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CERTIFICATE OF LIABILITY INSURANCE (16) .. ACORDN CERTIFICATE OF LIABILITY INSURANCE OP ID S~ DATE (MM/DDNYVY) HEADS-2 01/02/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33757-2456 Phone: 727-461-6044 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Ace American Insurance Co 22667 INSURER B: Majestic Insurnace Company Head Start Child Development INSURER c: & Familt Services 6698 68 h Avenue, North ~D INSURER D: Pinellas Park FL 33781-50 3 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. A X TYPE OF INSURANCE GENERAL LIABILITY - X COMMERCIAL GENERAL LIABILITY - I CLAIMS-MADE[KJ OCCUR~ X Prof/Sex Abuse POLICY NUMBER PD~,;!HJ'~rJ~,w;E P8ATE IMMlDDIYY LIMITS L TR NSR[ GEN'L AGGREGATE LIMIT APPLIES PER: --::--l n PRO- n X I POLICY JECT LOC AUTOMOBILE LIABILITY "-- X ANY AUTO f-- f-- H08123032 EACH OCCURRENCE $ 1000000 01/01/08 01/01/09 UAMA~t: $ 100000 PREMISES (Ea occurence) .' - -.-" ,,- '. $ 5000 MED EXP (Anyone person) PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 PRODUCTS - COMP/OP AGG $ 2000000 Emp Ben. 100/300 COMBINED SINGLE LIMIT $ 500000 01/01/08 01/01/09 (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE $ AGGREGATE $ $ $ $ X I TORY LIMITS I IU~~- "1 '''1 '''0 --- 01/01/.0-9- - _.~" I. 1 nnnnnD...- ., -, -~ E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 G20400869 A ALL OWNED AUTOS SCHEDULED AUTOS f-- X HIRED AUTOS - X NON-OWNED AUTOS c-- ---B- GARAGE LIABILITY R ANY AUTO EXCESS/UMBRELLA LIABILITY tJ OCCUR D CLAIMS MADE RDEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND _~I'LOYERl)'!:'~_ElI_I_rrY__ __ ___ ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ~~~'MtS~~~v~s~6~s below OTHER -- -WC-N0520010801-- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Certificate holder is an additional insured for general liability only with regard to 701 N. Missouri, Clearwater, FL CERTIFICATE HOLDER CANCELLATION CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTATIVES. AUTHO 0 RESENT VE @ACORDCORPORATION 1988 City of Clearwater ATTN: Earl Barrett P.O. Box 4748 Clearwater FL 33758-4748 ACORD 25 (2001/08) , 7tCORO,. CERTIFICATE OF LIABILITY INSURANCE OP ID S~ DATE (MM/DDIYYYY) HEADS-2 01/02/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33757-2456 Phone: 727-461-6044 Fax:727-442-7695 INSURERS AFFORDING COVERAGE NAIC# INSURED iNSURER A: Ace American Insurance Co 22667 INSURER B: Ma;estic Insurnace ComDany Head Start Child Development INSURER C: & Familt Services 6698 68 h Avenue, North tD INSURER 0: Pinellas Park FL 33781-50 3 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO 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. INSRt POLICY NUMBER DATE iMMJDDIYYl I P9~!C_Y.EXPIRATlgN LIMITS LTR TYPE OF INSURANCE DATE'/MM/DDIYY GENERAL LIABILITY EACH OCCURRENCE $ 1000000 - A.. X X COMME:RCI~.~_GENERAL LIABILITY ...G.~ Q~ O_Q.e.2~L _01i01 LOB _ _Ol./..o~lQ9 UAMAGt: I U r<<'" I CU l:'OOOOO -. ------ PREMISES (1<3 o"""r.AGej- .' -- - ~ ~LAIMS MADE [!J OCCU~ MED EXP (Anyon. person) $ 5000 X Prof/Sex Abuse PERSONAL & ADV INJURY $ 1000000 - GENERAL AGGREGATE $2000000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS. COMP/OP AGG $2000000 Xl . n PRO. n EmD Ben. 100/300 X POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 500000 A X ANY AUTO H08123032 01/01/08 01/01/09 (Ee eccident) - ALL OWNED AUTOS BODILY INJURY - $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY (Per accident) $ X NON.OWNED AUTOS - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ =1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ :=J OCCUR D CLAIMS MADE AGGREGATE $ $ ==l DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND pc<'lAW'T IUJ~' X TORY LIMITS ~ EMPLOYERS' LIABILITY -weN052 001 0 801.' , ------ n01:torto'S" 01.:/01709" $ 1000000 - 'ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? E.L. DISEASE. EA EMPLOYEE $ 1000000 ~~~MtS~~Jv~~?6~s below E.L. DISEASE. POLICY LIMIT $ 1000000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES J EXCLUSIONS ADDED 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 CANCELLATION City of Clearwater ATTN Earl Barrett P.O. Box 4748 Clearwater FL 33758-4748 CITYOFC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 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 REPRESENTATIVES, AUTHO 0 RESENT VE ~ @ACORDCORPORATION 1988 ACORD 25 (2001/08)