CERTIFICATE OF LIABILITY INSURANCE (2)
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CERTIFICATE OF LIABILITY INSoFit'N6E~ I
'RODUCER
;:"anier Upshaw,
1115 US Hwy 98
?O. Box 468
:"akeland, FL
Inc.
South
DATIo (MMIUUIYY)
03/28/00
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
33802
'1SURED
?inellas Youth Football
?O. Box 71
-..largo, FL 34294
Conference Inc.
INSURERS AFFORDING COVERAGE
'INSURERA:Cincinnati Insurance Company
I INSURER B:Twin City Fire Insurance Company
jllNSURER c: f
, INSURER 0:
I INSURER E:
I
;OVERAGES
THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
ANY REQUIREMENT. TERM OR CONDrrlON 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 CONDrrlONS OF SUCH
POUCIES. AGGREGATE UMrrs SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.~.f:1 TYPE OF INSURANCE : PDWCY NUMBER I POLICY EFFECTIVE iP9.I;!~ EXPIRATION; WMITS
A ~NERALLIABILITY iCAP7848907 ! 04/15/00 04/15/01 EACH OCCURRENCE s500. 000
X COMMERCIAL GENERAL LIABILITY I I FIRE DAMAGE (Anyone fire S 100 . 000
I CLAIMSMADE~ OCCUR I , MEDEXP(Anyoneperson) s5 000
f.~~~E.^,euM" .."em", I ::;:~:::::~:::. :::: : :::
fXl POLICyn ~~gT n LOC i
3 ~TDMOBILELIABILITY 24ZAF006583 07/22/99
~ ANY AUTO
_ ALL OWNED AUTOS
_ SCHEDULED AUTOS
.x. HIRED AUTOS
.x. NON-OWNED AUTOS
07/22/00 COMBINED SINGLE LIMIT 15-300 000
(Ea aCCident) .-J '
BODILY INJURY
(per person)
s
BODILY INJURY
(per aCCident)
s
PROPERTY DAMAGE
(per accident)
s
qGAR .AGE LIABILITY I
i
ANY AUTO i
RXCESS LIABILITY I
OCCUR D CLAIMS MADE!
DEDUCTIBLE I
RETENTION S !
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AGGREGATE
AUTO ONl y. EA ACCIDENTi S
EAACC Is
OTHER THAN
AUTO ONL Y: AGG I 5
Is
Is
Is
is
EACH OCCURRENCE
OTHER
is
1.;-;!,;:T~~c,1 IOJ~~ .___ ___
E.L. EACH ACCIDENT S
E.L.DISEASE.EAEMPLOYEE S
E.L. DISEASE .POLICY L1MI S
I
I
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DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/EXCLUSIONS ADDED BY ENDORSEMENTlSPECIALPROVISIONS
Certificate Holder isshown as ,Additional Insured under
Coverage ~.
General Liability
RECEIVED
CERTIFICATE HOLDER
: ADcmONALIN5URED,INSURER ~Ft
CANCELLATION 1- L Ii (' : ." ',. ,
SHOULD ANY OF THE ABOVE DESCfIIBED POUCIES BE CANCELU:D BEFORE THE EJa>IAATlON
DATETHEREOF,THEISSUING INSURERWIL~I'PY-'el~~~~N
NOTICETOTHE CERTlFlCAlC HOLDER NAMED TO THE lEFT, BUfFA/LURE TO DOSOSHALL
IMPOSE NO OBLIGATION OR UABIUTY OF ANY KINO UPON THE INSURER,ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZE REPRESENTATIVE
City Of Clearwater
POBox 4748
Clearwater, FL 34618
ACORD 25-S (7/97)1 of 2
#S21245/M21244
~ ACORD CORPORATION 1988
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