CERTIFICATE OF INSURANCE (3)
ISSUE DATE (MMJDDIYY)
10/13/93
PRODUCER
nns CEK'I1nCATE IS lSSum AS A MATIER 01' INFORMATION ONLY AND
CON'FERl! NO RlGK1'9 UPON THE CEK'I1nCATE HOLDER. nus CERTIJ1CATE
DOES Naf AMEND. EXI'END OR ALTER THE COVERAGE AITORDED BY THE
POLICIES BELOW
American Business Ins, SE
COl\1PANIES AFFORDING COVERAGE
P.O. Box 31666
COMPANY
LInTER A
COMPANY B
LInTER RELIANCE SPECIAL RISK
COMPANY C
LE'lTER
COMPANY
LE'lTER D
COMPANY E
LE'lTER
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Tampa, FL 33631-3666
INSURED
PINELLAS COUNTY EMERGENCY MEDICAL
SERVICES, ETAL
CIO RISK MANAGEMENT
400 S. FORT HARRISON, 3RD FLOOR
CLEARWATER, FL 34616-5165
n ".T
4 1~93
.;\
(".......\. ..\,>.'""\l.,..t\',);:':.~"
nus IS TO CEK'I1FY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN lSSum TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. N01WITH$I' ANDING ANY REQUlREMENI', TERM OR CONDmON OF ANY CONrRACf OR OTHER DOCUMENI' WITH RESPECf TO WlDCH nus
CEK'I1nCATE MAY BE ISSum OR MAY PERTAIN, THE INSURANCE AITORDED BY THE POUCIES DESCIUBED HEREIN IS SUIIJIlCf TO ALL THE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EIT. POLICY EXP.
TR DATE (MMIDDIYY) DATE (MMIDDIYY)
GENERAL LIABILITY
LIMITS
GENERAL AGGREGATE
B
COMM. GENERAL LIABILITY
CLAIMS MADE Docc.
OWNER'S " COIITRACf'S PRaf
PROD-COMP/OP AGG.
PERl!. " ADY. INJURY
EACH OCCURRENCE
nRE DAMAGE(One nre)
MED. EXP. One Por
SHI65013608
10/01/93
10/01/94
COMBINED SINGLE
LIMIT
1000ooo
SCHEDULED AurOS
fiRED AurOS
NON-QWNED AurOS
GARAGE LIABILITY
BODILY INJURY
(Porp<<SOn)
BODILY INJURY
(per oa:Idenl)
PROPERTY DAMAGE
EXCESS LIABILITY
UMBRELLA FORM
afHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
~~t~~~~~~~~;~;~~~~~~~t~~~~~~~mttt~r~;~~~j;f~~~~tt~f ~t~~;~~~~~t~~;~j~~~~~;~jtt~j~~~~;~~~~~~~rtt~~;~tt~~~
WORKERS' COMPENSATION
AND
EMPLOYER'S LIABILITY
STATUTORY LIMITS tr~:~~rtt}lff~t~rrrtttt::~::
EACH ACClDEIIT
DISEASE-POLICY LIMIT
DISEASE-EACH EMP.
OTHER
DESCRIPTION OF OPERATlONSILOCATlONSNEWCLESISPEClAL ITEMS
:~etii!tirieAiirnojj)Ef6ASttmnltaUj(lNALt:mU.iJs.URiI)@ttN~ANeEili1bi6N\tt~tt:ttntttttr~~~tt:tt}:tr~~~::ttr~:~tt:tmllillt~~lttttitlttfflI~~i::~:~~:~ftf:ti:
CITY OF CLEARWATER
CLEARWATER, FLORIDA
BECEIVE
OCT 2 5 1993 :.!~:
CITY CLERK DEP
SHOULD ANY OF TIlE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL ..l.lL.. DAYS WRITTEN NOTICE TO THE CERTlnCATE HOLDER NAMED TO THE
LEIT, BllI' FAILURE TO MAIL SUCH NaflCE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON TIlE COMPANY, ITS AGENfS OR REPRESENI'ATIVES.
"';;:c':.:';'
9/30/93
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. .
.................1. ..............'.....................
'.'...;..,'~~::.' ~...J.;\:":.~;,;
.:-;",'>
"; ISSUE DATE (MM/DD/YY)
" ~',: " - 'i .t,..:...~,;~~;;<::
At~ttlll..
CER1:lFICA TEIoF INSURANCE"
PRODUCER
AMERICAN BUSINESS
1 INSURANCE SOUTHEAST
P.O. BOX 31666
TAMPA, FLORIDA
33631-3666
COMPANIES AFFORDING COVERAGE
, INSURED
i
\ PINELLAS COUNTY EMERGENCY MEDICAL
SERVICES, ETAL
C/O RISK MANAGEMENT
400 S. FORT HARRISON, 3RD FLOOR
f~~~NY A WESTERN WORLD INSURANCE COMPANY
COMPANY B AMERICAN EMPIRE SURPLUS LINES INS CO
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
CLEARWATER, FL
34616-5165
COMPANY E
LETTER
'COVERAGES
: THIS IS TO CERTIFY THAT 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 POLlCIES_ LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YYI
LIMITS
A
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE X OCCUR.
NSL05087
10/1/93
10/1/94
GENERAL AGGREGATE $ 500,000
PRODUCTS,COMP/OP AGG. $
PERSONAL & ADV. INJURY $
GENERAL LIABILITY
OWNER'S & CONTRACTOR'S PROTo
X AMBULANCE DRIVERS &
ATTENDANTS MALPRACTICE
$5,000 DED. PER CLAIM
EACH CLAIM $ 500,000
FIRE DAMAGE (Anyone fire) $
MED. EXPENSE (Anyone person) $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
B
UMBRELLA FORM
3CX06228
COMBINED SINGLE $
LIMIT
SODIL Y INJURY $ I
(Per person) i
SODIL Y INJURY $ I
(Per accident)
PROPERTY DAMAGE $
EACH CLAIM $ 500,000
10/1/93 10/1/94 AGGREGATE $ 500,000
STATUTORY LIMITS
EACH ACCIDENT $
DISEASE-POLICY LIMIT $
DISEASE-EACH EMPLOYEE $
X OTHER THAN UMBRELLA FORM
WORKER'S COMPENSAT;ON
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER AS
CITY OF CLEARWATER
CLEARWATER, FLORIDA
ADDITIONAL INSURED CANCELLATION
R E eEl V E DSHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
OCT 2 5 1993 MAIL11L- DAYS WRITTEN NOTICE TO THE CERTIFICA'fE-HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
CITY CLERK DEPT LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
~~~ d~~