CERTIFICATE OF INSURANCE
PRODUCER
Marsh
3031 N. Rocky Point Drive, Suite 700
Tampa, FL 33607
Alln: MARILYN SMERIGLlO 813.207.5117
CERTIFICATE NUMBER
A TL-000915191-02
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED III THE
POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
,Hiu.W;k~W: j ~~~ti:i; P:f~~ !~;!~.~::rf~:ti
COMPANY
AN/A
INSURED
ALL CHILDREN'S HEALTH SYSTEM, INC.
ALL CHILDREN'S HOSPITAL, INC.
801 6TH STREET SOUTH
ST PETERSBURG, FL 33701
COMPANY
B ILLINOIS UNION INSURANCE CO
COMPANY
C ADMIRAL INSURANCE COMPANY
COMPANY
D
f.}~:i;JjtW~M(:;f{il
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
OATE (MM/DDfYY) DATE IMM/DDfYYI
LIMITS
GEIIERAL L1ABIUTY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
OWNER'S &CONTRACTOR'S PROT
B
EXCESS UABILlTY
XHLG 21685501002
GENERAL AGGREGATE $
PRODUCTS. COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
$
$
COMBINED SINGLE LIMIT $
BODILY INJURY $
. IPer person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
AGGREGATE
12/15/03 12/15/04 EACH OCCURRENCE
AGGREGATE
AUTOMOBILE LIABILITY
ANY, AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
THE PROPRIETOR!
PARTNERSIEXECUTIVE
OFFICERS ARE:
OT ER
INCL
EXCL
EL DISEASE-POLICY LIMIT
EL DISEASE-EACH EMPLOYEE $
ANY AUTO
UMBRELLA FORM
X OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
C PROFESSIONAL LIABILITY/
GENERAL LIABILITY
EXCESS OF CARRIER B
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/SPECIAL ITEMS
GENERAL LIABILITY SUBJECT TO $1,000,000/$2,000,000 SIR. PROFESSIONAL LIABILITY SUBJECT TO $3,000,000/$9,000,000 SIR. THESE ARE
POLICY LIMITS AND NOT APPLIED TO INDIVIDUAL STAFF MEMBERS.
CES FL-10071-1203-01
12/15/03
12/15/04
PER INCIDENT/OCe $10,000,000
AGGREGATE $10,000,000
Parks and Recreation Director
POBox 4748
Clearwaler, FL 33765
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE niE EXPIRATION DATE THEREOF.
lliE INSURER AFFORDING COVERAGE IMLL ENDEAVOR TO MAIL --3.ll DAYS II\IRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN. BlIT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
lIABILITY OF IWY KIND UPON THE INSURER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES. OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Shelia D. Robertson
SI..J.u. c ~
7.00/7.00 I7J1
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