PROVIDE FUNDING FOR YOUTH SERVICES FOR THOSE IN NEED AND INSURANCE CERTIFICATE
AGREEMENT
This Funds Agreement is made and entered into between the City of Clearwater, hereinafter
referred to as the City, and YWCA of Tampa Bay, hereinafter referred to as the Agency.
WHEREAS, it has been determined to be highly desirable and socially responsible to provide
youth services to those who would not otherwise have a means to fill these needs; and
WHEREAS, the City desires to help those in need by providing funding for the above services;
and
WHEREAS, the Agency provides such services and operates in the City;
NOW, THERFORE, the parties agree as follows:
ARTICLE I. TERM
The term of this agreement shall be for a period of 12 months commencing on the 15t day of
October, 2000 and continuing through the 30th day of September, 2001 (the Termination Date)
unless earlier terminated under the terms of this agreement.
ARTICLE II. RESPONSIBILITIES OF THE AGENCY
1. Services to be Provided: The Agency shall provide the above stated service in
accordance with the proposal submitted by the Agency and approved by the City, which
is attached and incorporated herein by reference.
2. Area to be Served: Services rendered through this agreement shall be provided within
the corporate limits of the City as it now exists and as its boundaries may be changed
during he term of this agreement.
3. Scheduled Reports of Agency Activities: The Agency shall furnish the City Human
Relations Department, Grants Coordinator, with an annual report of activities conducted
under the provisions of this agreement by October 31, 2001. Each report is to identify the
number of clients served, the costs of such service, and commentary on the viability,
effectiveness, results of measurable goals and objectives as set out in the agency's
proposal, and trends affecting the program. The agency will also provide a copy of its
most recent independent financial audit.
4. Use and Disposition of Funds Received: Funds received by the Agency from the City
shall be used to pay for the above services as further described in the grant proposal
submitted by the Agency to the City. Funds existing and not used for this purpose at the
end of this agreement term shall be deemed excess to the intended purpose and shall be
returned to the City.
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5. Creation, Use, and Maintenance of Financial Records:
a) Creation of Records: Agency shall create and maintain financial and accounting
records, books, documents, policies, practices, procedures and any information
necessary to reflect fully the financial activities of the Agency. Such records shall
be available and accessible at all times for inspection, review, or audit by
authorized City representatives.
b) Use of Records: Agency shall produce such reports and analyses that may be
required by the City and other duly authorized agencies to document the proper
and prudent stewardship and use of the monies received through this agreement.
c) Maintenance of Records: All records created hereby are to be retained and
maintained for a period not less than five (5) years from the termination of this
agreement.
6. Non-discrimination: Notwithstanding any other provisions of this agreement during the
term of this agreement, the Agency for itself, agents and representatives, as part of the
consideration for this agreement, does covenant and agree that:
a) No Exclusion from Use: No person shall be excluded from participation in,
denied the benefits of, or otherwise be subjected to discrimination in the operation
of this program on the grounds of race, color, religion, sex, age, national origin, or
disability.
b) No Exclusion from Hire: In the management, operation, or provision of the
program activities authorized and enabled by this agreement, no person shall be
excluded from participation in or denied the benefits of or otherwise be subject to
discrimination on the grounds of or otherwise be subjected to discrimination on
the grounds of race, color, religion, sex, age, national origin, or disability.
c) Inclusion in Subcontracts: The Agency agrees to include the requirement to
adhere to Title VI and Title VII of the Civil Rights Act of 1964 in all approved
sub-contracts.
d) Breach of Nondiscrimination Covenants: In the event of conclusive evidenced
of a breach of any of the above non-discrimination covenants, the City shall have
the right to terminate this agreement.
