CERTIFICATE OF INSURANCE (5)
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CERTIFiCATE
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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.
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Issue DATI! (,M1v1/DDIYY)
.., 3 / 11 9 5
PRODUCER
Long & Co., Inc.
P. O. Box 14958
Clearwater, FL 34629-4958
COMPANIES AFFORDING COVERAGE
~~~~~NY A
T~avelers Insu~ance Company
INSURED
~~~~~NY B
Tampa Bay Community Development
P. O. Box 12216 Corp.
Clearwater, FL 34616
COMPANY C
LETTER
~~~~~NY D
f~~~~NY E
C VERAGES ;.:;~-I:~~:!~ff!;~i~'l1~'\\~\j!;~;i:;,,'i'< . .,.' "
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.
; POLICY EFFECTIVE !POLICY ~;~I~~~;~~ '"
, DATE (MMIDDIYY) DATE (MMIDD/YY)
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
liMITS
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.:
A OWNER'S & CONTRACTOR'S PROT:
135015C167
3/1/95
3/1/96
~:~~~~L~G~~:()A::_. I ~ . ' Q Q_, 9 Q 0
~~,?~~?T~,',?O, ", ~P,'/,O,'~ .^~G. 'I !,) , 9,.9,' Q, ' 900
PERSONAL & ADV. INJURY S 1 , 0 0 0 , 00 0
EACH occURRENCE . I $ i , 0 0 0 , 50 d
FIRE DAMAGE (A~y one fire) ! $ . 5 0 , 0 b d
........ ._.........._.'.. ..1..-- ... ..'-
MED. EXPENSE (Anyone person): S 5 0 0 0
GENERAL LIABILITY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
COMBINED SINGLE $
LIMIT
BODILY INJURY $
'(Per person)
BODILY INJURY $
(Per eccldenl)
PROPERTY DAMAGE $
EACH OCCURRENCE $
.",.. .-
AGGREGATE $
--' ..-......,..~ ",,' _'"'A'''',"~''''' .
EXCESS LIABILITY
AND
I
I
RISK MANAGEMEN~
I
I
I
I
_J~T~~~~~~Y LIMITS I..
~A_C_H~~CIDENT I ~
~1~~~~=-POLl.CV..~~MIT ...1 S
DISEASE-EACH EMPLOYEE i $
WORKER'S COMPENSA nON
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEH1CLES/SPEC1AL ITEMS
CERTIFICATE HOLDER
~ .
!
. .'~:~'i!;"piIJ,~";lI1',l>:.r~~.4,,*~:.>~,t'L:,
City of Clearwater
Attn. Pat Fernandez
Economic Development Dept.
P. O. Box 4748
Clearwater, FL 34618-4748
L; SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
.: EXPIRATION DATE THEREOF, THE ISSUING COMPANY WilL ENDEAVOR TO
'; MAll~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
lEFT, BUT FAilURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
; I liABILITY OF AN INO UPON THE CO Y. ITS AGENTS OR REPRESENTATIVES.
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'RPdFtAflcn~ i 990
ACORD 25-5 (7/90)
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