CERTIFICATE OF LIABILITY INSURANCE (2)acoRO CERTIFICATE OF LIABILII
PRODUCER
Carlisle Fields & Company, LLC
P.O. Box 7910
Clearwater FL 33758-7910
Phone:727-797-0441 Fax:727-725-3663
INSURED
Young Women's Christian Assn
Of Tampa Bay
655 Second Avenue South
St: Petersburg FL 33701
Y INSURANCE OP ID CA DATE (MM/DD/YYYY)
YOUNG-8 01/06/09
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE' NAIC #
INSURERA Progressive commercial 10193
INSURER B: Philadelphia Ins. Companies
INSURER C: Zenith Insurance Compan
INSURER D:
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.
1aSR PIRA LIMITS
LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DO/YY DATE MM/DD/YY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
B X COMMERCIAL GENERAL LIABILITY PHPK373115 01/01/09 01/01/10 PREMISES(Eaoccurence) $ 100000
CLAIMS MADE X] OCCUR MED EXP (Any one person) $ 5000
GEN'L AGGREGATE LIMIT APPLIES PER:
]{ POLICY PRO LOC
JECT
AUTOMOBILE LIABILITY
A ANY AUTO 047436127
ALL OWNED AUTOS
X SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS,
GARAGE LIABILITY
-7 ANY AUTO
EXCESS/UMBRELLA LIABILITY
B X OCCUR ? CLAIMS MADE PHUB259124
H DEDUCTIBLE
X RETENTION $10,00
0
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AN] P17OMETUR7PXRTNMEXEC'LITIVE-
OFFICERIMEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
OTHER
OF OPERATIONS / LOCATIONS /
CERTIFICATE HOLDER
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 3000000
PRODUCTS - COMP/OPAGG $1000000
Em Ben. 1000000/3
COMBINED SINGLE LIMIT $ 300000
?___..._..._. 11/08/Q8 11/08/09 (Eaaccldent)
I -
_ BODILY INJURY
P
ll r. er person)
(
L?
i
JAN - 8 20
09
(Paid INJURY
$
LI
j PROPERTY DAMAGE ... .
'
$
(Pe
dent)
•-'-`-•----- ..,_-..._.... ,..: AUTO ONLY =EAACCIDENT $
OTHER THAN EAACC $
AUTO ONLY: AGG $
EACH OCCURRENCE $1,000,000
01/01/09 01/01/10 AGGREGATE $1,000,000
$
TORY LIMITS ER
E.L. DISEASE - EA EMPLOYEE $500000
E.L. DISEASE-POLICY LIMIT $ 500000
/ EXCLUSIONS ADDED BY
City of Clearwater Official
Records and Legislative SVCS
Cyndie Goudeau City Clerk
P.O. Box 4748
Clearwater FL 34618
/ SPECIAL
CANCELLATION
CITYO-4 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
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
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
h
' - v ` ' ?- - - CYACbRD CORPORATION 1988
ACORD 25 (2001108)
AcoRD,CERTIFICATE OF LIABILITY INSURANCE OPID CA DATE (MM/DD/YYYY)
You>`to-s 01/06/09
PRODUCER: THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS YPON THE CERTIFICATE -
Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES ,NOT AMEND, EXTEND OR
P.O. Box 7 910 ALTER THE COVERAGE AFFORDED'ZY THE POLICIES BELOW.
Clearwater FL 33758-7910
Phone:727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC#
INSURED - INSURER A: Progressive Commercial 10193
INSURER B: Philadelphia Ina. companies
Young Women's Christian Assn
Of Tampa Bap INSURER C: Zenith Insurance Company
655 Second Avenue South INSURER D: ,
S.t...Petersburg.FL 33701 -°
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED., NOTWITHST 4NDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ( R
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.
INS
LTR
NSR
TYPE OF INSURANCE
POLICY NUMBER EFFECTIVE
DATE MM/DD/YY EXPIRATION
DATE MM/DD/YY
LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
$ X COMMERCIAL GENERAL LIABILITY PFiPI{37 3115 01/01/09 01/01/10 PREMISES Ea occurence) $ 100000
CLAIMS MADE FX] OCCUR MED EXP (Any one person) $ 5000
PERSONAL & ADV INJURY $ 1000000
GENERAL AGGREGATE $ 3000000 -
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OPAGG $ 1000000
X POLICY JECOT LOC Em Ben. 1000000/3
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$ 300000
A ANY AUTO 047436127 11/08/08 11/08/09 (Ea accident)
ALL OWNED AUTOS
L I'
l !-
' BODILY INJURY
$
X SCHEDULED AUTOS r'..
f F...._ _. 'a •. W (Per person)
X
AUT05
HIRED - -
BODILY INJURY
$
X' ON-p
WNED AUTOS
N J N .3
209 (Per er accident)
Lt 1 PROPERTY DAMAGE $
{ (Per accident)
GARAGE LIABILITY
AUTO ONLY - EA ACCIDENT
$
ANY AUTO - _-- -,....?....._. OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
B X .OCCUR 7 CLAIMSMADE PHTIB259124 01/01/09 01/01/10 AGGREGATE $ 1,000,000
DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND TORY LIMITS ER .
C EMPLOYERS'LIABILITY Z049904506 06/24/08 06/24/09 E. L. EACH ACCIDENT $500000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED?
E.L. DISEASE-EA EMPLOYEE
$,5700000
If yes, describe under _
PGNG LIM' _
.. IONS bebw.
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
l?COTIlft ?A= Ul l 11C12 I:YNI.FI 1 a Ill IN
CITYC-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
City of Clearwater NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City Attorneys Office IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
Janet Skinner
645 Pierce Street REPRESENTATIVES.
Clearwater FL 33756 AUTHORIZED REPR NTATIVE n
ACORD 25 (2007103) v n?vmu a,vnrwl I IWIl I Vvo