CERTIFICATE OF LIABILITY INSURANCE (4)
04/08/2004 14:23 FAX 7275354774
GULFCOAST JEWISH FAMILV
III 002/002
ACORD. CERTIFICATE OF LIABIUTY INSURANCWi~ p~ 011 ;-e: (IIMIIlIIIYYJ
')8/20/03
PROOlICeR THIS CERTIFICATE IS ISSUeD AS A MATTER OF INFORIlI'TION
ONLY AND CONFERS NO RIGHTS UPON THE CSRTIFIC,'TE
B~ u , 8~o1lU In.~anC8 HOLDER. THIS CERTIFICATE DOES NOT AMENO, EXTEI ~D OR
1~lld AveDue If,S, Suite 610 ALTER THE COVERAGe AFFORDED BY THE POLICIES ~ELOW.
St.. Pet:eZ'sbu~g PL 33701 INSURERS AFFORDING COVERAGE
Phone: 727-4S'-leoo 1'ax,121-823-1988
lMIUftEu INSURER"'- Bava1 XnsU%'iUlCG Co,
Gulf Coa.~ "'ew1eh Faa1.1y IflSUReR 8: .....Z':i.t'~.t 1"DIiIU%'~Qe Cozp.
ftijlt<=t~t J:;r . 1flSuAe~ c: '-
Cleazwa~Z' n.~31'O '''~O; -
. I"!SURER E:
COVERAGES
THE POlICIES 01' lN8UfWICE U8TeO IlEI.OW HIW& ENISSUEO TO TI4IINSUMO NAMED MOVe FOR nE JIOUCV f'ERIOO ltlOItAT!D. N(l1WITttSTANOING
N<< ReQUIR&M&NT. TERM OR CONDITION OF Nf'( CONTRIoCT OR OTHER OQC:UMI!NT 1MTM MSPI!:CTTO WHlCtt THI8 CERTIFICATE _v IlEISSUfO OR
MAY PCATAlN. THE JNaUIWICE AFf"OROliO IT THE I'OUCI&S DaClU8EO _IS SU8Jecr TO ALL TttE ~.I!XClUSlOltS I'\NO COHOITION$ OF SUCH
POLICES. AGGAeGATE UMIT8 8HOWN MAY lfAVI ealN RIiOUC&O IV PAlO QJIlNS.
,.,... OF INIUMNCe POLICY NUllSER
GENERAL UAelUTY
A X COMMERCIAL GENEW UAeIl.lTV R2SP243818
C~~I ~ OCCUR
08/23/93
08/23/04
EACH oecu~
FIRE ~ 1Anr-'"')
MID PI' (Mr -.....,
I'ERSOfW,. &IDIIN.lURY
~AGGREGATE
PlUlOUCTS - COMPIOP AOG
....ITS
11 000 000
I J)O 000
U l 000
II 000 000
. 3 000 000
. 3 000 000
A
GEN'\. ~Te I.MT APPLIU PER:
X POLICY PR LOC
AVTOMOIlIU! LIMIUTY
N<< AUTO
AU. 0WNElJ AUTOS
X 8CHEDULliD AUTC3
X HIReD AU10S
~ NON-OVotoiED AUTOS
a2S'1'420074
COIBNm SINGU: LIMIT .1,000,000
08/2.3/03 08/23/04 (b -*"I)
BOOILY INJURY .
I.... J*IOftl
IIOllILY INJURY .
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PAOI'ERn' o.t.M.IIGE .
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AUTO ONI. Y . EAACClDENr .
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EACH OCQIIlAeNCE ,
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s
s
,
X IMITS
07/01/03 07/01/04 IU.. &ACMACCIOeHT " 00,000
E-L. DlBEA8E . EA EMI'LO '100,000
U. OISfASE - POLICY LIMff I ~ DO 000
08/23/03 08/23/04 EA OCCUR l,OOO,OOO
AGGUGllft 1 000 000
ANY AI1TO
IXC&lJ8 LIABILITY
OCCUR 0 CtAltdMADI
a
1002-02825-00
A PROnsszONU. L%AB
R2S':420075
QII 0I'iRA11OM8rL0CA~"'AOOl!D BY I!NlIlHaIBI&ImIPEC
CERTIFICATE HOLDER
N AODI1ICINIU. ~ INIlIREIt l,eT12It::
C%ftC-l
CANCEUATJOH
SHOULD"", OF 11lE ~ Cl!SCIUBIJ) PClUCEIIE eMCIU....1IIF ftE11tE ElII'M"nON
DAte ~, 1ME I8GVlNG 1N1UUIl-.L 1iMDIiAItlO" TO MAl.. .J.I: _DAYS"""'"
H01lCI TO 1HE caml'lCA1l! MaUlElt NMlliD 1'O,....-T. BlITFAlLU .E TO DO so SIW.L
IMPOSE 110 0IIUGA1ION OR l.IAIllLm' OF AN't KIND UPON tHE INllUREF 1T8 AGENTS OR
R!I'MI&NTA111IElL
AU~IQS
~ACORD CORP, nON 1188
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Ci.ty o~ Clearwablr
Zft~l:iag ~t
BDg1nee~ing SeJ:'Y1ce. D2.viaicm
p, O. Boz 4748
C1earwate: F.L 33156-5520
ACORD 2S-S (7117)