CERTIFICATE OF INSURANCE (2)
Brown & Brown Insurance
111 2nd Avenue N.E. Suite 610
St. Petersburg FL 33701
Phone: 727-456-1800 Fax:727-823-1988
INSURED
ACORD..
PRODUCER
COVERAGES
CERTIFICATE OF LIABILITY INSURANCer~~l~ P
DATE (MM/DDIYV)
10/03/03
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.
INSURERS AFFORDING COVERAGE
Pinellas Opportunity Council,
Inc.
3443 1st Avenue North
St Petersburg FL 33713
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Philadelphia Insurance Co.
AmeriTrust Insurance Co
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
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~f: - b~~lfrMI;f.E~l,;!JVE P.9-L!11rl;~PIRA WN
TYPE OF INSURANCE POLICY NUMBER DATE MM/DDlYVi DATE MM/DDIYV LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A ~ COMMERCIAL GENERAL LIABILITY PHPK061077 09/30/03 09/30/04 FIRE DAMAGE (Anyone fire) $100,000
- ~ CLAIMS MADE [!] OCCUR MED EXP (Anyone person) $ 5,000
PERSONAL & ADV INJURY $1,000,000
-
GENERAL AGGREGATE $2,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000
Xl n PRO- nLOC
X POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $1,000,000
A ANY AUTO PHPK061077 09/30/03 09/30/04 (Ee accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
~ SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
- $
~ NON-OWNED AUTOS (Per accident)
- =~~~M~~E $
~- - ------ - ------- -- -- -.-----.---- -- ~- --~. -- ~- --~-------- u_ ~ "----- -. ----- --- - - - -- --- --
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
.=J OCCUR D CLAIMS MADE AGGREGATE $
$
=l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY LIMITS I IU~~-
B EMPLOYERS' LIABILITY 1002-03212-00 09/30/03 09/30/04 $ 100,000
E.L. EACH ACCIDENT
EL. DISEASE - EA EMPLOYEE $100,000
E.L. DISEASE. POLICY LIMIT $500,000
OTHER
A Professional Lia PHPK061077 09/30/03 09/30/04 Each Occu 1,000,000
A Crime PHPK061077 09/30/03 09/30/04 Emp pish 500,000
-DESCRIPTION OI'"OPERA T101IIS/LOCATJONS/VE'HICl:ESIEXCLOSIONS ADDEO BVERtfuRSEMENTISPECOO: PROVISIONS _. _.-
CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED AS RESPECTS TO
LIABILITY.
,
CERTIFICA TE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ....3..0....- DAYS WRITTEN
Community Deve Block Grant prg NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Maria Orsello IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
112 South Orsello
Clearwater FL 33756 REPRESENTATIVES.
I AU~~,!E~
ACORD 25-S (7/97)
@ACORDCORPORATION 1988