CERTIFICATE OF LIABILITY INSURANCE (10)
ACORD. CERTIFICA TE OF LIABILITY INSURANCE CSR sc I DATE (MMlDDIYYYY)
YOUNG-8 08/28/06
PRDDUC!:R THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 7910 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Cl~arwater FL 33758-7910
Phone: 727-797-0441 Fax:727-725-3663 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A Progressive Commercial 10193
INSURER B Markel Insurance Company
Young Women's Christian Assn INSURER C zenith Insurance Company
Of Tampa BaK
i 655 Second venue South INSURER D
st, Petersburg FL 33701
INSURER E
CO;VERAGES
Tc-E P )LICIES OF INSURANCE LISTED BELOW HAVE BEEfi ISSUED TO THE INSURED NAMED ABO'vE FO., TolE F'OLICY PERIOD INDICATED. NOTWITHSTANDING
,OJ IY fi=QUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTolER DOCUMENT WITH RESPECT W WHCol THIS CERTIFICATE Ih\Y BE ISSUED OR
M, Y F ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A-L THE TERMS, E.xCLU:3Im,s AND CONDITIONS OF SUCH
P')L1CIES. AGGREGATE LIMITS SHOWN Mi\Y HAVE BEEN REDUCED BY PAID CLAIMS
1NSR ~~[ ~D~~(~~;rf6ri!:). -DATE (MMlDDIYY)
LTR TYPE OF INSURANCE PDLICY NUMBER LIMITS
GENERAL L1ABILllY EACH OCCURRf,NCE $1000000
f------ U, YlAbc
B X COMMERCIAL GENERAL LIABILITY 3602SS2583991 10/01/05 10/01/06 PREMISES (Ea ,)ceurence) $ 100000
- =:J CLAIMS MADE ~ OCCUR
MED EXP (Anyone person) $ 5000
-
PERSONAL & ADV INJURY $ 1000000
-
GEflERAL AGGF:EGATE $ 3000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1000000
I n PRO- nLOC -~
POLICY JECT Ernp Ben. 1000000/3
AUTOMDBILE L1ABILllY COMBINED SINGLE LIMIT
- $1,000,000
A X ANY AUTO 047436123 10/22/05 10/22/06 (Ea accident)
-
ALL OWNED AUTOS 60DIL Y INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODIL Y INJURY
- $
I~ON-OWNED AUTOS (Per aCCIdent)
-
- PROPERTY DAMAGE $
(Per aCCIdent)
GARAGE LIABILllY AUTO ONL Y - El\ ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B' =:J OCCUR D CLAIMS MADE 4602SS2581610 10/01/05 10/01/06 AGGREGATE $1,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WDRKERS CDMPENSATIDN AND I X IT~\lT~~~ I ID~-
EMPLDYERS' LIABILITY Z049904502 06/24/06 06/24/07
C ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ 500000
OFFICER/MEMBER EXCLUDED? I $500000
E L. DISEASE - =A EMPLOYEE
If ',es, describe under $ 500000
SFECIAL PROVISIONS below EL DISEASE - .~OLlCY LIMIT
OTHER
DESCRIPTIO'N O'F O'PERATIO'NS / LDCATIO'NS I VEHICLES I EXCLUSIO'NS ADDED BY ENDDRSEMENT I SPECIAL PRO'VISIO'NS
,
CE~TIFICATE HOLDER
CANCELLATION
CITYO-4
SHDULD ANY O'F THE ABO'VE DESCRIBED PO'LlCIES BE CANCELLED BEFO'RE THE EXPIRATION
DATE THEREO'F, THE ISSUING INSURER WILL ENDEAVOR TO' MAIL 10
DAYS WRITTEN
City of Clearwater
P.O. Box 748
Clearwater FL 34618
NO'TICE TO' THE CERTIFICATE HDLDER NAMED TO' THE LEFT, BUT FAILURE TO' DO' SO' SHALL
IMPO'SE NO' O'BLlGATIO'N O'R LIABILllY DF ANY KIND UPO'N THE INSURER, ITS AGENTS DR
REPRESENTATIVES,
AUTHDRIZED REPRE
PORATION 1988
ACORD 25 (2001/08)