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CERTIFICATE OF LIABILITY INSURANCE (7) ACORDN CERTIFICATE OF LIABILITY INSURANCE OP 10 DATE (MMlDDIYYYY) YOUNG-8 10 05 04 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 COVEMGE AFFORDED BY THE POLICIES BELOW. PRODUCER Carlisle Fields & Company, Inc P,O, Box 7910 Clearwater FL 33758-7910 Phone:727-797-0441 Fax:727-725-3663 INSURED INSURERS AFFORDING COVERAGE NAIC# Young Women's Christian Assn Of T~a Bay 655 Second Avenue South 8t, Petersburg FL 33701 INSURER A: INSURER B: INSURER C: INSURER 0: INSURER E: Zenith Insurance Co an Markel Insurance Co an Pro ressive Commercial 10193 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, NSR[ POLICY NUMBER POL E 1"2~EY,EX%~N LIMITS LTR TYPE OF INSURANCE DATE IMMlDDIYYI DATE"IMMID GENERAL LIABILITY EACH OCCURRENCE $1000000 f-- B COMMERCIAL GENERAL LIABILITY 3602S8258399 10/01/04 10/01/05 PREMISES lea occurence) $100000 r-- :=J CLAIMS MADE [!] OCCUR f-- MED EXP (Anyone person) $ 500.0 PERSONAL & AOV INJURY $1000000 r-- GENERAL AGGREGATE $3000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $3000000 n n PRO. nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1000000 - C ANY AUTO 04743612-1 10/01/04 10/01/05 (Ea accident) - ALL OWNED AUTOS BODILY INJURY - $ ~ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per acddent) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==I. ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1000000 B :=J OCCUR D CLAIMS MADE 46028S258161 10/01/04 10/01/05 AGGREGATE $1000000 $ ==I DEDUCTIBLE $ RETENTION $10000 $ WORKERS COMPENSATION AND !TORY LIMITS I IU~~. A EMPLOYERS' LIABILITY Z049904501 06/24/04 06/24/05 E,L EACH ACCIDENT $500,000 ANY PROPRIETORlPARTNERlEXECUTNE OFFICER/MEMBER EXCLUDED? EL DISEASE. EA EMPLOYEE $500,000 ~~~~tS~~J:~1~NS below EL DISEASE. POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS '04 OCT B AM11:31 CERTIFICATE HOLDER Howie Carroll Asst Dir of Housing City of Clearwater City Hall 112 S, Osceola Avenue 1 FL Clearwater FL 33758-4748 CANCELLATION CITYC -1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRITTEN NOTICE TO THE CERTlRCATE 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 REPRESENTATIVES. AUTHORIZED REP PORATION 1988 ACORD 25 (2001/08) ACORD.. CERTIFICATE OF LIABILITY INSURANCE OP ID R DATE (MM/DDIYYYY) YOUNG-8 10 05 04 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 Carlisle Fields & Company, Inc P,O, Box 7910 Clearwater FL 33758-7910 Phone: 727-797-0441 Fax:727-725-3663 INSURED INSURERS AFFORDING COVERAGE NAIC# Young Women's Christian Assn Of Tampa Bay 655 Second Avenue South St, Petersburg FL 33701 INSURER A: INSURER B: INSURER C: INSURER 0: INSURER E: Zenith Insurance Company Markel Insurance Company Progressive Commercial 10193 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, LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD~~~lJ~rJIr~E Pgk~CEY(rJ,~~~N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - B COMMERCIAL GENERAL LIABILITY 3602SS258399 10/01/04 10/01/05 PREMISES (Ea occurence) $ 100000 I CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 3000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $ 3000000 I n PRO. nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1000000 C ANY AUTO 04743612-1 10/01/04 10/01/05 (Ea accident) - ALL OWNED AUTOS BODILY INJURY - $ ~ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY - $ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1000000 B ~ OCCUR D CLAIMS MADE 4602S8258161 10/01/04 10/01/05 AGGREGATE $ 1000000 $ ~ DEDUCTIBLE $ RETENTION $10000 $ WORKERS COMPENSATION AND . ITORY LIMITS I IU~~- -A EMPLOYERS' LIABILITY Z.Q49.90-45-0J.--__._.___ __ -o.6.j2 4,lJl.4. f---CUii2A.iD.5- -.1.5.O_Q ,JlOlt_ . ANYPROPR1ETORlPARTNERlEXECUTIVE --- E.LEACJ:!M&1l200-_.__ OFFICER/MEMBER EXCLUDED? E.L DISEASE. EA EMPLOYEE $500,000 If yes, describe under E.L. DISEASE. POLICY LIMIT $500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITY005 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ 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 Risk Mgt Pat Fernandez PO BOX 4748 Clearwater FL 33758 PORATION 1988 ACORD 25 (2001/08)