CERTIFICATE OF LIABILITY INSURANCE (4)OP ID CJ
ACORD CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY)
CLEAR42 12/02/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 7 910 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: Auto owners Insurance Company 18988
INSURER B: Southern owners Insurance Co. 10190
Clearwater Regional Chamber of
Commerce INSURER C: Philadelphia Ins. Companies
1130 Cleveland Street
1 INSURER D
Clearwater FL 33755-484
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 DATEYMMDDYY E P DATEY MM/DD/YY N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
B
X
COMMERCIAL GENERAL LIABILITY
2069833108
08/01/08
08/01/09 'L 17
PREMISES(EaoN'rence)
$ 50000
CLAIMS MADE E ] OCCUR MED EXP (Any one person) $ 5000
C Direct & Officers PHSD305678 01/24/08 01/24/09 PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG s2,000,000
POLICY PRO LOC
JECT
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$ 1000000
B ANY AUTO 2069833108 08/01/08 08/01/09 (Ea accident)
ALL OWNED AUTOS M
A URY
BODILY $
? L (Perrperson)
SCHEDULED AUTOS ,
U
X HIRED AUTOS D BODILY INJURY
$
X NON-OWNED AUTOS p (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY
L
`PT AUTO ONLY - EA ACCIDENT $
LEGISLATIVE S VCC
ANY AUTO EA ACC
OTHER THAN $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE s2,000,000
A X OCCUR El CLAIMSMADE 4346391200 08/01/08 08/01/09 AGGREGATE $
DEDUCTIBLE I $
X
V
RETENTION $10,000
$
WORKERS COMPENSATION AND TORY LIMITS ER
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
E.L. EACH ACCIDENT
$
nci?r BERFXCLUDED2 -E.T-BIG A°,n-- LOYE -V-
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
A Crime 2024700808 08/01/08 08/01/09 Emp Disho 250,000
C Direct & Officers PHSD305678 01/24/08 01/24/09 D&O Liab 1,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Per Agreement For The Beach Visitors Center
b-?.k ?: rte. , C% C2,-a?
I!-L : Eco^.I>Q ; 2% sY-
CERTIFICATE HOLDER CANCELLATION
CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
112 S. Osceola Ave REPRESENTATIVES.
Clearwater FL 33765 AUTHORIZEDREPR N?TATIVE A
ACORD 25 (2001/08) v v '-, ?-- - &WcT)RD C'O'RPORATION 1988
OP ID RN
ACORD CERTIFICATE OF LIABILITY INSURANCE ID
N DATE (MMIDDIYYYY)
R 12/01/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, LLC 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: Auto Owners Laurance company 18988
INSURER B: Southern Orner¦ Laurance Co. 10190
Clearwater Regional Chamber of
Commerce INSURER C.
Philadelphia Ins. Companies
1130 Cleveland Street
FL 33755-4841
Cle
t INSURERD
arwa
er
INSURER E:
CAVFRAnFR
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 DATE (MWDDIYY) DATE (MMIDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
B X COMMERCIAL GENERAL LIABILITY 2069833108 08/01/08 08/01/09 PREMISESoccurence) $ 50000
CLAIMS MADE F-] OCCUR MED EXP (Any one person) $ 5000
C Direct & Officers PHSD305678 01/24/08 01/24/09 PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $2,000,000
POLICY jE7 LOC
AUT OMOBILE LIABILITY
COMBINED SINGLE LIMIT
$ 1000000
B ANY AUTO 2069833108 08/01/08 08/01/09 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per Person)
X HIRED AUTOS BODILY INJURY
$
X NON-OWNED AJJTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY ALTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 2,000,000
A X OCCUR F-1 CLAIMS MADE 4346391200 08/01/08 08/01/09 AGGREGATE $
DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND 1-1
TORY LIMITS ER
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $
- OFFICEPJMEMBER EXCLUDED? - E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER
A Crime 2024700808 08/01/08 08/01/09 Emp Disho 250,000
C Direct & Officers PHSD305678 01/24/08 01/24/09 D&O Liab 1,000,000
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Event: December 5, 2008; Miracle on Cleveland Street 5:00 pm to 8:00 Pm
Certificate holder is listed as Additional insured in regards to General
Liability.
CERTIFICATE HOLDER CANCELLATION
CITYCL4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
112 South Osceola Avenue REPRESENTATIVES.
Clearwater FL 33756
1 AUTHORIZED REP ATIVE
"441 el?6 IN
'141 ( )YI L?
ACORD 25 (2001/08) - 9-ACORD CCJRPORATION 1998