7. Liability and Indemnification: The Agency shall act as an independent contractor and
agrees to assume all risks of providing the program activities and services herein agreed
and all liability therefore, and shall defend, indemnify, and hold harmless the City, its
officers, agents, and employees from and against any and all claims ofloss, liability, and
damages of whatever nature, to persons and property, including, without limiting the
generality of the foregoing, death of any person and loss of the use of any property, except
claims arising from the negligence or willful misconduct of the City or City's agents or
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employees. This includes, but is not limited to matters arising out of or claimed to have
been caused by or in any manner related to the Agency's activities or those of any
approved or unapproved invitee, contractor, subcontractor, or other person approved,
authorized, or permitted by the Agency in or about its premises whether or not based on
negligence
ARTICLE III. RESPONSIBILITIES OF THE CITY
1. Grant of Funds: The City agrees to provide a total grant of $4,500.00 to fund the
program in accordance with this agreement and subject to City Commission budget
approval.
2. Payments: The total amount requested will be paid by the City to the Agency within 30
days after execution of this agreement by the City and the Agency but no earlier than
October 1 of the budget year for which the funds are authorized.
ARTICLE IV. DISCLAIMER OF WARRANTIES
This Agreement constitutes the entire Agreement of the parties on the subject hereof and may not
be changed, modified, or discharged except by written Amendment duly executed by both
parties. No representations or warranties by either party shall be binding unless expressed herein
or in a duly executed Amendment hereof.
ARTICLE V. TERMINATION
1. For Cause: Failure to adhere to any of the provisions of this agreement as determined by
the City shall constitute cause for termination. This agreement may by terminated with 5
days notice without any further obligation by City.
2. Disposition of Fund Monies: In the event of termination for any reason, monies made
available to the Agency but not expended in accordance with this agreement shall be
returned to the City.
ARTICLE VI. NOTICE
Any notice required or permitted to be given by the provisions of this agreement shall be
conclusively deemed to have been received by a party hereto on the date it is hand-delivered to
such party at the address indicated below (or at such other address as such party shall specify to
the other party in writing), or if sent by registered or certified mail (postage prepaid), on the fifth
(5th) business day after the day on which such notice is mailed and properly addressed.
1. If to City, addressed to Grants Coordinator, Human Relations Department, P.O Box 4748,
Clearwater, FL 33758
2. If to Agency, addressed to YWCA of Tampa Bay, 655 Second Avenue South, St.
Petersburg, FL 33701.
1t'
ARTICLE VII. EFFECTIVE DATE
The effective date of this agreement shall be as of the first day of October, 2000.
.IN WITNESS WHEREOF, the parties hereto have set their hands and seals this
"
day of
r
, 2001.
CITY OF CLEARWATER, FLORIDA
Countersigned:
By:~~J.~JI
William B. Home II, Interim City Manager
Attest:
Approved as to form:
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PameM . Akm, City Attorney
Witnesses as to Agency:
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5'uS(H1 ~II\LClW Oed)fU vLt
Attest:
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,5u,)CVl'l-&-f::< 0 \~) )f2fi e----&7 secretary
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CITY or CLEARWATER
SOCIAL SERVICES GRAN'!'
PROJECT APPLICATION FORM
Phone: (727)562-4060 for assistance
Due: January 26, 2001
A. Application Information
Applicant:
(Sponsor/Developer)
YWCA of Tampa Bay
Organization Name:
(If different)
Address:
655 Second Avenue South
City; State; Zip:
St. Petersburg, FL 33701
Telephone Number:
727-896-4629
Contact Person:
Sandra Lyth
Title:
Director, Strategic and Program Development
Telephone Number:
727-896-4629 ext 12
Period for which funds
are being requested:
March-April 2001
Signatur~.~. )
Date ~) 4'/, J;lOOI
NOTE:
Pamela Skyrme
Board of Directors Chairperson
The City of Clearwater reserves the right to fund applicants at a level lower
than requested.
