CERTIFICATE OF LIABILITY INSURANCE (12)
ACORD;; CERTIFICATE OF LIABILITY INSURANCE OPID ~ DATE (MMIDD/YVVY)
YOUNG-S 09/2S/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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.
Clearwater 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 TampaBaK
655 Second venue South INSURER D
st. Petersburg FL 33701
INSURER E'
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TI-E 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 TI-E TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I'"'''' 'N"sRC POLICY NUMBER ~OA';!~ (MMlDDNY) DATE (MMlDDNY) LIMITS
LTR TYPE OF INSURANCE
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
I-- 10/01/06 01/01/0S 'UAMAljt
B X COMMERCIAL GENERAL LIABILITY 3602SS25S3993 PREMISES (Ea occurence) $ 100000
I-- tJ CLAIMS MADE ~ OCCUR
MED EXP (Anyone person) $ 5000
I--
PERSONAL & ADV INJURY $ 1000000
I--
GENERAL AGGREGATE $ 3000000
I--
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 1000000
n n PRO- nLOC Emp Ben. 1000000/3
POLICY JECT
AUTOMOBILE LIABILITY ~ -'-,- --._- ------~ --' ~ --,"" -- -- ----
,- ------- ~-_._-- - -- - COMBINED SINGLE LIMIT $1,000,000
A ANY AUTO 047436125 11/0S/07 11/08/0S (Ea accident)
I--
ALL OWNED AUTOS RECEIV ~D BODIL Y INJURY
I-- $
X SCHEDULED AUTOS (Per person)
I--
HIRED AUTOS BODIL Y INJURY
I-- $
NON-OWNED AUTOS OCT O~; 20 7 (Per accidenl)
I--
PROPERTY DAMAGE $
,~- '.- ~,. (Per accidenl)
GARAGE LIABILITY n. ............,','1,. ," !'V;,,> AUTO ONL Y - EA ACCIDENT $
R ANY AUTO LEGf:: LPJrVE ii?'V,.::: ,"
OTHER THAN EAACC $
AUTO ONL Y AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B tJ OCCUR D CLAIMS MADE 4602SS25S1613 10/01/06 01/01/0S AGGREGATE $1,000,000
$
Fx1 DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATlON AND ~T lQ~-
ER
C EMPLOYERS' LIABILITY Z049904505 06/24/07 06/24/0S $ 500000
ANY PROPRIETORIPARTNERlEXECUTIVE EL EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000
If yes, describe under $ 500000
SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT
OTHER
-- - --_.-- ____'"C - - - I_...._c.~.__=c___, I -- O'- - -""-, -- -- -- -- - -----,-- --.- -_.- 1-
DESCRlPTlON OF OPERATlONS I LOCATlONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
Certificate Holder is listed as additional insured.
CERTIFICATE HOLDER
CANCELLATION
CLEARW6
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN
Clearwater Police Department
Chief Of Police
Sid Klien
645 pierce Street
Clearwater FL
NOTlCE TO THE CERTlFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLlGATlON OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATlVES,
AUTHORIZED REP
PORATION 1988
ACORD 25 (2001/08)
ACORDm CERTIFICA TE OF LIABILITY INSURANCE OP 10 8~ DATE (MMlDDIYYYY]
YOUNG-8 09/28/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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.
Clea:t:Water I'L 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 BaI
655 Second venue South INSURER D
st. Petersburg I'L 33701
INSURER E
COVERAGES
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 TH: TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR NSR[ TYpe OF INSURANCE POliCY NUMBeR D'1I~(MMlDDIYY) DATe (MMlDDIYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
- U"'VI""C
B X COMMERCiAl GENERAl LIABILITY 3602SS2583993 10/01/06 01/01/08 PREMISES (Ea occurence) $ 100000
- ::=J CLAIMS MADE ~ OCCUR
MED EXP (Anyone person) $ 5000
-
PERSONAl & PDV INJURY $ 1000000
GENERAl AGGREGATE $ 3000000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPIOP AGG $ 1000000
I n PRO- nLOC Emp Ben. 1000000/3
POLICY JECT
AUTOMOBILE LIABILITY --\~OMBINED SINGLE LIMIT
A == ANY AUTO---- '--.-.-".-' ,- 047436IZS--- ,-"--" --n/1JSm -cu/~ Ea accirleclL _ . n., $1,000,000
- PECEIVE
AlL OWNED AUTOS D BODIL Y INJURY
- $
X SCHEDULED AUTOS (Per person)
-
HIRED AUTOS 2~n~ BODIL Y INJURY
- ,rT o 'j $
NON-OWNED AUTOS " r: :.IU (Per accident)
- 'oJ'''''
PROPERTY DAMAGE $
(".~,.., .. .~\ I '.:c'" '-'I}:."\<.: c....; r") (Per accident)
GARAGE LIABILITY ..J~~: ;:::;:.;'/~.::-:~ L~:: ;)1 AUTO ONL Y - EA ACCIDENT $
~ ANY AUTO I. J J ,~,
OTHER THAN EAACC $
AUTO ONL Y: AGG $
eXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B ::=J OCCUR D CLAIMS MADE 4602SS2581613 10/01/06 01/01/08 AGGREGATE $1,000,000
$
~ DEDUCTIBLE $
X RETENTION $10,000 $
WORKeRS COMPeNSATION AND IT6~\t:~if's I IUER'
C EMPLOYERS' LIABILITY Z049904505 06/24/07 06/24/08
ANY PROPRIETORIPARTNERlEXECUTIVE E.L EACH ACCIDENT $ 500000
OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ 500000
If yes, describe under $ 500000
SPECiAl PROVISIONS below E.L. DISEASE - POLICY LIMIT
OTHER
.. -- - -- -- . ---- - - ".
