CERTIFICATE OF INSURANCE
ACORQy CERTIFIC OF LIABILITY INSU CE DATE (MM/DDlYY)
9/26/2002
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Pilkington Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P. O. Box 10066 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
11701 Belcher Road South, Suite 104 COMPANIES AFFORDING COVERAGE
Largo FL 33773-0066 COMPANY TIG Indemnity Company
A
INSURED: COMPANY Ameritrust Insurance Corporation
Pinellas Opportunity Council, Inc. B
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3443 1st Avenue North COMPANY v L .;JICT -z:a , ,'"_''' L4
St Petersburg FL 33713 C
COMPANY
0
COVERAGES
THIS IS TO CERIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEE~~ 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 F SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDL CEO BY PAID CLAIMS.
CO lYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATlm LIMITS
LTR DATE IMM/DDIYY) DATE IMM/DD/YY)
GENERAL L1ABILllY GENERAL AGGREGATE $ 3 000 000
~
~ :3MMERCIAL GENERAL LIABILITY PRODUCTS-COM~OPAGG $ INCLUDED
A ~ CLAIMS MAD{!] OCCUR MH 39259620 9/30/02 9/30/03 PERSONAL & ADV INJURY $ 1 000 000
OWNER'S 8. CONTRACTORS PROT EACH OCCURENCE $ 1.000000
~
FIRE DAMAGE (Anyone fire) $ 100.000
MED EXP (Anyone person) $ 15.000
AUTOMOBILE L1ABILllY 1,000,000
I--- COMBINED SINGLE LIMIT $
ANY AUTO
I--=-
ALL OWNED AUTOS
Y BODILY INJURY $
SCHEDULED AUTOS (Per person)
,." A- ~ HIRED AUTOS ., -. MH 3Q~~~~~0 9/30/02 .. 9/30/03 ...' -.-. '.
BODILY INJURY $
~ NON-OWNED AUTOS (Per accident)
- PROPERlY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
~
~ ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
~ f---.
AGGREGATE $
EXCESS L1ABILllY EACH OCCURRENCE $
~- UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND I-l&~ l:i'Mlfs I I'tW- $
EMPLOYERS'L1ABILllY 100,000
b 1002-03212-00 9/30/2002 9/30/2003 EL EACH ACCIDENT $
THE PROPRIETORlR INCL EL DISEASE.. POLICY LIMIT $ 500.000
PARTNERS/EXECUTIVE
OFFICERS, ARE: "n'_ "'EXCL .'. .n... _ -.. __ e. --.-.-----,--.-- EL UISEASE~ EMPLOYEE" $- 100.000- ---.-- -
.
OTHER
A PROFESSIONAL MH 39259620 9/30/02 9/30/03 AGGREGATE $ 3,000,000
EA PROF $ 1,000,000
A CRIME MH 39259620 9/30/02 9/30/03 E1D $ 500,000
DESCRIPTION OF OPERATlONS/LOCA TONSNEHlCLES/SPEOAL ITEMS
CERTIFICATE HOLDER CANCELLATION
City of Clearwater Community Development Block SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Attn: Maria Orsello 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEF ,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR L1ABILlT
112 South Osceola OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
Clearwater FL 33756 AUTHORIZED REPRE~~~ ->-\ ~ ..
David G. Pilkington'::: ; :J I... . "..
ACORD 26-5 (1/95) ... N 1988
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