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INSURANCE CERTIFICATES
L) 0 • oriARAI IONS -.,tipplwiimilr.!(1 by Applii„ible muds)) ..Afta Med %-XtFlitred ' ADDRESS: (Number & Street, Town, County, State & Zip No.) • Lr49rilppf5m1Hrs Pr)ft rtNiQ. • 12.1ar.5j-e.. ADI ne 11/41 OLA 10 rto 05 1.0% cpm. hist PACKAGF POLICY 1,()11cyNumliI:R PP • • Plpc.41as Oppfity 3c4p4 Poqvi • 1960 r.).-110.4 �ad . c.:1424mpte7, F.4.or4.4p. 335 • jillerest of pried instIted in insured / owner Lil4eflffal lossoe J tenant The mu! insurel is: individual 18 1=1 PartnerstliP El corporation a' Posiness pf the gamer; insurer! is — , - — 2 , Pnlic't Period: :,,maa oo No, SI I ,-. WM: ' 1,1.40 -. 1 T9' lel...:-.T9 THE AMERiCAN pRuqc-iisTs1 INsuirtANc cpmemmy \\ CINP!NFU, 'pijq 5262 ' 4 )Af LI' REPORT and AGENT'S RECORD i ....._..._._ .., _ - Reinsurance ! ' Co. T Amount Premium • r:eA Trans...'' Terr. or .1 Town t! • .- Agency office —grass . Man. Comm. . sEcrinti 1.-- Property Coverages Fire pier , - Ilipatite.form(s): __ j...1rait of Lability attached . ilp - supplement supplement 1 iwand Marine •per:: ..._ attached _pj.2004 , SECTION II — Liability Coverages ZINO:M°' of Liability Aiplicable form(s) ".,•-,---,..',,e:•:-.---,s1.e General Liability and Tenants' P.'',anufacturers' and Contractors Contractual Liability - rrOperations and 1 P;emises Medical Payments '.. Liability Liability Products , Bodily Injury Liability -.. ' - 100 ,000 each occurrence 163950, , \ . L9484 — - . . . .11 . ig Liability [1] LI . -. $ 1,00,000 aggregate each occurrence - Properly D ., amage , ' , i ahilItY i,spleted $ •.. "Do ,000 ,000 uggregate .. , . Reit person accident person . , ,p00 each ,000 each !-Corriprifie:n-sive Automobile Liability . . ,,$ Bodily Injury Liability $ • ,000 each occurrence Property pamage Lialo. ity $ ,000 each occurrence tomobile Medical Payments II . •each person tir,rsured Motorists • •• I . r.)atttoiliiiill_s . , . • bro 466 . ,000 each person _ . _ _ . . .. , . . ... .. 9288_ ____ ,. ,_,__:__ • , ' ' Applicable forei(s) ' :,' -. ,000 Part for Iiimits• of each Liability 'f• i ialiiiity Liability Irap)iiriv,._ accident ...-- uarage • Automobile Physical Damage r, P/ofessional Liabili1/ • Persorial a111111 Lability. L. . SECTION III — Other Coverages . ..... ___ . • L-..1• ' - 1-1 , 1. I , . See Covorage ...,.. , See Covoragn Sr Covem ,., Sflo Covpt 1 per suppleMent attached per supplement attached .9 Pail for 'lipids ill Par for 1.irrii! et ... „ . .9.1 1-0116.1.1Y , . • 1 2c,glary & -Robbery . Crrip•ehensive Glass SECTION )1/__ Workmen's Compensation and/or Employers' Liahility Coverage , 4.6111 01-10.NPY ' See ;!1?filieqllie 101.111(sPtiq .P •ApplicRhie f °rods) ' , • .[Iod Endorsements and Additional il-rTTSIEL.!Erir77. rierilidM •0P9 , Coverages iS -Oyalle: effective (Identify by form !lumbers) r r , ., ' c, ' ,,•Estimated •On F9,412} date of policy $ 0-1-1..no ls( Anniversary • . ' . fil CrITP rip, if other , Total Advance premium $ 11->r, oni,:j.'s •!