CERTIFICATE OF INSURANCE
ACORD,. CERTIFICATE OF LIABILITY INSURANCE OP 10 K1 DATE (MM/DDIYYYY)
NEIGH 1 04/01/03
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Brown & Brown, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Daytona Beach Office HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 2412 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Daytona Beach FL32115-2412
Phone: 386-252-9601 Fax:386-239-5729 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Philadelphia Indemnity Ins (0
INSURER B: Commerce & Industry Ins Co
NEIGHBORLY SENIOR SERVICES INC INSURER C:
13650 STONEYBROOK DRIVE INSURER D:
CLEARWATER FL 33782
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.
'~i~ ~~~i POLICY NUMBER POLI%EFFEcn;r POLlcr{FXPIRATlgN LIMITS
TYPE OF INSURANCE ' DATE MM/DDIYY DATE MM/DDIYY
GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000
I---- I 12/30/02 12/30/03 PREMISES (E~~~~u~~nce)
A X COMMERCIAL GENERAL LIABILITY PHPK039661 $100,000
--- ---- . ,WIDE [bJDCCUR __._.___~__________ ____ n' ------ .- ,---- --.-------- --~-- '-- MED_EXP_!Any_nne ~) $ 5,QQO~. ., ~
X PROFESSIONAL LIMIT $1,000,000 r PERSONAL & ADV INJURY $1,000,000
-
LIABILITY AGGRE $2,000,000 GENERAL AGGREGATE $2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $2,000,000
I n PRO- nLOC i I
POLICY JECT
AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ 1,000,000
-
A X ANY AUTO PHPK039661 12/31/02 12/31/03 (Ea accident)
,-
ALL OWNED AUTOS BODILY INJURY
-- (Per person) $
SCHEDULED AUTOS
--
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
X PHYSICAL DAMAGE COMPRE $500.00 PROPERTY DAMAGE
- (Per accident) $
DEDUCTIBLES COLLIS $1,000.00
GARAGE LIABILITY AUTO ONLY, EA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ 1,000,000
A o OCCUR D CLAIMS MADE PHSD043617 12/31/02 12/31/03 I AGGREGATE $1,000,000
I $
R DEDUCTIBLE $
RETENTION $ I $
WO"ffi"O''''''''O,^'' , I T~~/ ~,~Ws , iU~~-
-B . :~~'6:~~~~~~~E~E~~TI~;----WC91i9125 9 ,-'--~- '--03/2 4""toz- --o31Z1! 7 or El~CH ACCIDENT ITO 0-;-000' '-.
OFFICER/MEMBER EXCLUDED? E.L. DISEASE, EA EMPLOYEE $ 500,000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
/:-"
" : '.1
---~ ~ ',.
CERTIFICATE HOLDER CANCELLATION
CITY OF CLEARWATER
CITY HALL
ATTN: HOWIE CARROLL, ASST HD
112 S OSCEOLA AVE
CLEARWATER FL 33756
CLECI 0 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
E LEFT, BUT FAILURE TO DO SO SHALL
@ ACORD C
ACORD 25 (2001/08)