NORTHWOOD ESTATES HOME OWNERS ASSOCIATION INC. / CERTIFICATE OF INSURANCE
CERTIFICATE OF INSURANCE
The company indicated below certifies that the insurance afforded by the policy or policies numbered and
described below is in force as of the effective date of this certificate. This Certificate of Insurance
does not amend. extend, or otherwise alter the Terms and Conditions of Insurance coverage contained in any
policy numbered and described below.
CERTIFICATE HOLDER:
CITY OF CLEARWATER
PARKS & RECREATION DEPARTMENT
ATTN - DEBBIE REID
PO BOX 4748
CLEARWATER. FL 33758-4748
INSURED :
NORTHWOOD ESTATES HOA INC
POBOX 14732
CLEARWATER, FL 33766
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I [ ] Other Liability
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I AUTOMOBILE LIABILITY
I [ ] BUSINESS AUTO
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I ] Umbrella Form
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Should any of the above described policies be cancelled before the
expiration date. the insurance company will endeavor to mail
written notice to the above named certificate holder, but failure to
mail such notice shall impose no obligation or liability upon the
company. its agents, or representatives.
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TYPE OF INSURANCE I
LIABILITY I
[X] Liability and I
Medical Expense I
[X] Personal and I
Advertising Injuryl
[X] Medical Expenses I
[X] Fire Legal I
Liability I
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POLICY NUMBER
& ISSUING CO.
77-PR-178050-0001
NATIONWIDE
MUTUAL FIRE
INSURANCE CO.
I POLI CY
EFF. DATE
06-01-00
I POLI CY
IEXP. DATE
I 06-01-01
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LIMITS OF LIABILITY
(*LIMITS AT INCEPTION)
Any One Occurrence. , , . . . . , $ 1. 000,000
Any One Person/Org '.,..,. $ 1. 000.000
ANY ONE PERSON .......... . $ 5.000
Any One Fire or Explosion $ 100,000
General Aggregate* ',...., $ 2.000.000
Prod/Comp Ops Aggregate* . $
[ ] Owned
[ ] Hired
[ ] Non-Owned
Bodi ly Injury
(Each Person) ....,..,., $
(Each Accident) ,....... $
Property Damage
(Each Accident) ..,..... $
Combined Single Limit,... $
EXCESS LIABILITY
Each Occurrence....,..,.. $
Prod/Comp Ops/Disease
Aggregate* ....,....,... $
] Workers'
Compensation
and
Employers'
Liability
STATUTORY LIMITS
BODILY INJURY/ACCIDENT... $
Bodily Injury by Disease
EACH EMPLOYEE ....,...., $
Bodily Injury by Disease
POLICY LIMIT,...,...,.. $
Authorized Representative: LARRY T, AUSTIN
Countersigned at: 29275 US 19 NORTH
~rL.
Effective Date of Certificate:
Date CertifiGffte Issued:
06-01-2000
02-27-2001
MAR U 7 200',
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DESCRIPTION OF OPERATIONS/LOCATIONS
VEHICLES/RESTRICTIONS/SPECIAL ITEMS