--/.3-4-.;/ t $ 2nd Anniversary $ than annual:- F.'iill',!: S Cover?ges are subject to the General Provisions, of f pp WW1 • 10,71 kr12-.9 PRPOTo.4iyaPp Ins4mnpp Agepey.,Flori.c.la Form 'Y., PN1102-5.74 Authorized Representative dd -0N ,C.!lod •1 11aWi!, o1-6si1oijo tJ 40 1ho gu!s1le halal ,)etio§.16H jo 5slieddd diqeAed 6.1e 11641M se2tWeP;aSOlh. 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Location of all premises owned by, rented to or controlled by the !pulpit insurer! fFNMI If 4MF bPCTION A5,.!lpfIFSS SHOWN I 11F/4 I OF OFCLARATIONSI See Below l:Jte-est of named insured in such premises ( r.isnrriel Lessee i Tenant ri QUIP( - 7.; names insured r.•11P, : s:es -azards insured nereunder known to exist at the effective Op of this policy, unless athepyise stated herein. SeMEpq4 arforded i only with respect to such of the following povarages as aro indicted pY specific premium charge or charges. The limit of the compaoy's iinst each such Coverage shall be as stated herein. subject to .all the terms of this policy having reference thereto. _. Coverages BRIA! PM! 4( Hazard,s Description of tjaardS . L Breminiff Bases § )91. , PPR. , ili i)rr;191tTOT rt- N 1Pillirt" (0) hilts (I) MmIsslans :11qtft4. Limits pf PattilitY • 4,1. 1P1 Per (s) rr (P) or (I) 10f R9Y4.9ce Premiums • each :qemirrpnce ' nenrenete . • , A—Sctily Injury Liability . , • pirophot Insgfell 19-MQ4------$ 0°00(/' ' 3,00e0944,----$ cost PPr T11)0 Damage Liabillty , ,• , $- . $ (9).F91 Tropp Pf Receipts i Ts rrn oumbers of endorsements attached at issue . • .. ., $ Total rlflYaflPe Premium '• I __. BRIA! PM! 4( Hazard,s Description of tjaardS MP . 79P5P / Breminiff Bases § )91. , PPR. , ili i)rr;191tTOT rt- N 1Pillirt" (0) hilts (I) MmIsslans :11qtft4. Advance Premiums 4,1. 1P1 Per (s) rr (P) or (I) 10f it , ' r?eir9.Fr,to't ro)(9) uol oil imi (1!lplissiPp5 l'eff1pflIng P.O, gged Of Ar9 riPiligPliq" . liurilir !Neu Xppl.ticd TP94-4g1Pd ____ ________ - - , PrgliertY Damage . , Premises • Operations All premises and oper#5.pnp of the timed Tnp4red (dOPIPPR#P Rated -. on the average daily attendann0 Increased Tdmitp Basle Charge 1 , . _ Escalators (Number at Premises) -. S Ne known exposures pirophot Insgfell Independent pontrqctors S pone at inception cost PPr T11)0 at cast , . _ Completer! Operations , i None at Inception (9) fiecelPI9 (9).F91 Tropp Pf Receipts i Products . luded ln Comppq#p 1,1140 (P) s9rel co per $1,000 pf Sales ligt,41 A14011,11111 # 1.1.11 rielPIPP14_, t_ 'TWO ', $ Tnri: , When used as a premium basis: i 11 "admissions" means the total number of persons, other man employees ef,the rimer! irmurerl, uPinitten to the event insured nr to events copducted on the pi-emises whether on paid admission tickets, complimentary tl?kets Pr it./ssR., • , '. ' • , 2. "cost" means the total cost to the oarnpd insured with respect to rinernfinns neriermun for the parpeci ipqr00Porio.g the oplicyperipilptindependent- ccntractors of all work let or sub -let in 'connection with each specific PIRIPP„ti 1pc ofng the pp0 of all labor materials an epipmpnt furnished, used or delivered for use in the execution of such Wqri whether,furnisherl py the . ekrer, contractor or I*Prifrupfer, IftpltglioF all tees, allowances, bonuses or commissions made, paid or due; . 