CERTIFICATE OF LIABILITY INSURANCE (4)
o t 9/17/2002 1053 AM
S d
F
10M L~'
a e: en ers ax c aug In nsurance Ul:j' 20f2
Ce. . {L RECEIVED
(\Otl"'#; ~ TI_
ACORD.. CERTIFICATE OF LIABILITY INSURAN :E B8€B~E! toOjT~ ( IMIDO/V Y
1/17/ ~2
PROOUCER THIS CERTIFICATE IS ISSUEI AS A IIIIATTER OF INFORMATION I
ONLY AND CONFERS NO RI~ -!TSU
McLaughlin Insurance Agency HOLDER. THIS CERTIFICATE R~~~ ~rcl:m&~N
828 Lynn Fells Parkway ALTER THE COVERAGE AFFI
Melrose MA 02176
Phone: 781-665-2775 Fax: 781-665-0295 INSURERS AFFORDING COVERAGE
INSURED INSUREf'!. A St. Paul Fire & Marine Ins.
INSURER B OneBeacon Insurance Group
Boston Concessions Group, Inc. INSURER c: General Star Indemnity Companx
Attn: Michael J. DeMarco
111 Sixth Street ...--..____..___.e______ -..
Cambridge MA 02141 INSURER D: Associated Industries Ins. Co.
i INSURER E Trumbull Insurance Company
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.
INSR ~~~Cf~~~~yVE Pg~~~~:r~~~~N
LTR TYPE OF INSURANCE POUCV NUMBER LIMITS
GENERAL LIABILITY EACH OCCURRENCE 1 500,000
t---
A ~ COMMERCIAL GENERAL lIABIUTY CK06901568 08/01/02 08/01/03 FIRE DAMAGE (Anyone fire) 1 50,000
t---- o CLAIMS MADE [!J OCCUR MEO EXP (Anyone persoll) 1 5,000
PERSONAl & AQV I!\UURY 1 _~OO,OOO_
t---- -----~----- -------..------ ..------ .~ ,.. .-
GENERAl AGGREGA TE 11,000,000
I--
GEN'L AGGREGATE UMIT APPUES PER: PRODUCTS. COMP/(lP AGG i 1,000,000
Ii POLICY _n j:C~ n LOC
AUTOMOBILE UABILlTV COMBINED SINGLE lIMlT
-. 11,000,000
B ANY AUTO (Ea aCCident)
-
- ALL OWNED AUTOS BODILY INJURy
1
X SCHEDULED AUTOS QBAN13037 10/10/01 10/10/02 (Per person)
t--
r!- HIRED AUTOS BOOlL Y INJURY
1
...!.. NON.OWNEO AUTOS (per i1CCldent)
- PROPERTy DAl'AAGE 1
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT 1
q ANY AUTO OTHER THAN EA ACe 1
AUTO ONLY: AGG 1
EXCESS LIABILITY EACH OCCURRENCE 1.~LQ Q~.QQQ_._.
C ~'OCCUR o ClAIMS MADE NUG-054277P 08/01/02 08/01/03 AGGREGA\. 12,000,000
1
R DEDUCTIBLE 1
RETENTION $ 1
WORKERS COMPENSATION AND X I ~gR~T~~~s I 10m
ER
D EMPLOYERS'LIABIUTY 2001318520 12/29/01 12/29/02 i 500,000
E.L. EACH ACCIDENT
E L DISEASE - EA EMPLOYEE 1 500,000
EL DISEASE - POliCY LIMIT I 500,000
OTHER
E Liquor Liability VQOOO1684 08/01/02 08/01/03 EA OCC 500,000
AGG 500,000
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLEBiEXCLUSIONS ADOED BY ENOORSEMENTISPECIAL PROVISIONS
The following are included as Additional Insured under Liquor Liability
and General Liability Policies: Globe Facilities,LP 300 Cleveland
St. ,Clearwater, FL 34615 and City of Clearwater, 10 South Missouri Ave.,
Clearwater, FL 34616.
CERTIFICATE HOLDER I Y I ADDITIONAL INSURED: INSURER LETTER; CANCELLATION
HARBOOl SHOULD ANY OF THE ABOVE DESCRlBEO POUCIES BE CANCELLEO BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUINC INSURER WILL ENDEAVOR TO MAIL ..J.~ lAYS WRlnEN
NonCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO ~HALL
The Harborview Center IMPOSE NO OBUOATION OR LIABILITY OF ANY KINO UPON THE INSURER. ITS AGENTS OR
300 Cleveland Street
Clearwater, FL 34615 REPRESENTATIVES.
AUTHORIZEDTLSiJ'VE m~ jl ~%
I FA V,1n\. ~: N'u
ACORD 25-S (7/97) V " V@ACORDCORPORATION1988