CERTIFICATE OF INSURANCE (009)
Marsh & McLennan, Inc.
P. O. Box 82
Indianapolis, Indiana 46206
COMPANIES AFFORDING COVERAGES
COMPANY A
LEITER
COMPANY B
LEITER
COMPANY C
LETTER
COMPANY D
LE TTER
COMPANY E
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time, Notwithstanding any require~ent, term or conditio
of any contract or other document with respect to which this certiticate may be issued or may pertain, the insurance afforded by the policies described herem IS subject to all th
terms, exclusions and conditions of such policies.
NAME AND ADDRESS OF INSURED
The Athletic Congress/USA
Florida Athletics Congress
and All Sanctioned Clubs and
433 N. Mills Avenue
"Mal I1t984
t~ :
Sponsors
- ~
, \'.
TYPE OF INSURANCE
POLICY NUMBER
POLICY
EXPIRATION DATE
Limits of Liability in Thousands (000)
EACH
OCCURRENCE
AGGREGAT
GENERAL LIABILITY
BODilY INIURY
$
A
[]I COMPREHENSIVE FORM
o PREMISES--OPERATIONS
o EXPLOSION AND COLLAPSE
HAZARD
o UNDERGROUND HAZARD
[]I PRODUCTS/COMPLETED
OPERATIONS HAZARD
o CONTRACTUAL INSURANCE
[XJ BROAD FORM PROPERTY
DAMAGE
o INDEPENDENT CONTRACTORS
o PFRSONAL INJURY
PERCiCJNAL INJUHY
$
PROPERT'> DAMAGE
1/1/85
GLPG05145016
BODILY INJURY A"'D
PROPERTY DAMAC;, 1$
COMBINED
$ 1, 000
1 , 000
AUTOMOBILE LIABILITY
o COMPREHENSIVE FOllM
DOWNED
o HIRED
o NON-OWNED
BODILY INJuny
(EACH PERSor"
BODILY IN.JURY
(EACH ACCIDENT)
EXCESS LIABILITY
MAR 1 1984
CITY CLL::RK
PROPERTY DAMA(;f
BODILY INJURY AND
PROPERTY DAM,\GE
COMBINED
A
[XI UMBRELLA FORM
o OTHER THAN UMBllELLf.
FORM
BODILY INJURY A'W
1/1/85
XBC50-68-98
PROPERTY IIAMAGE
$ 3,000
COMBII'.ED
WORKERS' COMPENSATION
and
uEMP10YERS'[IABIUTY
OTHER
I["IIC H Ai.:CIDE T)
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
insured (certificate holder
employees as respects their
sanctioned event during the
The provisions of this policy shall apply to the additional
named below), their directors, trustees, officers, agents and
liability arising out of the use of their facilities for any
period January 1, 1984 to January 1, 1985.
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,
Family Festival Run - 5K - 3/10/84
NAME AND ADDRESS OF CERTIFICATE HOLDER Sanction 114045
City of Clearwater, Office
112 s. Osceola Avenue
Clearwater, Florida
DATE ISSUED February 24, 1984
/~/lt~
f'~t <1 WfH(}fl.Ill6 REPRfj!'IJ!1\':.:.23: MS/ tk
of City Manager