3, "receipts" means the gross amount of money charged by the namellomrerl for snpn operations 4.ft1P MIle9 imfirpd or py Pt hers luring the policy period 35 3•E rated on 2 receipts basis other than receipts from. telecast4,'hroa0Castlog or motion Noires, an loplortas faiies, other than faxps.whiOh the pared insured co:lects as a separate item and remits .direptIr to'? egyernmerPl•filY1.4-- . ,,, . "remuneration" means the entire remuneration earned during r1T POltFY nerind by urgurietprs pd ly q.11 PRIPIRPP$ qf thP, PAW !MITI, other than Chauffeurs (except operators of mobile -equipment) and aircraft pilpit qoo co pts subject any nyerfnne mings or ion rule applicable in accordance with the manuals in use by the 'cqfppalyi 111111t0IPP of romfineraf 5. "sales" means the gross amount of money charged by the garpedif1pri fir py *pie tracting ender his llama for all ports pnci propos sold or distributed during the policy period and charged d4ring the pplicy,peribOf4 ins 1 qiipp, sprviPiriii_pr,rp.pir. 469 IPPIVIPs 16)(Ps. Athol lhan taxes which the named and such others collect es a separate item and remit directly ,o a npritiliwttrql 911/1$1911. 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Allpoq y3ns 40 41100033 uc sbdelllep i)U!ijoo0 pelbsW a4; 1sl)e11e 4!ns ALIO pica}ep o) A;lip pus )4du 844 ar,ey Ilb4s AUedWoa dui pub '506611660o 0e Aq pasneo 'sa!jdde eaueJnsui s!1{) y3!yuL 04 a2ewep A4iadold •a Jo AJnjOf Allpoq l0 asneaaglsa2ewep se Aed o4 paje2)jgo /Medal ewooeq jle(3s palnsui 64; 4o)ijM sU1ris j)e palnsu1 ay140 liegaq,uo iced !1!M Auedwoo 8141 , •AiI11HVI139VWV0 A1H3d08d—a 3911H3Ab3 A11118V11 AUOrNI AIidoe—V 39Vd3A03 '! 4 GENERAL.;f PQiSEMENT �) NP, INSURED School 3oard of Pine1lap Cqu ra y PPHCY NUMB f1 PP 90 08 94 AFFECTIVE DATE 1-1-78 POLICY PPPIOP TP 1-1-•3.1 Additional $ PRFMIl1M CFf ANGE: (I( atly) I I !le?! -Rn. $ 2t4yflgf 4 flY4e41 Tf1$4FWJe AgePcy T1-9404 8-1 {fctive date 1-1-78 Expiration Date 1-1-01 Second and Third Year Prf-u0.ums P. q be dptermi.neci fItjs pplicI jlr tiNI1N'f'I fllj)It.fwistt f"rl.�II1'�I,iS�,if'fl)1 ' .f hi: enclor.r:rnr:nl forrw, a part of the pollry'lo wlllch f IIQcllvr !VIM If1Ir )Ihlrt `1r1F1:}jtl)fr Ill1lc}lttr1 DRUGGISTS' .9,na0 wge OTN. , r $fc AMERICAN BUILDING, CINCINNATI, ONTO 45202 Pf�QPL I9 in Iti'e,IPlicy t{l1lvs i1>aw[wistrsttllrxi ipr p1ft•. COU.NTEIlSICiN TJRE.OF,,6UT1ipmzp-prAc3 NT- GEN;ALEpORSEMENT • NO. 1 INSURED Pinellas County School Board Additional $ cliANGF (if any) 1 Rpturn $ row)/ NUMBER PP 90 08 94 EFFECTIVE DATE POLICY PFRIOP' TO Reymond 1!Y4!!!P IPP NOWY Florida In consideration of the prp1144m Ox -F(04 and preiduti 't;C). be4000n1410 at each Anniversary Date item 2 0 010 Policy is amended to read: Jan. 1, 1978 .0 Jan 1, 3.9111 1 PRODUCER, This Polif:y slII)iflf:! Pq1Plwist! 