2
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B. Activity (Check One)
Adult Crime
Child Abuse
Elderly
Hunger
Juvenile Crime
Physical Illness
Parenting Adolescents
Substance Abuse
Unsupervised Children
x
Youth Development
Other (Describe Below)
3
C. AMOUNT 01' rmmXNG C01UUi:NTLY IUl:QtJESTED
(Not to exceed $10,000)
$6,950.00
D. SPECII'ICALLY FOR WHAT MLL TIllS MOREY BE USED.
(Line item budget for this amount)
To purchase computers and educational software in support of UKing's
KidsH, a program of the YWCA located at the Martin Luther King Center,
1201 Martin Luther King Avenue, Clearwater.
4 computers and 4 monitors @ $1,000 per set
1 laser printer @ 800
4 Service Plans @ 250
5 locks @ 30
Educational software 1,000
Total Requested: $6,950.00
E. BRIEI' DESCRIP'l'ION 01' PROJECT YOU MSR 'l'O I'ONI) UTILIZXNG THIS GRANT.
King's Kids is a tutoring and educational support program for elementary
school aged children who otherwise would be unsupervised after school. The
YWCA provides teachers develop individual learning plans for participants,
give individual and group instruction, and support participants in their
areas of strength while helping them to improve on areas of deficiency.
Volunteers augment the work of the teachers in working with individual
participants. It is a primary prevention program.
The computers and educational software would provide much-needed access
for these children to the technology they must be familiar with in order
to advance effectively in school, and open doors to another learning style
- that of educational software. With hands-on support from the teachers
and volunteers, King's Kids can make continuous use of the equipment from
2PM to 6PM five days per week. (*See Heasurab~e Objectives on Page 6.)
King's Kids is a collaboration with the City of Clearwater Recreation
Department, whose staff provide recreation activities for the participants
as well. The program has been in place for more than 10 years.
F. BRIEI' DESCRIPTION or YOUR OYDALL ORGARIZATXON.
The YWCA of Tampa Bay is a non-profit (501(c) (3)) organization serving
women, girls, and families in Pinellas County since 1919. It is an
affiliated member of the YWCA of the USA, with an annual budget in excess
of $4 million. The organization is governed by a Board of Directors and a
Board of Trustees.
The YWCA of Tampa Bay has a staff of 145 people, and provides services to
more than 6,000 individuals annually. These services include Youth
Development (2 sites), Child Care (6 sites), Emergency and Transitional
Housing for homeless families, Healthy Families (5 sites), Adolescent
Pregnancy and Parenting Services (3 sites), and Hispanic Services. YWCA
programs, when taken as a whole, provide uwrap-aroundH capability.
4
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G. NUMBER 01' CLIENTS SERVED BY TRIS PROGRAM.
50 - 60 per year, depending on turn-over. The program is full at 50, and
has a constant waiting list.
R. PERCJ!:N'1'AGE 01' THESE CLIENTS WHO ARE CITIZENS 01' CLEARWATER.
98%
I . ctJRREN'l' OVERALL ORGANIZATION BODGET (PLEASE ATTACH) .
Attached
J. II' TRIS IS S'.l'.AR.T UP OR IaTCHmG I&)JIEY, SPECIFY THE DETAILS
i . e.: WHICH AGENCY OR ORGANIZATXON WILL PROVIDE THE IaTCR, THE
REQUIBEMEN'l'S AND THE AMOtJN'1' 01' THE HATCH .
There is no matching money being sought. However, the funds requested will
augment an existing program, King's Kids, which is funded by the United
Way of Pinellas County, Inc
K. IS YOUR AGENCY A REGISTERED SO~ (C) (3) NON-PROFIT AGENCY OR m THE PROCESS
01' BECOMING ONE.
The YWCA of Tampa Bay is a 501 (c) (3) organization.
L. DOES YOUR I'ACILITY HAVE OR IS IT m THE PROCESS 01' ACQUIRmG THE
APPROPRIATE LICENSURE FOR THE DELIVERY 01' THE SBRVICES DESCRIBED m THIS
APPLICATION.
The YWCA of Tampa Bay does not require any additional licensure.
