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CERTIFICATE OF LIABILITY INSURANCE (9) '-- / '..../ ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR SC DATE (MMIDDIYYYY) YOUNG-8 07/25/05 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. '. 7 ...)J PRODUCER Carlisle Fields & company, Inc P.O. Box 7910 Clearwater FL 33758-7910 phone:727-797-0441 Fax:727-725-3663 INSURED INSURER A: INSURer< B INSURER C: INSURER D: Progressive Commercial Markel Insurance Company Zenith Insurance Company NAIC# 10193 INSURERS AFFORDING COVERAGE Young Women's Christian Assn Of Tampa Bay 655 Second Avenue South st. Petersburg FL 33701 COVERAGES INSURE:~ E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED I>lAMED ABOVE FOR THE POLICY PERIOD INDICATED NOlWlTHSTANDING 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 DAn; (MMlDD/YV) -DATE (MM/DDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 I-- B ~ COMMERCIAL GENERAL LIABILITY 3602SS2583991 10/01/04 10/01/05 ~='Es (Ea occurence) $ 100000 :::J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000 f-- PERSONAL & I'DV INJURY $ 1000000 GENERAl AGGREGATE $ 3000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 1000000 h n PRO- nLOC Emp Ben. 1000000/3 POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT f-- $1,000,000 A ~ ANY AUTO 047436123 10/22/04 10/22/05 (Ea accldenl) ALL OWNED AUTOS BODIL Y INJURY f-- (Per person) $ SCHEDULED AUTOS f-- HIRED AUTOS BODIL Y INJURY f-- $ NON-OWNED AUTOS (Per accident) I-- PROPERTY DAMAGE $ (Per accident) GARAGE LIASILTTV AUTO ONL Y - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONL Y: AGG $ EXCESs/UMBRELLA L1ABILTTV EACH OCCURRENCE $1,000,000 B tJ OCCUR D CLAIMS MADE 4602SS2581610 10/01/04 10/01/05 AGGREGATE $1,000,000 $ R DEDUCTIBLE $ X RETENTION $10,000 $ - X I TORY LIMITS I IUER WORKERS COMPENSATION AND C EMPLOYERS' LIASILTTV Z049904501 06/24/05 06/24/06 $ 500000 ANY PROPRIETORIPARTNERlEXECUTIVE EL EACH ACCIDENT OFFICERlMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000 If yes. describe under EL DISEASE - POLICY LIMIT $500000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS The certificte holder is listed as lessor/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 CANCELLATION CITYCLR SHOULD ANY OF THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DAn; THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICAn; 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 REPRE CITY OF CL~TER, FLORIDA Janet Skinner 612 Franklin st Clearwater FL 33765-5414 PORATION 1988 ACORD 25 (2001/08) ---- ACORDN CERTIFICATE OF LIABILITY INSURANCE CSR sc I DATE (MM/DDNYYY) YOUNG-8 07/26/05 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 FL 33758-7910 Phone: 727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Progressive Commercial 10193 INSURER B Markel Insurance Company Young Women's Christian Assn INSURER C' Zenith Insurance Company Of Tampa BaA 655 Second venue South INSURER 0 St. Petersburg FL 33701 INSURER 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 NSR[ TYPE OF INSURANCE POLICY NUMBER PD~,;!~TJ'~rDE~~E PQl-LC!(F-~!,IRA T~~N LIMITS DATE MM/DDIYY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - B X COMMERCIAL GENERAL LIABILITY 3602SS2583991 10/01/04 10/01/05 PREMISES (Ea occurence) $ 100000 I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000 -I--' ---- . ---------,--- -. -~.._---._------_.- .' - -,,'--'-~.~-- ".----------- PERSONAL & ADV INJURY $ 1 - GENERAL AGGREGATE $ 3000000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000 I n PRO- nLOC Emp Ben. 1000000/3 POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 - A X ANY AUTO 047436123 10/22/04 10/22/05 (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 $ l ANY AUTO OTHER THAN EAACC $ AUTO ONLY AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000 B =:J OCCUR D CLAIMS MADE 4602SS2581610 10/01/04 10/01/05 AGGREGATE $1,000,000 $ ~ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X I TORY LIMITS I IOJ~- C EMPLOYERS' LIABILITY Z049904501 06/24/05 06/24/06 E.L. EACH ACCIDENT $ 500000 O'FmWMRJ~1~~~~m5~fECUTIVE - . _._~--- - "----- E. L. DISEASE. EA EMPLOYEE $ 500000 If yes, describe under E. L. DISEASE - POLICY LIMIT $ 500000 SPECIAL PROVISIONS below OTHER ""'- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ~~V Certificate holder is listed as an additional insured. *30 Days Cancellation applies to Worker's Compensation Policies, 10 Days ~~ ~ ~ Cancellation for all other policies - Applies to Florida Employees OnlY~ ~~ ~~ ~ f;)~ <::>~ ~ "jJO~v~ CERTIFICATE HOLDER CANCELLATION ,*~~ ~.. CITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE C~' l ~ EFORE THE EXPIRATION ~, , ,;j;V DATE THEREOF, THE ISSUING INSURER WILL ENDEAVoR..T~" L ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFt. BUT FAILURE TO DO SO SHALL City of Clearwater RECEIVED IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City Attorneys Office P.O. Box 4738 REPRESENTATIVES, Clearwater FL 33758-4738 AUGO 1 2005 AUTHORIZED ~;IVEjJ (0hJ~lo ACORD 25 (2001/08) v v '- . -- . <gACORD CORPORATION 1988 CITY ATTORNEY