111 Endor'.,:trmcit f,rrrr);jrtf thr, pnlicy b vdhielh ti J1Jjnn 1!10 qrnfIrvvisp.stiltv!i fnuwe AMERICAN f3611-PIN9. ciffcifIkATI. PflP 45202 'ffIHNTrnslqW-1411PpfAupijzFp i\OPNT • FRpscfor,Tp PACKAGE POLICY PROPERTY COVERAGE—SECTIO11 I—FIRE sprfl-Fmgtir JflIrflfl(( ri y for '(ilr,Ir1(J, IIi.Fj, Ari7onri, Norq(L), crwc polow!, 01 itrogin, I Irmnii, 1•1•111o, I limo!, Irlrimr)(1, flittiqy, 1 •••:1•,•••fiq, te1,•rd,111•1,,M11111(pll, Miy.1;i•,(1•1120squii Novivirl, No, rTh'w 11 11rtIi I 14 1 1,114,mci, Pri•erri, pholy ',11,1!) l rtIrII I1 11,11,01c1, 11101, 1(11,),,r1, Wr..1 Wr,com,jr• 011,1 Thjs sypplempni 90'4 otkPliPci to f.! form iIt qt rglipy Nkilphor oi the E AMERICAN p.Ruqc!5Ts,! iNsruRmic compoy Cincinnati; Ohio I riceritior, lowi148 Expiration Y,PqM Fr 99 98 DflNS it it important that the written p9rtirr o allal pQicies coni pp) same froopr, fel piilptty milt?. Ipey FIR §ppp!fl pp mr.ip ppliprpi at - - - Lrl;IJRtI(l s PROViorp M;n1f11;1 ONLY -mow. rrpip, ArlpfPR Psr. puvRtopfs flipICAirp ny r.ttiMIHM 4ril? MIAINsf 11111fli ANP OR OTHER CQV(.RAGES ONLY wiirn rnoottsrn iirpFoN, oh. hpre PERIL(S) Insurer! Apninst and cover- Pr9v.ifilifkr(111§Frf rfaTP Pt EcIl) Af4PLINT FIRE AND LIGHTNING EXTENDED COVERAGE A.O.P. ,Amount fire or Fire —nr"i and Extended Cov- erage, er Miler Peril • 1,000. Per Cent of Co -Insurance Applicable 1,OPOI X X ?rl X X X tt PREMIUM AUVANUL IleAt Incl. 44e1.1 TOTAL(s) $ show corntrhoiph, type 01 roof app pcp4p4ftcy• pf tion Dr$,PPIPTIDA AND Locktiofi Ilicipprry ceifFREP oinorchyPrafi of cpppipingtny proporty cnyerFtl• °mimeo as a ftwallifiptato tionitiqr of fri!IF$. °P cqq904 !,444.44ng occ$4004 *a 09400 094rd 44flpe! 19Prte at ' 196J gaSt44.4 R9i4. Omegayliterp'Flo • • - SoPiect ffIrm, !$),. ra,P4Pf! 1,1Proif!: eta es rig' (19sert Forr ilyTpeEd4n,p,ate(s) ) FFFQ1A(5.7,4,p ba•rli67VIgtrtf411 mu62:413:113,) Mortgagp ciatqpi Subject to provisions pfljip merlgqgp plqqe tittaphed hereto, loss, if any, an buildipg iten, shall e nqyPIP to; • (Insert name(s) ot roortpngee(s) Icicitessjes> • ... kittlqrl?Pft,PPrPPniqtivP .' . . ,. IN CONSIDERATION OF THE PRP,Y!!Pti5 IA. NP Uir41-AuPti4 $filri 911 Appfp li F 11 -r p AND OF the'preniium above sPepified, this corhpany, f8r th6 term ot yeor$ spetifipcf ciPove frOm face, ion epte showIrciga0,At [loon (Sionqcircf Thr-ietc expiration dote shown above At flog() (fPfidprii TITO Pt lOcCIti91-1 Pt property inv°IvPci, to 91 qrpqqnt not p..cooecliff0 the Or001-Int(s) ohoyp cpec,fied, does insure the iasureCf named ctbgve'9n'cl leqcl, Ppres.entSltivp,, 110, thP PxtPilt pf the oftwol ff,lsh volHe of tie propFrN qt the time of los, .