5
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M. HAS YOUR ORGANIZATION RECEIVED OR IS IT EXPECTING 'l'O RECEIVE I'UNDING
WHETHER CASR OR XN-RIND CONTRIBUTIONS) I'ROM THE CITY 01' CLEARWATER. DURING
THE FISCAL YEAR. I'ROM OC'l'OBER 1, 2000 THROUGH SEPTEMBER 30, 2001?
YES
x
NO
IF YES, PLEASE EXPLAIN:
The YWCA is receiving funds from the City of Clearwater Police Department
through the Weed and Seed program for Hispanic Services, in the amount of
$104,788.00 for the period August 2000 - September 30, 2001.
********************************************************************************
MEASURABLE OBJECTIVES FOR KING'S laDS:
I. Ninety five per cent (95%) of the children who have received services for
a minimum of six months will increase their reading and math scores as
measured by the Florida Comprehensive Achievement Test (FCAT).
Indicator: Increase in score on the post test. FCAT is administered at the
beginning (pre) and the end (post) of the academic school year.
Data Source: Collected by curriculum specialist and individual teachers
from feeder schools. Information release form is obtained from parents.
II. Ninety five per cent (95%) of the children who have received services for
a minimum of six months will be promoted to the next grade, as measured by
their report card.
Indicator: Promotion to the next grade level.
Data Source: final report card.
6
I~
YWCA OF TAMPA BAY
BUDGET
10/10100
FY
2000-2001
BUDGET FISCAL YEAR 10/112000 - 913012001
HUD 173,988
FEMA 22,428
. USDA 126,000
STATE 0
WAGES 180,817
Healthv Start 28,838
Healthy Families 926,841
Coordinated Child Care 896,638
LOCAL GOVERNMENT 0
City of St. Petersburg/Social Action 13,094
ESG, City of St. Petersburg 28,000
Pinellas County/Social Action-Homeless initiati 14,281
Pinellas County/Social Action 11,000
ESG, Pinellas County 0
City of Clearwater 80,000
JWB 800,318
Pinellas Village 98,235
Career Options 0
United Way 195,261
Other United Way Funding 50,136
Donations/Contributions this year actual x 103% 110,000
Wills/Bequests 100,000
Fund RaisingSpecial Events 50,000
School Board in Kind 187,848
Other In Kind 10,000
Interest 23,763
Pinellas County Foundation 7,000
Program Fees 478,106
Transitional Housing Rent 15,343
Non Cash Revenue (Depreciation) 25,172
Cash forward 151,073
Other Revenue 1,850
Pledge Income 960
Memberships 6,000
TOTAL REVENUE 4,785.670
EXPENDITURES
Salaries $3,071,166
Employee Benefits 353,590
Payroll Taxes 322,441
Fringe Benefits 676,031
Professional Fees 55,501
Occupancy 258,451
TraveVTranspsortation 25,147
Utilities (GasIWater/Power/Phone) 84,082
Office Expenses (Supplies/Printing) 68,832
Outcome Development 0
Membersip Fees & Dues 25,235
SpecifIC Assistance to Individuals 157,657
Miscellaneous 70,037
Operating Expense 732,943
In Kind Expenses 187,848
Capital Expenses 6,650
ADMINISTRATION (0
Total EXDenditures 4,786,670
SURPLUS OR DEFICIT 0
IJN1FIED FUNDING APPLICATION
To: (funder): City of Clearwater
For time period of: March-April 2001
AppliCDnt Information (print or tvpe):
Legal Name of Organization: YWCA of Tampa Bay
Complete Address: 655 Second Avenue South
St. Petersburg, Florida
33701
Phone (727) 896-4629
Fax (72) 821-7438
~~il sandra@vwcaoftam>>abav.or2
Federal Tax Identification Number: 59-0638517
Contact Person: Sandra Lyth
Title:Director StrateRic & ProRram Development
Organization Type: _Public _Private..!.... Non-profit _ Other
Service Area: ..!..... County _ City of
Other
Agency currently funded by ( check all that apply):
l St. Petersburg _ Florida Dept. of Children & Families
..2L Clearwater _ Florida Dept. of Justice
_ Largo .JL Pinellas County Foundation
l Pinellas County _ Allegany Franciscan Foundation
_ Area Agency on Aging _ Eckerd Family Foundation
-!...JuvenileWelfareBd. LOther:HUD. FEMA. WAGES. Healthv Start.
