CERTIFICATE OF LIABILITY INSURANCE (4)
Carlisle Fields & Company,
P.O. Box 7910
Clearwater FL 33758-7910
Phone: 727-797-0441
Inc
OP ID MK
YOUNG-8 06/18/03
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.
DATE (MM/DDfYY)
ACORD,.
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Fax: 727-725-3663
INSURERS AFFORDING COVERAGE
INSURED
INSURER A;
Zenith Insurance Company
INSURER 8:
Young Women's Christian Assn
Of Tampa Bay
655 Second Avenue South
St. Petersburg FL 33701
INSURER c:
INSURER 0;
INSURER E:
COVERAG.ES
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 CONDlT1ONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR POLICY EFFECTIVE POLICY EXPIRATION
LTR TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDNY) DATE (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
-
COMMERCIAL GENERAl LIABILITY FIRE DAMAGE (Anyone fire) $
I CLAIMS MADE D OCCUR MED EXP (Anyone peraon) $
- .... PERSONAL & ADV INJURY $
-
GENERAL AGGREGATE $
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $
I POLICY n PRO- nLOC
JECT
AUTOMOBilE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Eaaccldent)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Peraccldem)
-
- PROPERTY DAMAGE $
(Per ecddent)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=1 ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
:=J OCClJR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND I WCS~~T.U-l:' I 10TH-
-. EM'PLOYERS' LiABILiTY-"" ---~. . ---- - --- -------- ."~-
A BINDER-76ll 06/24/03 06/24/04 E.L. EACH ACCIDENT $ 500,000
E.L. DISEASE. EA EMPLOYEE $ 500,000
E.L. DISEASE. POliCY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVlStONS
The certificte holder is listed aslessor/additional insured.
*30 Days Cancellation applies to Worker's Compensation Policies, 10 Days
Cancellation for all other policies - Applies to Florida Employees Only.
CERTIFICATE HOLDER I y I ADDITIONAL INSUREDj INSURER LETTER: CANCELLATION
CITYCLR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
-
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
CITY OF CLEARWATER, FLORIDA
612 Franklin St REPRESENTATIVES.
Clearwater FL 33765-5414 ~"fJ ( )!:'h I ~ 10
I
ACORD 25-S (7/97) v V" . -- @ACORD Cdm"ORATION 1988