000 .-i
0
0
EACH OCCURRENCE $1,000,000 I'-
In
FIRE DAMAGEIAnv one fire) $50,000 0
MED [)(P (Anv one person) Z
$
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COMBINED SINGLE LIMIT y
=
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Q,I
BODILY INJURY U
(Pel' person)
BODILY INJURY
(Per accident)
PROPERW DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THA~I AUTO ONLY
02/28/05 ACH UCCURRENCE
AGGREGATE
0716127
X COMMERCIAL GENERAL LlABILlW
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
Aggl'ega.te
A EXCESS LIABILITY
X UMBRELLA FORM
XYZO0076205905
02/28/04
OTHER THAN UMBRELl.A FORM
WORKER'S COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETORI
P ARTNERSIEXECUTIVE
OFFICERS ARE
INCL
EXCL
EL DISEASE POLICY LIMIT
EL DISEASE-EA EMPLOYEE
city of Clearwater
Attn: Mr. Earl Barrett
Real Estate Service Manager
P.O. Box 4748
Clearwater FL 33768-4748 USA
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
DESCRipTION OF OPERATIONSILOCATIONSNEHICLESlSPECIAL ITEMS
certificate Holder is Additional Insured with respect to General Liability as it pertains to: part of the southeast
1/4 of section 19, Township 27 south, Range 17 East, Hillsborough county, FL.
EXPIRATION DATE TIIEREOF, TljE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOT":E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUTF AlLURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY I<INO UPON Tile COMPANY ITS AGeNTS OR REPRESENTATIVES
AUTHORIZED REPRESENTATIVE
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