CERTIFICATE OF INSURANCE
C.W. BOLLINGER CO,
499 Bloomfield Avenue
Montclair, NJ 07042
COMPANIES AFFORDING COVERAGES
, ,-
eta..
NAME AND ADDRESS Of INSURED
m~~~NY A FEDERAL INSURANCE COMPANY
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LETTER
This Is to certify that policies of insul1lnce listed below havB been issued to the insured named above and are in force at this time, Notwithstanding any requirement. term or condition
of any contl1ld 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.
AMATEUR SOFTBALL ASSOCIATION of AMERICA
P. O. Box 11437
Oklahoma City. OKlahoma 73136
COMPANY
LETTER
TY PE OF INSURANCE
POLICY NUMBER
POLICY
EXPIRATION DATE
GENERAL LIABILITY
A
o COMPREHENSIVE FORM
lXl PREMISES-OPERATIONS *
o EXPLOSION AND COLLAPSE
HAZARD
o UNDERGROUND HAZARD
o PRODUCTS/COMPLETED
OPERATIONS HAZARD
o CONTRACTUAL INSURANCE
o BROAD FORM PROI?ERTY
DAMAGE
o INDEPENDENT CONTRACTORS
o PERSONAL INJURY
BODIL Y INJURY
73079007
i~'I" '
j-' 'ltn.:.;~ f' . .'.'
.!!..._. li...... ~~
3/1/84
PROPERTY DAMAGE
$
v ~_, "'-
,/
1':'1()'.
. u' '~'J
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
$ 1,000
$ 1,000
AUTOMOBilE LIABILITY
D COMPREHENSIVE F~RM
DOWNED
o HIRED
o NON-OWNED
'. '
PERSONAL INJURY
CITY CLERK
EXCESS LIABILITY
BODIL v INJURY
(EAC H PERSON)
BOOll Y INJURY
(EACH ACCIDENT)
PROPERTY DAMAGE
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
J
$
o UMBRElLA FORM
o OTHER THAN UMBRELLA
FORM
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
WORKERS' COMPENSATION
and
EMP1,OYERS'lIABIlITY
DESCRIPTIONOFOPERATlONS/LOCATlONSNEHICLES Coverage shall apply to the Certificate Holder listed below but
only with respect to liability involving the administration, practice or play of Amateur
Softball activities sanctioned and approved by the Amateur Softball Association of America.
-----NO COVERAGE IS PROVIDED UNDER THIS POLICY FOR TEAMS OR LEAGUES-----
*Insurance provided under this certificate excluaes bodily injury and property damage claims resulting from hazardous field conditions
arising out of improper maintenance and upkeep of such fields, including bleachers, grandstands, concession areas, dugouts, playing
surfaces, backstops, fences, and parking facilities, unless the registered teamS/leagues of the Amateur Softball Association of
America are legally responsible for such maintenance and upkeep via ownership, lease or other written contractual agreement.
Cancellation: Should any of the above described poliCies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail ~ 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,
../
NAME AND ADDRESS OF CERTIFICATE HOLDER
City of Clearwater Rec. & Parks Dept.
10 S. Missouri Ave
Clearwater, FL 33156
~ED May 1, 1983 ~ .
~ ..../J=; ...--"."".<..
..-~ ..' _,.....-f" .~'; --:...
......--; . .~ /;../..~, .;.'..,...
/ \
( ^"'~",,' "",,,,,'^,,,,
//