-L United Way Healthy Families, Coordinated Child Care
Certifications: (1) If required to register for solicitation of funds, is the Agency currently
registered with the State? .L Yes _ No The County? -L Yes _ No
(2) If incorporated, has the Agency Annual Report been ffied with the Florida
Secretary of State? L Yes_No
Name and Title of Agency Representative submitting this runding request:
Sandra Lyth
Director Strate2ic & ProiTam Develo>>ment
Dau:~""'~ ~OO)
Received in runder's office by:
Date:
UFAl
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BOARD OF DIRECTORS -# reQuired in Bv Laws =
NAME/OFFICER
OCCUPATION
AREA OF EXPERTISE
SEE ATTACHED
,
.,. .
UFA1
, ..
RACE/GENDER
"
YWCA of Tampa Bay
Board of Directors
2000-2001
Margaret Abbey
842 Snell Isle Blvd.
St. Petersburg, FL 33704
822-8510 White Female
Nurse
Michele Hellstem
4134 4th Avenue North
St. Petersburg, FL 33713
321-4006 White Female
HR Supervisor
Kathy Binder
7150 Sunset Way #504
St. Petersburg, FL 33706
360-0988 White Female
Mediator
Jean Higham
7000 16 Street South
St. Petersburg, FL 33705
867-3831 White Female
Assistant Public Defender
Susannah Costello
315 10th Avenue NE
St. Petersburg, FL 33701
827-3733 White Female
Marketing/Communications
Marilyn Johnson
219 27th Avenue North
St. Petersburg, FL 33704
553-9155 White Female
Paralegal
Yate Cutliff
601 42 Street South
St. Petersburg, FL 33713
323-0714 Black Female
Attorney
Mary Jean Kissner
4825 WmdmiII Palm Terrace NE
St. Petersburg, FL 33703
521-4273 White Female
VP Tax Manager
Kathryn Dorn
7326 Demens Drive South
St. Petersburg, FL 33712
864-2124 White Female
Insurance
Phyllis Martin - (homeless representative)
429 6th Avenue South
St. Petersburg, FL 33701
823-2859 White Female
LPN
Diane Foley
144 16th Avenue North
St. Petersburg, FL 33704
894-6944 White Female
Senior Research Analyst
Vera Noble
10354011I Street South
St. Petersburg, FL 33711
327-5077 Black Female
Community Volunteer
Willette Givens
. 145 22nd Avenue SE
St. Petersburg, FL 33705
895-2081 Black Female
Phannacist
Christina Pasqualone
One Beach Drive SE #1303
St. Petersburg, FL 33701
821-8100 White Female
Market Development
Roslyn Graham-Haynes
1000 62nd Place South
St. Petersburg, FL 33705
867-1396 Black Female
Mortgage Processor
Patricia Patterson
302 Orangewood Lane
Largo, FL 33770
585-0295 White Female
SpeechlLanguage Pathologist
Laura Green
10524 Greencrest Drive
Tampa, FL 33626
831-0250 White Female
Attorney
Carol Rasor
8131 140th Street North
Seminole, FL 33776
393-6320 White Female
Deputy Sheriff
'Tarni Simms-Powel
206 8th Avenue North
S1. Petersburg, FL 33701
898-2310 White Female
PameJaSkyrme
109 North Lincoln Avenue
Clearwater, FL 33755
442-9302 White Female
Organizational & Employee Development
Joan Steelman
3280 37th Way South
S1. Petersburg, FL 33711
864-3038 White Female
NurselHeaIth Care Risk Manager
Laurie Stone
120 Bay Point Drive NE
S1. Petersburg, FL 33704
827-0787 White Female
Realtor
Parri Tantillo
1010 W. Adalee Street
Tampa, FL 33603
915-9522 White Female
Financial Services
Robin WIlber
210 Isle Drive
S1. Petersburg Beach, FL 33706
360-3410 White Female
Student
(Applications2... ctyclw. 0 12)
Client
51582
3YOUNWOM
ACORD.,..
