CERTIFICATE OF INSURANCE (221)
PRODUCER
ISSUE DATE (MMIDDIYY)
11/22/95
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Palmer & Cay/Carswell, Inc.
TIllS CERTIFICATE IS ISSUED AS A MA ~ OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TIllS CERTIFICATE
DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW
Girl Scout Accounts
P. O. Box 847
COMPANIES AFFORDING COVERAGE
Savannah, GA 31402
COMPANY
LETI'ER A St. Paul Fire & Marine Ins. Co
INSURED
COMPANY
LETI'ER
B
Tampa
FL 33679
COMPANY C
LETI'ER
COMPANY
LETI'ER D
COMPANY E
LETI'ER
Suncoast GSC
Attn: Ann F Hensler
POBox 18066
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIlE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITI! RESPECT TO WHICH TIllS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TIlE INSURA1'lCE AFFORDED BY THE POLICIIlS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFF. POLICY EXP.
TE DATE (MMIDDIYY) DATE (MMIDDIYY)
LIMITS
A GENERAL LIABILITY
COMM. GENERAL LIABILITY
CLAIMS MADE [iJOCC,
CK06805025
1/01/96
1/01/97
GENERAL AGGREGATE
PROD-COMP/OP AGG.
PERS. & ADV. INJURY
EACH OCCURRENCE
1000000
1000000
1000000
1000000
0000
5000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
COMBINED SINGLE
LIMIT
BODILY INJURY
(Per per,on)
~ [f~
BODILY INJURY
(per accident)
PROPERTY DAMAGE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
WORKERS' COMPENSATION
AND
EMPLOYER'S LIABILITY
_B1SK
~,~
~C.lDENT
DISEASE-POLICY LIMIT
DISEASE-EACH EMP.
OTHER
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS
Certificate Holder is named Additional Insured as respects use of
premises for Girl Scout activities.
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City of Clearwater
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL .12....- DAYS WRITI'EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFr, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Risk Management Office
LIABILITY OF ANY lJIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
I
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POBox 4748
Clearwater, FL 34618
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... AUTHORIZ;JlD ~P!WENTA~
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