CERTIFICATE OF INSURANCE (4)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
RH U LEN NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
A DIVISION OF MARKEL SERVICES, INC. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
217 BROADWAY
MONTICEllO, NY 12701 COMPANIES AFFORDING COVERAGE
Phone: (914) 794-8000
Girls, Inc.
610 East Druid Road
Clearwater, Fl 34616
COMPANY A
LETTER
Frontier Insurance Company
CODE
INSURED
P~B
NOV 19199~
CITY CLE1::tK DEPT
'i::OMPANY
LETTER E
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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.
CO
LTR
TYPE OF INSURANCE
POUCY NUMBER
POUCY EFFECTlVE POLICY EXPIRATION
DATE (MM/DDfYV) DATE (MM/DD/VV)
ALL LIMITS IN THOUSANDS
A GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [][] OCCUR.
OWNER'S & CONTRACTOR'S PROTo
GENERAL AGGREGATE
$
None
500
500
500
50
5
GlS-C005065-00
11/10/91
11/10/92
PRODUCTS-COMP lOPS AGGREGATE $
PERSONAL & ADVERTISING INJURY
EACH OCCURENCE
FIRE DAMAGE (Anyone fire)
MEDICAL EXPENSE (Anyone person)
COMBINED
SINGLE $
LIMIT
BODILY
INJURY $
(Per person)
BODILY
INJURY $
(Per accident)
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
$
EXCESS LIABILITY
EACH
OCCURRENCE
OTHER THAN UMBRELLA FORM
WORKER;g COMPENsATION
AND
EMPLOYERS' LIABILITY
$
$
$
(EACH ACCIDENl)
(DISEASE - POLICY L1MI1)
(DISEASE- EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSjVEHICLES/RESTRICTlONS/SPECIAlITEMS
Exclu~ions: Oral Contractual, Sexual Abuse, Trampoline, Medical Payments for Students/Athletic Participants, Designated Products &
Pollution. .
Certificate holder is incl. as additional insured for operations conducted by the named insured.
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...... ........ ...................
....... ..........
mm:}}m:mm:m:m::}::I;:}tM:~@!Q~@A:n.o.t.if:m:m::tm:mm:mm}m:m::m:m:}t:m::m:m:m:tttt::m:m:m:m:tt;}::m:mm}:t:}:::m:m::;m::m:::}m:'tm:=}:}}}mm:=::}:tm:m:::;::}};=}::
. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 1Q DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
n. LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
City of Clearwater
Post Office Box 4748
Clearwater, Fl 34617
...
CERTIFICI TE OF INSURANCE \ _
PRODUCER
D
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.
COMEGYS INSURANCE CORNER
POBOX 40660
ST PETERSBURG FL 33743
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
AMERICAN STATES INS CO
INSURED
COMPANY B
LETTER
AMERICAN STATES INS CO
GIRLS INCORPORATED OF
PINELLAS
7700 61ST ST NO
PINELLAS PK FL 34665
COMPANY C
LETTER
COMPANY D
LETTER
AMERICAN STATES INS CO
THIS IS TO CERTIFY THAT 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 CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EffECTIVE
DATE (MM/DDIYY)
POLICY EXPIRATION
DATE (MM/DDiYY)
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY 01 A !II 18 5183 8
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [i] OCCURRENCE
OWNERS & CONTRACTORS PROTECTIVE
8/13/91
8/13/92 GENERAL AGGREGATE $ 1 000
PRODUCTS COM PlOPS AGGREGATE $
PERSONAL & ADVERTISING INJURY $ 500
EACH OCCURRENCE $ 5 0 0
fiRE DAMAGE (ANY ONE fiRE I $ 50
MEDICAL EXPENSE WJY ONE PERSON) $ 5
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
X SCHEDULED AUTOS
HIRED AUTOS
NON OWNED AUTOS
GARAGE LlABILrTY
01BA1040018
6/18/91
6/18/92
CSL
$1 000
BODIL Y
INJURY
(PER $
PERSON
BODILY
INJURY
rC~~oENTI $
PROPERTY
DAMAGE $
EACH
OCCURRENCE
AGGREGATE
$
$
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
liC3057156,
10/05/91
0/05/92 STATUTORY
$ 500
$ 500u
$ 500
(EACH ACCIDENT)
(D'SEASEPOUCY LIMIT)
(DISEASE,EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I RESTRICTIONS I SPECIAL ITEMS
CITY OF CLEARWATER IS NAMED AS AN ADDITIONAL INSURED
CITY OF CLEARWATER
POBOX 4748
CLEARWATER FL 34617
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
PIRATION 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 KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
~ARK BERSET;?;?la/ #~.