HOLD HARMLESS AGREEMENTHOLD HARMLESS AGREEMENT
THIS AGREEMENT is entered into this 1)
day of January
1983 by and between the CITY OF CLEARWATER FLORIDA a municipal
corporation and CLEARWATER HORSESHOE CLUB
WHEREAS the City is a municipal corporation owning and
operating Ed Wright Park in the City of Clearwater which park is used
by the Clearwater Horseshoe Club and
WHEREAS the Club and the City are desirous of constructing
additional storage to the existing storage structure in accordance with
all building codes and regulations and as per attached plans
NOW THEREFORE the parties agree as follows
1 The City agrees (a) Secure building permits for storage room
addition
(b) Secure all materials for storage room
addition
(c) Construct foundation footers and slab
for storage room addition and
(d)Monitor and inspect work of club volunteers
on storage room addition
2 The Club agrees (a) Construct the walls of the storage room
addition
(b) Construct the roof of the storage room
addition and
(c) Complete all other aspects of storage room
addition including carpentry painting
windows etc
3 The Clearwater Horseshoe Club agrees to indemnify defend
and hold harmless the City and its employees from all claims loss of any
nature whatsoever legal proceedings and damages (including costs and
attorney s fees) involving real and personal property bodily injury and/or
wrongful death directly or indirectly arising out of or caused by the
conditions stated in paragraphs 1 and 2
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2/'3
1
1
4 The Clearwater Horseshoe Club further agrees to provide the
City with a policy of insurance having such coverage and limits necessary
to protect the City and its employees from loss or liability and naming
the City and its employees as additional insured The City Manager and
City Attorney may review and approve the policy prior to the execution
of this Agreement
IN WITNESS WHEREOF the parties hereto have executed this
Agreement the day and year first above written
CITY ci > C : EAR WA
Approve•_ as to form and
ney
WITNESSES
4 'P-(
2
Attes
City Clerk
CLEARWATER HORSESHOE CLUB
By
President
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THIS? CERTIFICATEIISNISSUE� k/)tf'Az'MATTER.i INF•RM' TISN �NLY AN� CNF S; N G TSS SUPIN. THS C,E,R7IFIOA� E NILS. Rtw
•,THIS CERTIFICATE_ti�,ES )NST; ,AIyIEN�, EXTEN111e. R V A ..AFI R TH r.R 1 I
ME ND DDRESS OF AGENCY
Rhodes Insurance Agency, Inc
P 0 Box 5164
Clearwater, FL 33518
Er
COMPANIES AFFORDING COVERAGES a
LETTER
COMPANY , Ohio Casualty Insurance Company ig
COMPANY
LETTER D 13 RECEIV
Ex
NE
MAR
24 19tH
AME AND ADDRESS OF INSURED
Clearwater Horseshoe Club
Ed Wright Park
Lakeview & Greenwood Avenue
Clearwater, FL 33516
COMP NY
LETTER
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COMPANY
LETTER
COMPANY
LETTER
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�LE ARY
LETTER
TYPE OF INSURANCE
POLICY NUMBER
POLICY
EXPIRATION DATE
L m is of !Jab I ty in Thousands
(000)
EACH
OCCURRENCE
AGGREGATE
A
GENERAL LIABILITY
❑ COMP E E S E OM
[2 EM SES -0 ERATIONS
❑ EXPLOSION AND COLLAPSE
AZARD
❑ UNDERGROUND HAZARD
❑ RODUCTS/COMPLETED
OPERATIONS ZARD
❑ CONTRACTUAL INSURANCE
❑ BROAD FORM PROPER Y
D MAGE
❑ NDEPENDENT CONTRACTORS
❑ PERSONAL I JURY
Binder
p
1/20/84
BODILY INJURY
ROPER Y D MAGE
$ 3oa,
$ 50,
$
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
$
PERSONAL INJURY
$
AUTOMOBILE LIABILITY
❑ COMPREHENS VE FORM•,
❑OWNED
❑ H RED
❑ NON OWNED
BODILY INJURY.
(EACH PERSON)
BODILY INJURY
(EACH ACCIDENT)
$
$
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, .
?'
