CERTIFICATE OF LIABILITY INSURANCE
ACORD
CERTIFICATE OF LIABILITY INSURANCE
DATE (MMIOOIVY)
6/12/01
'"
PRODUCER
Pilkington Insurance Agency,lnc.
P. O. Box 10066
11701 Belcher Road South, Suite 104
Largo FL 33773-0066
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COVERAGES
THIS IS TO CERIFY THAT THE POLICIES OF INSURANCE LI TED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIO
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 REDUC~D BY PAID CLAIMS.
LCTOR i POLICY NUMBER I POLICY EFFECTIVE POLICY EXPIRA TIO~ LIMITS
TYPE OF INSURANCE I DATE (MMIOD/YY) DATE (MMIOD/YY) I
I GENERAL LIABILITY ! GENEP.AL AGGREGATE! $
rXl COMMERCIAL GENERAL LIABILITY II PRODUCTS - COMP/OP AGG i $
A rTl CLAIMSMADE!JCj OCCUR PHPG120573 6/10/01 6/10/02 I PERSONAL&ADVINJURY : $
R=., OWNER'S & CONT~CTORS PROT I EACH OCCURENCE ! $
I FIRE DAMAGE (Anyone fire) '$
I
I MED EXP (Anyone person) , $
l AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT : $
I ----, ANY AUTO ,
~ ALL OWNED AUTOS I
'I BODILY INJURY
. ~ SCHEDULED AUTOS I (Per person)
A PHPG120573 6/10/01 6/10/02
L.:J HIRED AUTOS
I ^ I NON-QWNED AUTOS
r=r ~
I I
..........,
I i
GARAGE LIABILITY
WA'ANT PHILADELPHIA INDEMNITY INS CO
The Mustard Seed Foundation
2510 Central Ave
St Peterburg FL 33712
B
C
COMPANY
D
BODILY INJURY
(Per accident)
H ANY AUTO
Y
AGGREGATE $
I EACH OCCURRENCE $
I AGGREGATE . $
!
EXCESS LIABILITY
A I PROFESSIONAL
LIABILITY
I
i I TORYLIMITS' i ER $
I
! EL EACH ACCIDENT . $
i EL DISEASE - POLICY LIMIT : $
EL DISEASE - EA EMPLOYEE $
6/10/01
6/10/02
OCCURRENCE
AGGREGATE
'$
$
.$
$
$
$
1,000,000
2,OOQ,OOO
The Mustard Seed Foundation, Inc.
2510 Central Avenue
St Petersburg FL 3371
Fax:
SHOULD ANY OF THE ABOVE DESCRIBED POll ES CAN ELLED BEFOR THE
I EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO .MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
E;_GJf; IVE D'
HOUS~ .AND URbAI. ",~v,"LvPMENT I
. CITY OF a.EARWAT~R . .
. .,-.--.--............ -- --.... ".-...-