-}-ut cc.' exceeding the crr,cunt which it .4YOUIC! cost to repair or replfice the property with moteriol of lie 1<inc and quality within q reosonobie time ofter sI.J.c'n lass, without allowance for any ncreased cost of ropair Pr rpcpnstryFtiPn py reason of any ordinance or !my regHlqtiri9 FonstrHcticin pr repo,r,tond without compensation for loss resulting from interryptinn pf easiness ormont-ifocre, nor in orlY PYPilt fpr more /hwy. the iritqrpst .qf the in=u'd:agoinst oil DIRECT LOSS BY 94g, ppliTHRip AND BY REMOVAL !ppm pftEmIsp .ENpAtiqpgp fly TML. PERILS INsPli .1--1- AGAINST IN 'nip POLICY, gxcgri. A§ HEREINAFTER FF'Qvippl.tPlhe -lerern while loccaeol or contained as described in-: This policy, or pro rata "for five days at each proper pc to whieWcipy pf the' property shpill necessarily he removed for preseryotion frorn the , rqqpqty .09§cril* perils insured ogoinst in this policy, but not 'els0WhPIT. . Assignment of this policy shall not be valid except with the written Fl$Pn.t of this CPPIPPPY. ., .•. , . This policy is mode and accepted subject to the foregoing provisions on sppulotions and those hereinafter stated, which are herede hy maq port . of ;his polic, together with such other provisions, "stipulations and agreements qs rnoy-pd olcIecf hereto, qs provided in this policy. . .: .,i. ni,st, PP 2004 - 5/74 i . 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Ali o)rjtjods sSa Uri 'JOU 'sall!Jn3ds •A4Jado.4d paida,xa Jo AouoLU 4gJp jo sOJUD4 ;Ad 'spaap 'ADuaJJn) puo 1s111q 'sjuno3)o JoAoj 400 I&&Us ADilod 5141 algoinsuiufl •b4dJdg1 6u1ibldi pOJnsul 0114 Aq 6UiJoaMs asjbj Jo 15014 Auo ;c dsb) Ul Jo '010131.14 polosll! a141 jo 1soJa4u! ay4 10 '4001001 4)3(gns 0111 Jo 03Ubih5Jl S114j 6111u10066o a)uolsWnDJo JO 4004 101.101 bW AUb p3jUd501do15lw Jo 13100000) Aljn; 11M sb4 paJhsti! 3y4 0 10140 Jo aJo;oq •pnoij Jay1o1M '41 pion 014 11 AD11od aJilu( 5i44 '4uawlbaiuoD Aq Z3 13 611 £L o_ c' EL IL O/ 69 99 7E9 09 6S �0 9 Z5 I0 00 Or 1 1' (111 60 2” 9. C^ IC �1- 64 a! LC 9Z. 07 ll 61 21 LI 91 :_ 1 1.1 11 01 6 8 9 e c- 7 SCHOOL BOAD OF PINELLAS COLINTY, FLORIDA Gus Sakkis Superintendent 1960 E. Druid Road P.O. Box 4688 Clearwater, FL 33518 Telephone: (813)442-1171 August 31, 1979 City Clerk City of Clearwater P. 0.. Box 4748 Clearwater, Florida 33518 RECEIVED SEP 4 1979 CITY CLERIC RE: Contract between City and School Board - Use of fire training facility Dear Sir: Rev. Arthur Libby Albers, Chairman John R. Espey, Vice -Chairman Jerry Castellanos Betty L. Hamilton Calvin A. Hunsinger Martha Rudy Wallace Gareth R. Whitehurst According to our Risk Management Department, Mr. Jerry Wymer has a copy of the School Board's insurance policy with regard to the above and you should contact him for same. Please send me a fully executed copy of the contract. Thank you for your cooperation herein. Very truly yours, 9 B. Edwin Johnson Cfl'") School Board Attorney / /pac