CERTIFICATE OF LIABILITY INSURANCE (8)
From: Terry Goltry At: Carlisle Fields & Company FaxID: 727-725-3663 To: Ms, Patti Bacha
Date: 6f23f2005 04:22 PM Page: 2 of 2
ACORD. CERTIFICATE OF LIABiliTY INSURANCE CSR sc I DATE (MMlDDNVVV)
YOUNG-8 06/23/05
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 7910 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater r.L 33758-7910
Phone: 727-797-0441 Fax: 727-725-3663 INSURERS AFFORDING COVERAGE NAlC #
INSURED INSUlER A Zenith Insurance Company
INSURER B: Markel Insurance Company
Young Women's Christian Assn INSURER c' Progressive Commercial 10193
Of T~a BaX
655 Se ond ~enue South INSURER D:
st. Petersburg r.L 33701
INSUlER E:
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 NSRC 'M'E OF INSURANCE POLICY NUMBER I I'D~WlriMltf8~" DATE (MMlDDIYY) LIMITS
GENERAL LIABILIlY EACH OCCURRENCE $lQOOOOO
-
B X .~ COMMERCIAL GENERAL LIABILITY 3602S8259399 .. 1.0/01/04 10/01/05 I PREMISES (E';,~~~~~~ence) $ 100000
- tJ CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
PERSONAL & />DV INJURY $ 1000000
-
- GENERAL AGGREGATE $ 3000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3000000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILIlY COMBINED SINGLE LIMIT
- $ 1000000
C ANY AUTO 04743612-1 10/22/04 10/22/05 (Ee eccident)
f-
ALL OWNED AUTOS BODILY INJURY
I-- $
~ SCHEDULED AUTOS (Per person)
HIRED AUTOS BODIL Y iNJURY
f- $
NON-OWNED AUTOS (Per eccident)
I--
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILIlY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESSIUMBRELLA LIABILIlY EACH OCCURRENCE $ 1000000
B tJ OCCUR o CLAIMS MADE 4602SS258161 10/01/04 10/01/05 AGGREGATE $ 1000000
$
R DEDUCTIBLE $
RETENTION $10000 $
WORKERS COMPENSAllDN AND ITORy'l.IMI'T's I IVER
A EMPLOYERS' LIABILIlY Z049904503 06/24/05 06/24/06 $500,000
ANY PROPRIETORlPAR1NERlEXECUTIVE EL EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500,000
If yes, describe under $ 500 ,000
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT
OntER .
DESCRIPTION OF OPERATIONS I LOCAll0NS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMEIIIT I SPECIAL PROVISIONS
Certificate Holder is listed as Additional Insured.
CERTIFICATE HOLDER
CITY-97
CANCELLATION
SHOULD ANY OF ntE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ntE EXPlRAll0N
DATE ntEREOF, ntE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOllCE TO ntE CERllFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLlGAll0N OR LIABILIlY OF ANY KIND UPON ntE INSURER, ITS AGENTS OR
REPRESEIIITATlVES.
AlITHORlZED REP
PORATION 1988
City of st. Petersburg
Ava Nelson
PO Box 2842
st. Petersburg r.L 33731
ACORD 25 (2001/08)