CERTIFICATE OF INSURANCE (2)
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DATE (MM/DDiYY)
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6/13/06
PRODUCER
800-824-9245
TInS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TInS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
Acordia
7 Giralda Farms
2nd Floor
Madison, NJ 07940
COMPANIES AFFORDING COVERAGE
COMPANY
A
FEDERAL INSURANCE CO.
INSURED
COMPANY
PINELLAS HABITAT
FOR HUMANITY
3071 1 18TH AVE N
ST. PETERSBURG, FL 33716
B
RECEIVED
COMPANY
c
COMPANY
TInS 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 WllICH THIS
CERTIFlCATE 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. LIMITS SHOWN MAY IIA VE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF.
DATE (MM/DDiYY)
POLICY EXP.
DATE (MM/DDiYY)
LIMITS
A
GENERAL LIABILITY
COMM. GENERAL LIABILITY
CLAIMS MADE [L] OCCUR
35781707
4/01/06
4/01/07
GENERAL AGGREGATE
PROD-COMP/OP AGG.
PERS. & ADV. INJURY
EACH OCCURRENCE
FIRE DAMAGE(One Fire)
MED EXP(Any one person)
COMBINED SINGLE
LIMIT
2 00
1
1000000
Hired & Non-
Owned Liab.
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-oWNED AUTOS
o
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY-EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
EACH OCCURRENCE
AGGREGATE
-WOPJa:RS-{';Cl',~SAT1-0N---ANI}
EMPLOYERS' LIABILITY
-sTKl"UTORY LIMITS
THE PROPRIETOR!
PARTNERSIEXECUTIVE
OFFICERS ARE:
INCL
EXCL
EACH ACCIDENT
DISEASE-POLICY LIMIT
DISEASE-EACH EMPL.
OTHER
'06 JUN 16 PM1:3
DESCRIPTION OF OPERATIONSILOCA TIONSIVEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED AS THEIR INTERESTS
MAY APPEAR WITH RESPECTS TO CONTRUCTION OF HABITAT FOR HUMANITY
HOMES WITHIN THE CITY OF CLEARWATER.
CITY OF CLEARWATER
SIIOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SIIALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
112 S. OSCEOLA AVE
CLEARWATER, FL 33756