HISTORICAL DWELLING CERTIFICATE OF INSURANCE
, "
THIS CERTIFICATE IS ISSUED AS A M';\TTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND ORAL TER THE COVERAGE AFFORDED BY TH.E POLICIES BELOW.
Wm. Allen & Assoc., Inc.
P. O. Box 1138
-Dunedin, Fl. 34697-1138
813-736-2505
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY B
LETTER
Old Dominion Ins. Co.
INSURED
Clearwater Historical Society
PoO. Box 175
Clearwater, Flo 34617
C~~
LETTER C
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
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 CONDI-
TIONS OF SUCH POLICIES,
TYPE OF INSURANCE
POLICY EFFECTIVE
OA TE (MMiDOIYY)
POLICY EXPIRATION
OA TE (MMiDOIYY)
POLICY NUMBER
GENERAL Llf.BILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS,
UNOERGROUND ... . .. . ,'"
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERA nONS
CONTRACTUAL
INOEPENpENT COr-;TRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
Applied For
1/20/88
1/20/89
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PASS.)
ALL OWNED AUTOS (OTHER THAN)
PRIV, PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERA TIONSlLOCA TIONSNEHICLES/SPECIAL ITEMS
As respects historical dwelling location:
LIABILITY LIMITS IN THOUSANDS
EACH AGGREGATE
OCCURRENCE
BODILY ;-
INJURY $ $
PROPERTY
DAMAGE $ $ l!'
"
BI & PO $ ~OO
COMBINED 500
PERSONAL INJURY $
BODilY
INJURY $
(!'fR !'fRSON)
BOOIl Y "
INJURY $
(!'fR ACCIDEN1)
PROPERTY
DAMAGE $
BI & PO ,
COMBINED $
BI & PO $
COMBINED
STATUTORY ,;
$ (EACH ACCIDEN1) ~
$ (DISEASE-POLICY lIMI1)
$ (DISEASE,EACH EMPLOYEE)
1350 S.Greenwood Ave.
Clearwater, Fl. 34615