INSURANCE AND MEMO (2)
....'. --.- ...
TO:
FROM:
COPIES:
I
C I'V 0 F C LEA R W ATE R
Interdepartment Correspondence Sheet
Lucille Williams, City Clerk
~/
Ream Wilson, Director, Parks and Recreation
SUBJECT: St. Petersburg Junior College - Certificate of Insurance
DATE:
February 19, 1981
Attached are copies of Certificates of Insurance which should be attached
to the Agreements on file between the City of Clearwater and Sto Petersburg
Junior College. Please contact me in the event you have any questionso
RW:pp
Attachments
RECEIVED
ffB~O 1.981
.I:JT.Y CLERK
l ,
Gallagher' Bassett Insurance
3118 Gulf to Bay Blvd.
Clearwater, FL 33515
COMPANIES AFFORDING COVERAGES
Service
Suite 120
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LmER
NAME AND ADDRESS OF INSURED
St. Petersburg Junior College
Fla. Corom. College Risk Management Consortium
Santa Fe Community College
P. O. Box 1530
Gainesville, FL 32602
COMPANY
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. 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 of liabilit in Thousan s )
EACH
OCCURRENCE
TYPE OF INSURANCE
POLICY
EXPIRATION DATE
AGGREGATE
POLICY NUMBER
GENERAL LIABILITY
[Jl COMPREHENSIVE FORM
[Jl PREMISES-oPERATlONS
~ EXPLOSION AND COLLAPSE
L1i HAZARD
[Jl UNDERGROUND HAZARD
r:1 PRODUCTS/COMPLETED
l...,)il OPERATIONS HAZARD
~ CONTRACTUAL INSURANCE
r:1 BROAD FORM PROPERTY
~ DAMAGE
QINDEPENDENT CONTRACTORS
ex PERSONAL INJURY
BODILY INJURY
$
$
Self insurer as per
State of Florida Statute
768.28 and 111.07 3/1/82
PROPERTY DAMAGE $
$
BODIL Y INJURY AND
PROPERTY DAMAGE $
COMBINED
$
PERSONAL INJURY
$
AUTOMOBILE LIABILITY
D COMPREHENSIVE FORM
DOWNED
D HIRED
D NON-QWNED
BODILY INJURY
(EACH PERSON)
BODILY INJURY
(EACH ACCIDENT)
$
$
EXCESS LIABILITY
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
$
D UMBRELLA FORM
D OTHER THAN UMBRELLA
FORM
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITY
OTHER
(EACH .celDENT)
DESCRIPTION OF OPERATlONSIlOCATIONSNEHICLES
;t~
PURPOSE: Use of recreational facilities by St. Petersburg Junior College
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail -30.- days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
-+-
NAME AND ADDRESS OF CERTIFICATE HOLDER:
City of Clearwater
Parks and Recreation Department
P. O. Box 4748
Cleanvater, FL 33518
ATTN: Mr. Ream Wilson, Director
Donald R.