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029-Tabernacle of Prayer For All People�U t'/Ju f cg - ®mi1 5 PAGE 001 SMP LIABILITY DECLARATIONS - SCHEDULED INSURANCE COMPANY LANSING, MICHIGAN 48909 RENEWAL PREMIUM TERM 02 -17 -88 TO 02 -17 -89 AGENT BOYD- WALLACE INSURANCE AGENCY 12 -017 114 S PALMETTO AVE POLICY NUMBER SANFORD FL 32771 814612 20192372 INSURED SANFORD TABERNACLE OF PR AYER INC POLICY PERIOD FROM 12:01 A.M. 02 -17 -88 ADDRESS 950 W 13TH ST TO UNTIL CANCELLED SANFORD FL 32771 POLICY CHANGE CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES. EFFECTIVE DATE OF CHANGE : MO - - -- DAY - - -- Y - - -- LIMITS OF LIABILITY COMBINED SINGLE LIMIT BODILY INJURY & PROPERTY DAMAGE $300,000 EACH OCCURRENCE $300,000 AGGREGATE MEDICAL PAYMENTS $1,000 EACH PERSON $25,000 EACH ACCIDENT CLASSIFICATION -CODE- LOCATION PREMIUM BASIS RATES BI PD PREMIUM BI PD PREMISES - OPERATIONS FLORIDA ID 0020 CODE 65150 -1 FRONTAGE PER LINEAR FOOT VACANT LAND - EXCLUDING REAL ESTATE 50 .1310 INC 7 INC DEVELOPMENT PROPERTY MEDICAL PAYMENTS .0170 1 ADDITIONAL INTEREST 1 INC 906 W 13TH ST SANFORD FL ID 0025 CODE 82115S -1 AREA PER 100 SQ FT DAY NURSERIES 540 23.5540 INC 127 INC INCL COMPLETED OPERATIONS 1 I ID 0010 CODE 86612 -1 AREA PER I 100 SQ FT CHURCHES INCL COMPLETED OPERATIONS 4,004 6.8580 INC 275 INC INCL PARSONAGE 950 W 13TH ST SANFORD FL MEDICAL PAYMENTS 2.1550 86 PRODUCTS- COMPLETED OPERATIONS EXCLUDED EXCEPT AS PROVIDED UNDER PREMISES OPERATIONS CLASSIFICATIONS ISSUED 1 -19 -88 26666 (6 -80) 115 1 CASUALTY 650 Q • T ,4''wq'•+hMi.".'. X71.. p". i' P^ �rP'X•'Rr^r^'�..^^'^,yt"YM�pwp` � A...,, .- ..�.,,,.. ^'.w+.'gw.r ^�.....y..�.. 1 ADDITIONAL INTEREST ENDORSEMENT Policy Number 201 92372 It is agreed that such insurance as is afforded by the policy for bodily injury or property damage lia- bility shall also apply to each interest named herein as an insured, but only with respect to such liability arising out of the specific interest indicated. The inclusion herein of such additional interest or interests shall not operate to increase the limits of the Company's liability. v Name and P.O..Address Interest Ci ',y Of Sanford PO Box 177:; Sanford, F L 32771 2684 (11 Le ysor 1 rz COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS PAGE PAGE 1 ,4uto owners INSURANCE COMPANY LANSING MI 48909 -8160 INSURED: SANFORD TABERNACE OF PRAYER, INC. PO BOX 1822 SANFORD FL 32772 -1822 RENEWAL?mr.� }---� POLICY NUMBER 814612 20192372 00 80A A 8 1989 AGENT :12017 BOYD - WALLACE INSURANCE AGENCY 0M Of SAMIF®Rp 114 S PALMETTO AVE SANFORD FL 32771 POLICY PERIOD: FROM 02/17/89 TO 02/17/90 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT S 300,000 (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT $ 300,000. PERSONAL AND ADVERTISING INJURY LIMIT $ 300,000 EACH OCCURRENCE LIMIT $ 300,000 FIRE DAMAGE LIMIT $ 50,000 ANY ONE FIRE MEDICAL EXPENSE LIMIT $ 5,000 ANY ONE PERSON LOCATION OF PREMISES YOU OWN, RENT OR OCCUPY PREM NO BLDG NO 950 W 13TH ST. 00001 001 SANFORD FL 32771 PREMIUM - CLASSIFICATION - CODE SUBLINE BASIS RATES PREMIUM CODE 41650 CHURCHES OR OTHER HOUSES OF WORSHIP PREM/OP INCLUDING PRODUCTS AND /OR COMPLETED OPERATIONS , CODE 41714 DAY CARE CENTERS INCLUDING PRODUCTS PREM /OP AND /OR COMPLETED OPERATIONS AREA EACH 1000 4,004 102.985 $ 412.00 PERSONS EACH 1 29 7.737 $ 224.00 CODE 49950 ADDITIONAL INTERESTS MANAGERS /LESSORS OF PREMISES CITY OF SANFORD PREM /OP 4,004 4.953 20.00 TERR 006 COUNTY 059 LOCATION TOTAL PREMIUM 5 656.00 LOCATION OF PREMISES YOU OWN, RENT OR OCCUPY PREM NO