CERTIFICATE OF LIABILITY INSURANCE (3). C>RCERTIFICATE OF LIABILITY INSURANCE OPID SA FMTE (MMIDDfYYYy)
YOUNG-8 01/20/10
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 1027 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-7910
Phone:727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC#
INSURED s
/
INSURER A: Phil
aQelphia zns. companies
???.n
,t? (L,C.f'? - r
ogressive Commercial
INSURER B: PT
10193
Yo g Women r s Christian Assn
Of Tampa Bay INSURER C:
655 Second Avenue South
701 -
INSURER D:
St. Petersburg FL 33 ---
INSURER E:
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS-
LTR NSR TYPE OF INSURANCE POLICY NUMBER N DATE MMIDD FE "rIVE .0 DATE MODPIb N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1000000
A X COMMERCIAL GENERAL LIABILITY PHPK3 7 3115 01/01/10 01/01/13 PREMISES Ea occurence $100000
CLAIMS MADE l "] OCCUR MED EXP (Any one person) $ 5000
PERSONAL & ADV INJURY $ 1000000
- GENERAL AGGREGATE $ 3000000
GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 3 0 0 0 0 0 0
X POLICY JECT LOC Em Ben. 1000000/1
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
300000
B ANY AUTO 047436128 11/08/09 11/08/10 (Ea accident) $
ALL OWNED AUTOS BODILY INJURY
$
X SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
A X OCCUR CLAIMSMADE PHUB259124 01/01/10 01/01/11 AGGREGATE $ 1, 000, 000
DEDUCTIBLE
X RETENTION $10,000 $
WOR
AND KER
EMP S COMPENSATION
LOYERS' LIABILITY
TORY LIMITS ER
YIN
- ..ANY PROPRIEZORIPARTNERIEXECU71Yf _..___ ..._.Y ....__, .: _._ _ . - .... :. ....:.. _ - _ . ..E.L..EACH ACCIDENT - = • -.$
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH) ?
E.L. DISEASE - EA EMPLOYEE
$
H s, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $
OTHER I
J
012010
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BTIENBORS?
5
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SRI
LEGIS
A
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITYCLR DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
CITY OF CLEARWATER, FLORIDA
ki REPRESENTATIVES.
Janet S
nner
612 Franklin St AUTHORIZED REPRE NTATIVE
h
Clearwater FL 33765-5414
ACORD 25 (2009/01) 0 19W2ffft4%B0M.CORep6TMQK_4WIh lpft wserved.
The ACORD name and logo are registered marks of ACORD
TIT, T061AEllM
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized
representative or producer, and the certificate holder, nor does it affirmatively or negatively amend,
extend or alter the coverage afforded by the policies listed thereon.
ACORD 25 (2009101)