CERTIFICATE OF INSURANCE
......"Att.tlll.. ............1.1.111.11.11...1............1.........1.1........i.m.I.".lli.II... '..".'.."....".....,..,..,.....,..,..,.....,.....,..,..,..,'.,.'Ii,.,'.,.,',',;,...........,....,.....,...."."..,..,.,."...,..".....,'............................................................... -.uE DATE4 (MMIDD24 fYY)g 5
~:~:~:~:~;~:~:~:~:~:~:~:~:~:::::::::::::::::::::::~:::~:~:~:~::::::::::::::::::::::::::::::::::::::::::::::::-;--;::=:::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::;:;:;:;:::;:;:::;:::;:;=;:;=;:;:;:;:;:;:;:;::;;=;:;:;:;:;:::;:;:;:;:;:::;:;:;:::;:::;:;:::::;:;:::::;:::;
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CER11FICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
MUTUAL INSURANCE INC
POBOX 12350
ST PETE FL 33733
~~YA
AUTO OWNERS INS CO
IN8URED
~ANY B
PINELLAS HABITAT FOR
HUMANITY INC
POBOX 16101
ST PETE FL 33733
~ANY C
~ANY D
~ANY E
THIS IS TO CERTIFY TltAT THE POlICIES OF INSURANCE USTED 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 CONDf11ONS OF SUCH POLICIES. UMlTS SHOWN MAY HAVE BEEN REDUCED BY PAlO ClAIMS.
CO.
lR . TYPE OF IiI8URANCE
POLICY NUItIIER
......... .............................................................................
, , ,
. POUCY EFFEctIVE . POLICY EXPlRAnON.
, DATE tfoMOOfYY) . DATE (MMIDDIYY)
LIMn
GENERAL LIU&ITY 23 2035452 3
COMMERCIAL GENERAL lIA8IUTY
ClAIMS MADEJc:.. H OCCUIl
OWNER'S & CONTRACTOR'S PROT.
4/16/ 9 5 4/16/ 9 6~~~'':'E:(i~~H'HH.:3.(>..C>Hd>.(>..C>,
. PFIOOUCTS.cOMPIOP AGG. ..
................... ....................... ........................
. PERSONAL & N>V. INJURY H~~<>.(>.L<>.<>.(>.,
,.,'~,c:l<:<:lJ.~~~~"" ""~,~,<>.,c>.,f.'.C>'c>.'c>.H
. FIRE DAMAGE (Any - hI HH',!5.(>.,fHc>.(>.(>.,
. MED. EXPENSE (Any _ pel'lOnl .5 000
AUTOII08ILI! UAIIUTY
ANY AUTO
AU. OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE UA8IUTY
- ;~-'\
[ffi~~~nJ~~
APR 2 7 1995
COMBINED SINGLE .
UMIT
BODlL Y INJURY .
(I'<< ..-nl
BODlL Y INJURY .
(I'<< IOCldenl)
PROPERTY DAMAGE .
EACH OCCURRENCE .
AGGREGATE .
EXCE88 UAIIlUn'
L/MBRB.LA FORM
OTHER 1HAN UMBREllA FORM
R!SI( MAt~AGEME~Jr
DISEASE-POLICY UMIT .
DISEASE-EACH EMPLOYEE .
"JlVQfI_~~'__~~~____
MID
EMPLOYUS' LlA8UTY
OTHER
IIE8CIUPTION OF OPERA'IIOIIU OCA~ IIEII8
NAMED ADDITIONAL INSURED: CITY OF CLEARWATER
~,
.4 Pr'J _ i' ~.vSHOUlD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
, IT 2 8 1/':-; I EXPIRATlON DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO
Crr '.;:;;::!ia MAIL ~ DAYS WRITTEN NOnce TO THE CERTIFICATE HOLDER NAMED TO THE
CITY OF CLEARWATER Y ctt/?..H LEFT, BUT FAIlURE TO MAIL SUCH NOnce SHALL IMPOSE NO OBUGATION OR
RISK MANAGEMENT OFFICE 'I( Di.;pr.<< UABIUTY Of' ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
POBOX 4740
CLEARWATER
FL 34618
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