CERTIFICATES OF INSURANCE/1995 & 1996
...... .......,.................,...............,.-......................
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............................................ ::::::::;:;:;::::;;:;::;:::;::::::::::::;:-:.:-..... ..... 12 12 9 5t~:
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
<At:ttll.... . mEB1IIE)mJl.~tIIE IHSIB~HeE,
PRODUCER
:.;.:.:.:.:.:.;........:.....'.:.;.;.;:.;.:.:....:.:.:.;.;.:.:.:.:.:-'.:-:.:-;.:.:.:.;.;.:.:.:.:.:.;.:.'.:.:.:.:.;.;.;.;.>;.;.;.:.;.:';.:.;.:-;.:.:.:.:.:.:.:.:.;.:.;.:.:.:.:.;.'.:.;.;.:.:.;.;.;.;.:::.;
... ..........
:';.:.:.:.:.;.:.;.:.:.:.:.:.:.:.:.:.:.:.;.:.:.;.
Altamura Marsh & Assoc
P.O. Box 6980
Clearwater FL 34618 6980
COMPANY
A AMERICAN STATES INS CO
INSURED
Golden Cougar Band
Boosters Inc
POBox 13127
Clearwater FL 34621 3127
COMPANY
B
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOlWlTHSTANDING 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
POLICY EFFECnvE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DDIYY)
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
A GENER.'lllABllITY 01CL407938-1
Y COMMERCIAL GENERAL LIABILITY
N CLAIMS '-'lADE [XJ OO:;UR
OWNER'S & CONTRACTOR'S PROT
08/15/95 08/15/96 GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
AUTOMOBilE liABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT $
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE I $
EACH OCCURRENCE $
AGGREGATE $
$
EXCESS liABiliTY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE, POLICY LIMIT $
DISEASE - EACH EMPLOYEE $
THE PROPRIETOR!
PARTNERSIEXECUTIVE
OFFICERS ARE:
OTHER
RINCLI
' EXCL
DESCRIPTION OF OPERA TlONS/lOCA TlONSNEHICLES/sPECIAlITEMS
CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED
RE: PHILLIES PARKING
500 000
500 000
500,000
500 000
50 000
5 000
$
$
CITY OF CLEARWATER
RISK MANAGEMENT DEPT
P.O. BOX 4748
CLEARWATER, FL 34618
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEllED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO MAil
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE lEFT,
BUT FAilURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
R REPRESENTATIVES.
Clearwater FL 34618 6980
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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.
COMPANIES AFFORDING COVERAGE
.-........-.-..-........,...............................
... . - .........,........-....--.
< At~.tlll..
PRODUCER
Altamura Marsh & Assoc
P.O. Box 6980
COMPANY
A AMERICAN STATES INS CO
INSURED
Golden Cougar Band
Boosters Inc
POBox 13127
Clearwater FL 34621 3127
COMPANY
B
COMPANY
C
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,
CT~I TYPEOFINSUAANCEi'>OUCYNUMBER p~::,:~~r P:~Y(=~N .-----
A GENERALUABIUTY 01CL407938 08/15/94 08/15/95 GENERAL AGGREGATE
UNlITS
$
500
500
500
500
50
5
000
000
000
000
000
000
COMMERCIAL GENERAL UABIUTY
N CLAIMS MADE rn OCCUR
OWNER'S & cONTRACTOR'S PROT
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED EXP (Anyone person) $
I AUTOMOBILE UABIUTY
ANY AUTO
All. OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-DWNED AUTOS
ri5) I
li1l !E~!EUWf!
MAR
COMBINED SINGLE UMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
I GARAGE UABIUTY
ANY AUTO
EXCESS UABIUTY
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE $
UMBREu.A FORM
OTHER THAN UMBREu.A FORM
I WORKERS COMPENSATION AND
EMPLOYERS' UABIUTY
I THE PROPRIETOR!
PARTNERS~ECUTIVE
OFFICERS ARE:
OTHER
INCL
STATUTORY UMITS
EACH ACCIDENT $
DISEASE - POUCY UMIT $
DISEASE, EACH EMPLOYEE $
EXCL
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPEClAL ITEMS
CERTIFICATE HOLDER IS NAMED AS AN ADDITIONAL INSURED
RE: PHILLIES PARKING
CITY OF CLEARWATER
RISK MANAGEMENT DEPT
P.O. BOX 4748
CLEARWATER, FL
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"AN 2 J e/)
C1r'y 1995
ClEf/( /)
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SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
34618
. ION 1993
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