''
PROPERTY DAMAGE
•$
—
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
>,,
k•
,*
EXCESS LIABILITY
❑ UMBRELLA FORM
❑ OTHER THAN UMBRELLA
FORM
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
$
WORKERS COMPENSATION
and
EMPLOYERS LIABILITY
STATUTORY
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$
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OTHER
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ESCRI TION OF OPERATIONS/LOCATIONSNEHICLES
Additional Insured City of Clearwater and its Employees
Cancellation Should any of the above described policies be cancelled before the expiration date thereof the issuing com
pany will endeavor to mail 30 days written notice to the below named certificate holder but failure to
mail such notice shall impose no obligation or liability of any kind upon the company
ORD 25 (1 79)
NAME AND ADDRESS OF CERTIFICATE HOLDER
City of Clearwater
Parks & Recreations Department
Clearwater, FL 33515
DATE ISSUED 1/20/83
Arr''AUTHORI ED REPRESENTA •E
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f3? a•alt.::^g. M. f..w.. -fi �.•r `i`nt!:i`l;es .: e' 7fcue3='^ xY','
\HIS ANDER, IS A°TEMRQRARY IN.;
YHA CONDITIONS StIQWN 0N';tTf
NAME AND ADDRESS OF AGENCY
Rhodes Insurance Agency, Inc
P 0 Box 5164
Clearwater, E`L 33518
COMPANY
Ohio Casualty Insurance Company
Effective,),) 00 a m 1/20/ 19 83
Expires ? 12 01 am 0 Noon 2/20/ 19 83
❑ This binder is issued to extend coverage in the above named
company per expiring policy f#
( pt
dbl )
NAME AND MAILING ADDRESS OF INSURED
Clearwater Horseshoe Club
c/o Norman Gaseeau
1908 Nugget Drive
Clearwater, FL 33515
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f1X
Description of Operation/Vehicles/Property
Location of Premises Ed
Lakeview
Clearwater,
.... z.11,- °`§ 7ti r� 'i..,1,,, .`i ;,: it;
Wright Park
& Greenwood
F.
,.. r +.'i
33516
1
Ave
Type and Location of Property
Coverage/Perils/Forms
Amt of Insu ance
Ded
P
1R
0
P
E
R
T
Y
L
Type of Insurance
Coverage/Forms
Limits of Liability
EachOccurrence
Aggregate
1
BXI
I
L
T
Y
❑ Scheduled Form 0 Comprehensive Form
Premises/Operations
0 Products/Completed Operations
0 Contractual
0 Other (specify below)
0 Med Pay $ P $ P
P A d
0 Personal Injury
0 A 0 B 0 C
Bodily Injury
Property
Damage
$300,000
$ 50,000.
$
$
Bodily Injury &
Property Damage
Combined
$
$
Personal Injury
$
A
U
T
0
0
B
1
L
E
0 Liability 0 Non owned 0 Hired
0 Comprehensive Deductible $
0 Collision Deductible $
0 Medical Payments $
0 Uninsured Motorist $
0 No Fault (specify)
0 Other (specify)
Limits of Liability
Bodily Injury (Each Person) $
Bodily Injury (Each Accident) $
Property Damage $
Bodily Injury & Property Damage
Comb ned $
0 WORKERS COMPENSATION — Statutory Limits (specify states below) 0 EMPLOYERS LIABILITY — Limit
SPECIAL CONDITIONS/OTHER COVERAGES
NAME AND ADDRESS OF 0 MORTGAGEE 0 LOSS PAYEE ]ADD L INSURED
City of Clearwater & Its Employees
Parks & Recreations Department
Clearwater, FL 33515
ACORD 75 (11 77)
LOAN NUMBER
natur
V./4
orized Representative Date
CONDITIONS
This Company binds the kind(s) of insurince stipulated on the reverse side This insurance is subject
to the terms conditions and limitations of the policy(ies) in current use by the Company
This binder may be cancelled by the Insured by surrender of this binder or by written notice to the
Company stating when cancellation will be effective This binder may be cancelled by the Company
by notice to the Insured in accordance with the policy conditions This binder is cancelled when
replaced by a policy If this binder is not replaced by a policy the Company is entitled to charge a
premium for the binder according to the Rules and Rates in use by the Company
i
1
•
CITI OF CLEARWATER
Interdepartment Correspondence Sheet
TO Sue Lamkin Deputy City Clerk
FROM Art Kader Asst Director Parks and Recreation
COPIES
SUBJECT Ed Wright Park - Addition to Horseshoe Shed
DATE January 21 1983
As per your request attached is an official plan for the addition
to the Horseshoe Club Shed located at Ed Wright Park I would
appreciate your attaching this to the agenda item concerning this
subject and that this will become the official record for the
City c.-ce ning same
Rr-CE VEC
JAN25 83
CTX LEI