CERTIFICATE OF INSURANCE (2)
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Wallace Welch &: Willingham Inc - ONLY AND CONFERS NO RIGHTS UPON THE CERTlACATE
3810 16th Street North HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 33020 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
St. Petersburg P'L 337331\ 'EC E IV ED COMPANIES AFFORDING COVERAGE
ICei th W. Gramling COMPANY
813- 22-7777 ~ A Commerce Mutual Ins. Co.
INSURED
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COMPANY
B
Scottsdale Insurance Company
CIfY CU1K c~Pl,
Religious Community Services
1855 Highland Ave South
Clearwater P'L 34616
COMPANY
C Maryland Casualty
(;9\lgM9E$
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COMPANY
o
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
GARAGE LIABILITY
ANY ALlTO
POUCY EFFECTIVE POLICY EXPIRATION LIMITS
DATE lMMIDDlYY1 DATE (MMIDDIYY)
GENERAL AGGREGATE . 1,000,000
10/01/94 10/01/95 PRODUCTS - COMP/OP AGG . 1,000,000
PERSONAL & ADV INJURY . 1,000,000
EACH OCCURRENCE . 1,000,000
FIRE DAMAGE (Anyone firel 50,000
MED EXP (Anyone personl . Excluded
10/01/94 10/01/95 COMBINED SINGLE LIMIT .1,000,000
BODILY INJURY
(Per person)
~ BODILY INJURY
~ : :
U; (Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT .
OTHER THAN AUTO ONLY:
EACH ACCIDENT .
AGGREGATE
EACH OCCURRENCE
AGGREGATE
STATLlTORY LIMITS
EACH ACCIDENT 100,000
10/01/94 10/01/95 DISEASE - POLICY LIMIT 500,000
DISEASE - EACH EMPLOYEE 100,000
10/01/94 10/01/95 Limits See Policy
GENERAL LIABILITY
B COMMERCIAl GENERAL LIABILITY CLS 0 4 9416
CLAIMS MADE [!] OCCUR
OWNER'S & CONTRACTOR'S PROT
AUlTOMOBILE LIABILITY
C X ANY AUTO
AU OWNED ALlTOS
SCHEDULED ALlTOS
HIRED ALlTOS
NON-OWNED ALlTOS
ECA-17786188
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERSiEXECLlTIVE
OFFICERS ARE:
OTHER
INCL 1581-7
EXCL
C Property
ECA17815805
DESCRIPTION OF OPERATIONSIlOCATlONSNEHICLES/SPECIAL ITEMS
RB: 1125 Holt Avenue, Clearwater, Fl
Certificate Holder is Additional Insured with respect to Gen Liab only.
CLEAR01
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BLIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
City of Clearwater
Attn: Risk Management Office
P.O. Box 4748
Clearwater FL 34618
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