_.n._" . - - - ,
DeSCRIPTION OF OpeRATIONS J LOCATIONS J veHICLES J EXCLUSIONS ADDeD BY ENDORSEMENT J SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
CITYO 0 5 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THe ISSUING INSURER WILL eNDEAVOR TO MAIL 30
DAYS WRITTeN
City of Clearwater -
Pat Fernandez
PO BOX 4748
Clearwater FL 33758
-"'(~L
NOTICE TO THE CeRTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURe TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSUReR, ITS AGeNTS OR
REPRESENTATIVES.
AUTHORIZED REP
PORATION 1988
ACORD 25 (2001/08)
ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP 10 L~ DATE (MM/DDIYYYY)
YOUNG-8 11/30/07
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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.
ClearwaterFL 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 BaX
655 Second venue South INSURER D:
st. Petersburg FL 33701
INSURER E:
COVERAGES
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.
L TR INSR[ POLICY NUMBER ~OLI~iIEI'F_E~T!XE P!:.l!"~](~'RfIRA ~~N LIMITS
TYPE OF INSURANCE DATE MM/DDIYY DATE MM/DDIYY
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
- UAMAl;t: I U Kt:N I cu
B ~ COMMERCIAL GENERAL LIABILITY 3602SS2583993 10/01/06 01/01/08 PREMISES (Ea occurence) $100000
=:J CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000
f--
PERSONAL & ADV INJURY $ 1000000
-
GENERAL AGGREGATE $ 3000000
-
GEN'L AGGREnE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 1000000
I PRO- n Emp Ben. 1000000/3
POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
-
-A- i- .'. ANY~UTO - -04'1436125_ . _l:1,IQ~IO"J_ 1 1.lQ8IO.8 (Ea accident)
-.' ---- ------ - --- -.-.---.-.-..
- _____~==~=""...,.,,=o__:_- .-- --
ALL OWNED AUTOS BODILY INJURY
- .--- ,....'....'r- (Per person) $
~ SCHEDULED AUTOS ... .-, I", V~
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS DEe ( 7 2007 (Per accident)
-
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY ....,;.. ~! " AUTO ONLY" EA ACCIDENT $
......,.,.,. .
R ANY AUTO ,.
.. <..It( 'i '-'...., ... EA ACC $
OTHER THAN
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $1,000,000
B o OCCUR D CLAIMS MADE 4602SS2581613 10/01/06 01/01/08 AGGREGATE $ 1,000,000
$
8 DEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND I WC--sTATlJ-1 IU~~-
TORY LIMITS
C EMPLOYERS' LIABILITY Z049904505 06/24/07 06/24/08 $ 500000
ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT
OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 500000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500000
SPECIAL PROVISIONS below
OTHER ~----- -..-,-'
-. - - ----_.__...-~---_.--'--'--
~--- .--~" - ----...- .- ~----
-. -.--.,- ~~'----- _.------ ------- --.-------- ..--_.
- ------.------ ~--_._-~..- i---.-.-.
-' ..-..-----. --'-
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
CERTIFICATE HOLDER
CANCELLATION
CITYO-4
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 DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
City of Clearwater Official
Records and Legislative SVCS
Cyndie Goudeau City Clerk
P.O. Box 4748
Clearwater FL 34618
PORATION 1988
ACORD 25 (2001/08)