CERTIFICAE OF LIABILITY INSUR
DATE (MM/DD/VY)
09/15/00
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.
NCE
PRODUCER
HRH Company of Tampa
5405 Cypress Center
POBox 23968
Tampa, FL 33623
INSURED
Young Women's Christian
Association of Tampa Bay
655 Second Avenue South
St. Petersburg, FL 33701
Drive
INSURERS AFFORDING COVERAGE
INSURERA:Royal S ecial Risks Ins Co
INSURERB:General Star Indemnity AON
INSURERC:FCCI Insurance Company
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N01WITHSTANDING
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.
'~f~ TYPE OF INSURANCE POLICY NUMBER Pgk!fEY,Ef~lhCJ)~ POLICY EXPIRATI~~ LIMITS
A GENERAL LIABILITY RSP242236 08/08/00 10/01/01 EACH OCCURRENCE $1,000, 000
r--
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire $300 000
---- ----- -I-CL.AIMSMADEUU-OCCUR ----- - - - - ---;~- -------.-- .- _.--- -- ---- >-- $10 --.000 -----
ME D EXP (Anyone person)
PERSONAL & ADV INJURY $1,000, 000
f-----
f----- GENERAL AGGREGATE $3 . 000 . 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $3 , 000 , 000
n POLICY n ~~gT Ii LOC i
A AUTOMOBILE LIABILITY IRSP242236 08/08/00 10/01/01 COMBINED SINGLE LIMIT
f----- $1,000,000
X ANY AUTO (Ea accident)
f----- I I
ALL OWNED AUTOS I BODIL Y INJURY
f----- , $
SCHEDULED AUTOS , (Per person)
f--
~~ HIRED AUTOS ,
I BODIL Y INJURY $
X NON-OWNED AUTOS (Per accident)
f----- :
f----- PROPERTY DAMAGE $
(Per accident)
~rAGE LIABILITY AUTO ONL Y- EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y: AGG $
B EXCESS LIABILITY IUG352768C 08/08/00 10/01/01 EACH OCCURRENCE $1. 000. 000
o OCCUR D CLAIMS MADE AGGREGATE $1,000,000
I $
~ DEDUCTIBLE I $
X RETENTION $10000 $
C WORKERS COMPENSATION AND 38629 06/24/00 06/24/01 X IT"Xg$'ifr.1~;" I IOJ~-
-,--- EMPLOYERS' LIABUJIY_ ---._~ ~ --"--' ----"- .._...........-O_~_ --- -- - T ----- - -- EL.EACFrACCIDENr - - $leo, 000---.--
E .L. DISEASE-EA EMPLOYEE $100,000
E.L. DISEASE-POLICY L1MI $500 000
OTHER i I
I i
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER I I ADDmONALINSUR:D'INSURERLETTER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
ATT: PAT FERNANDEZ DATETHEREOF,THE ISSUING INSURER WI LLENDEAVORTO MAl L3-D- DAYS WRITTEN
CITY OF CLEARWATER, RISK MGMT NOTlCETOTHE CERTIFICATE HOLDER NAMED TO THE LEFT, BUTFAILURE TO DO SO SHALL
P.O. BOX 4748 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITSAGENTS OR
CLEARWATER, FL 33758 REPRESENTATIVES,
AUTHORIZED REPRLENTATlh
I D orz .s. A J.l." ""(e.-L..
9
ACORD25-S(7/97)1 of 2 #S47967/M47962
CC: HCll5tNG I Rl5~
JLM @ ACORD CORPORATION 1988