CERTIFICATE OF INSURANCE (3)
-1
CERTIFICATE OF INS~~*CE
Iss~IE DATE: 8/8/97 JLM
PRODUCER
AMERICAN PHOENIX CORP OF
TAMPA BAY/WEST COAST INS
P.O. BOX 10340
ST. PETERSBURG,FL 33733
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.
COMPANIES AFFORDING COVERAGE
CO. LETTER A NATIONAL UNION FIRE INS CO
CO. LETTER B FCCIINSURANCE CO
CO. LETTER C
CO. LETTER D
INSURED
YWCA OF TAMPA BAY
655 2ND AVENUE SOUTH
ST. PETERSBURG,FL 33701
COVERAGES
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 MAYBE ISSUED ORMAY 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.
TYPE OF POLICY POL EFF
INSURANCE NUMBER DATE
COMMERCIAL MLP2291605 8/8/97
GENERAL
LIABILITY
CLAIMS MADE
X OCCURRENCE
OWNER'S &
CONTRACTOR'S
PROTo
CO
LTR
A
POL EXP
DATE
8/8/98
A AUTO L1AB
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
NON-OWNED & HIRED
A EXCESS
LIABILITY
X UMBRELLA FORM
WORK COMP 38629
& EMPLOYERS'
LIABILITY
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/SPECIAL ITEMS
MLA2043857
8/8/97
8/8/98
BOUND
8/8/97
8/8/98
B
6/24/97
6/24/98
LIMITS
GENERAL AGG
PROD/COM/OP AGG
PERSONAL & ADV
INJURY
EACH OCCURRENCE
FIRE DAMAGE (ANY
ONE FIRE)
MED. EXPENSE (ANY
ONE PERSON)
COMB SINGLE LMT
EA. OCCURRENCE
AGGREGATE
EACH ACCIDENT
DISEASE-POL LMT
DISEASE.EA.EMP.
$3,000,000
3,000,000
1,000,000
1,000,000
300,000
10,000
1,000,000
$1 ,000,000
$1 ,000,000
$100,000
500,000
100.000
,,'1,. l' '0"0
~~i \\; '~-,.I '!:_~
(:i'" j~ .
CANCELLATION \lU-" ",,~
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE '~l!-:: \ ", 8;;
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL f:-,\,j\,r 'Oeo'.
10 DAYS WRlrrEN NOTICE TO THE CERTIFICATE HOLDER NAMED BELOW, BUT ~.d \l'JosW \
FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY So \
OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
CERTIFICATE HOLDER
ATT: PAT FERNANDEZ
CITY OF CLEARWATER, RISK MANAGEMENT DEPT.
P.O. BOX 4748
CLEARWATER, FL 34618-4748
A7tS~~~E
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