CERTIFICATE OF LIABILITY INSURANCE (5)
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Art~ur J. Gallagher
260p McCormick Dr.,
Cle.rwater FL 33759
Phone: 727-797-4190
tlSURD
& Co. (FL)
suite 300
OP ID DATE (MM/DDIYYYY)
BOYSA-1 10/30/06
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.
ACORDm
CERTIFICATE OF LIABILITY INSURANCE
Fax:727-791-1613
INSURERS AFFORDING COVERAGE
Markel Insurance Company
NAIC#
38970
Boys and Girls Clubs of the
Suncoast Inc.
5111 66th street North Ste 200
st Petersburg FL 33709
COVIERAGES
INSURER A:
INSURER B
INSURER C
INSURER D
INSURER E:
TI-lE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TI-lE INSURED NAMED ABOVE FOR TI-IE POLICY PERIOD INDICATED. NOTWITl-ISTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITl-I RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY: PERTAIN, THE INSURANCE AFFORDED BV 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.
LTR I~RC TYPE OF INSURANCE POLICY NUMBER DATE (MMlDDIYY) DATE (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY 8502CY258186-3 10/16/06 10/16/07 ~~,~~c 'v ~c,,'c~ $ 100,000
PREMISES (Ea occurence)
- ~ CLAIMS MADE ~ OCCUR
MED EXP (Anyone person) $ 5,000
-
PERSONAL & ADV INJURY $ 1,000,000
GENERAL AGGREGATE $3,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $3,000,000
I n PRO- nLOC Emp Ben. 1,000,000
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODIL Y INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODIL Y INJURY
- $
NOr-f-OWNED AUTOS (Per accident)
I--
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTl-lER THAN EAACC $
AUTO ONL Y AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND ITORY LIMITS I IU~~
~PLOYERS' LIABILITY
P#-IY PROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $
CFFICERIMEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $
~es. describe under
ECIAL PROV ISIONS below E.L. DISEASE - POLICY LIMIT $
ClTHER
DESCR'TlON OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
The City of Clearwater has been added as additional insured with regards to
Gen.ral Liability as required by written contract.
CERTIFICATE HOLDER
CANCELLATION
CITOFCL
SHOULD ANY OF TIHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ~E EXPIRATION
City of Clearwater
Municipal Services Bdlg
100 S. Myrtle Ave
PO Box 4748
Clearwater FL 33758-4748
DATE ~EREOF, ~E ISSUING INSURER WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN
NOTICE TO ~E CERTIFICATE HOLDER NAMED TO TI-lE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON ~E INSURER, ITS AGENTS OR
ACORD 25 (2001/08)
@ACORDCORPORATION 1988