CERTIFICATE OF INSURANCE
; IU/LU/UJ 1~;L~
10/02/03 13:39 FAX
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727441265"~
connelly Ins
Brown & Brown
J<.:rIC !:Sutler -+Margo WallJolt
Insu~~a~BId1 )j. ~~
141 001
LI L
-
ACORD.. CERTIFICA1 OF LIABILITY INSU~I"Cl;oR~!i~ J!' DATE CMMIDD/VVI
10/02/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CEiRTIFICATE
630 Chestnut Street HOLDER. THIS CERTIFICATE DOES NOT AMEN[~. EXTEND OR
P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33757-2456 INSURERS AFFORDING COVERI~GE
Phone: 727-461-6044 FaxI727-442-7695
INSURED INSURER A: Scottsdale Insurance Co.
North Greenwood Communit~ INSURER B:
Cultural Arts Center, LL &: Mt "--
Car.mel CDC of Clearwater, Inc INSURER c:
1014 Pennsylvania Ave INSURER D:
Clearwater FL 33755-3139
I INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURE!) NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWm ISTANDING
ANY REQUIREMENT. TI:KM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITU RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED DYTIIE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXClIJSIONS AND CONDmONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'!"3'..R TYPE OF INSURANCE POLICY NUMBER ~ P.9L ON LIMITS
LTR DATE DATE fMMlDDIYY
GENERAL LIABIUTY EACH OCCURRENCE 51,000,000
I-- 09/26/03 09/26/04
A X COMMERCIAL CENERAL LIABILITY 103975020 FIRE DAMAGE (Anyone nrel 550,000
I- =:J CLAIMS MADE ~ OCCUR
- MED EXP (Anyone p."'c 0) $ 5.000
PERSONAL a. ADV INJUHY sl,OOO,OOO
-
GENERAL AGGREGATE $ 2,000,000
-
GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG 51,000,000
Xl .nPRO. n
X POLICY JEeT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE UM:T
- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- S
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE UABIUTY AUTO ONLY. EA ACC'[IENT S
-I ANY AUTO OTHER THAN I:Jl,ACC 5
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURREI'ICE 5
=:J OCCUR o CLAIMS MADE AGGREGATE $
$
==1 DEDUCTIBLE $
RETENTION S $
WORKERS COMPENSATION AND I TORY LIMITS I IUE1t
EMPLOYERS' LIABILITY E.L EACH ACCII'lENT
$
E.L. DISEASE - EA EMP LDYEE, $
E.L. DISEASE - POLICY LIMIT I $
OTHER
-- ,.,. -
DESCRIPTION OF OPERATIONSILOCATIDNSIVEHICLESlEXCLUSIONS ADDED BY ENOORSEMENTISPECIAL PROVISIONS - :IVI,;;;L/
Arts Academy
NOV 0 6 2003
OFFICIAL RECORDS AND
--
CERTIFICATE HOLDER I y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION "''' ,..~CS Ut:t',
CITYC-1 SHOULD Am OF THE ABOVE DESCRIBED POLICIES BE CAN(::ELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILl. ENDEAVOR TO MAIL ~ DAYS WRITTEN
Parks &: Recreation Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Margo Walbott IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
100 S Myrtle Ave
Clearwater FL 33756 REPRESENTATIVES.
A~(:EN~
I
ACORD 25-5 (7/97)
@ACORDCORPORATION 1988
10 ~o 73-CO