CERTIFICATE OF LIABILITY INSURANCE (14)
OP ID S DATE (MM/DD1YYYY)
HEADS-2 12 28 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.
ACORDN
CERTIFICATE OF LIABILITY INSURANCE
PRODUCER
Brown & Brown Insurance
17757 US Highway 19 N, Ste 660
P.O. Box 2456
Clearwater FL 33757-2456
Phone:727-461-6044 Fax:727-442-7695
INSURED
Head Start Child Development
& Famil~services
~~~~lI:s p~~~n~'3~~ij~50~~
COVERAGES
INSURERS AFFORDING COVERAGE
NAIC#
22667
10699
37974
41718
INSURER "'-
INSURER B:
INSURER C:
INSURER 0:
INSURER E:
Ace American 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.
LTR NSR[ TYPE OF INSURANCE POLICY NUMBER ~~1MMlDDIYY) Pgk'fEY(MMlDDIYY) LIMITS
GENERAL LIABILITY __u u EACH OCCURRENCE $1000000
- ~----- --- - ~ .- .u --~- - - ---.- .
A X X COMMERCIAL GENERAL LIABILITY G20400869 01/01/07 01/01/08 ~~iS'ES (E~~~~~nce) $ 100000
l CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
~ Prof/Sex Abuse PERSONAL & f>JJV INJURY $ 1000000
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000
XI nPRO- n Emp Ben. 100/300
X POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 500000
-
A ~ ANY AUTO H08123032 01/01/07 01/01/08 (Ea accidant)
ALL OWNED AUTOS BODILY INJURY
- (Par person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- (Per accident) $
NON-OWNED AUTOS
-
'-- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
tJ OCCUR D CLAIMS Mf>JJE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
..---. -- weRKERG OOMPE:tl&J', TIONANS-------- .-- ---- --'-"-~ - ---.----- --- --- -- Lx 1 WR'UUIoUIS I iUJ.Ii-
_.EEL
B EMPLOYERS' LIABILITY 30610266 01/01/07 01/01/08 $ 100000
ANY PROPRIETORIPARTNERlEXECUTIVE E.L. EACH ACCIDENT
OFFICERlMEMBER EXCLUDED? E.L_ DISEASE - EA EMPLOYEE $ 100000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER
C Mt Hawley MCP0134583 OS/24/06 OS/24/07 Property Schedule on
D Endurance Special. CPN10000155500 OS/24/06 OS/24/07 File with Aaenc
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS f>JJDED BY ENDORSEMENT / SPECIAL PROVISIONS
Certificate holder is an additional insured for general liability only with
regard to Sanderlin Center Playground - 918 Palmetto Street, Clearwater, FL
CERTIFICATE HOLDER
CITYOFC
City of Clearwater
ATTN Earl Barrett
P.O. Box 4748
Clearwater FL 33758-4748
ACORD 25 (2001/08)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHO 0 RESENT
E~
@ACORD CORPORATION 1988