BLDG NO 221 E. 27TH ST. 00002 001 JACKSONVILLE FL 32206 PREMIUM CLASSIFICATION - CODE SUBLINE BASIS RATES PREMIUM CODE 41650 AREA EACH 1000 CHURCHES OR OTHER HOUSES OF WORSHIP PREM /OP 3,927 102.985 $ 404.00 INCLUDING PRODUCTS AND /OR COMPLETED OPERATIONS T ERR 006 COUNTY 016 LOCATION TOTAL PREM $ 4 04.0 0 55040 (11/87) ��' 3823 02/28/89 COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS PAGE PAGE 2 ,4ut0- Owners RENEWAL INSURANCE COMPANY POLICY NUMBER 814612 20192372 00 89 LANSING MI 48909 -8160 INSURED: SANFORD TABERNACE OF PRAYER, AGENT:12017 INC. BOYD - WALLACE INSURANCE AGENCY PO BOX 1822 114 S PALMETTO AVE SANFORD FL 32772 -1822 SANFORD FL 32771 POLICY PERIOD: FROM 02/17/89 TO 02/17/90 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE. LOCATION OF PREMISES YOU OWN, RENT OR OCCUPY PREM NO BLDG NO 906 W 13TH ST. 00003 001 SANFORD FL 32771 PREMIUM CLASSIFICATION - CODE SUBL BASIS RATES PREMIUM CODE 49450 ACRES EACH 1 VACANT LAND PREM /OP 1 .772 $ 1.00 INCLUDING PRODUCTS AND /OR COMPLETED OPERATIONS TERR 006 COUNTY 059 LOCATION TOTAL PREMIUM $ 1.00 AUDIT TYPE: ANNUAL AUDIT TO PREMIUM $ 1,061.00 FORMS APPLICABLE: CG2144 11/85 CG2022 11/85 55030 07/87 CG2240 11/85 CG2146 01/87 IL0021 11/85 55081 08/88 CG0001 11/85 CGO041 05/86 CG0220 11/86 IL0017 11/85 55050 07/87 55064 07/87 CL175 02/86 55069 01/88 . CG2011 11/85 55040 (11/87) 3824 02/28/89 Tabernacle Of Prayer For All People The Center of Hope 950 W. 13th Street MAILING ADDRESS: P. O. Box 1822, SANFORD, FLORIDA 32772 -1 ELDER CARRIE BUIE BRYANT, PASTOR September 20, 1983 M W atten E . Knowtu City Manage& P.U. Cox 1118 San�otd, HoAi,da 32111 Dean Mt. Knowtes: APOSTLE JOHNNIE WASHINGTON, OVERSEER v� GREETINGS IN THE WONDERFUL NAME OF JESUS! I am in tece.ipt o4 your Eextet %egaAd.ing tea6e o4 City Ptopetty. Thete4ote, pf -ease be adv.iaed that we would tike to renew out teaae 4ot another yeah. Bncto.sed hetew.i.th i6 a check jot the amount agteeded upon. Thank you, and may God continue to bte63 you, out City and out coun- .tty .Zs my ptayet. Si ncetety, Etdet Catt,i,e Buie Bryant Pa3 0 B e / Encto6uAe L E A S E THIS AGREEMENT, made and entered into this z4�'�► day of August, A.D., 1982, by and between CITY OF SANFORD, FLORIDA, a municipal corporation, hereinafter referred to as Lessor, and TABERNACLE OF PRAYER FOR ALL PEOPLE, 950 W. 13th Street, Sanford, Florida, hereinafter called Lessee; WITNESSETH, for and in consideration of the premises and the covenants and agreements hereinafter contained, Lessor does hereby lease unto Lessee that property in the City of Sanford, Florida, described as: East 50 feet of Lot 8, Block G of A.D. CHAPPELL'S SUBDIVISION, Plat Book 1, Page 71, Seminole County, Florida; to have and to hold the same for a period of one year beginning the 24th day of August, A.D., 1982 and ending the 23rd day of August, A.D., 1983, unless the said term shall be sooner termin- ated as hereinafter set forth. And Lessee in consideration for the aforesaid lease does hereby covenant and agree as follows: 1. To pay Lessor rent for said premises at the rate of ONE DOLLAR ($1.00) per year, in advance. 2. Lessee agrees to carry liability insurance in the sum of $300,000.00 for each separate occurrence; that Lessee agrees to furnish proof of said insurance to Lessor with Lessor maintained as beneficiary of the said insurance. A copy of said policy shall be filed with the City Clerk. 3. Lessee shall at all times refrain from engaging in the sale of alcoholic beverages on the leased premises at any time during the term of this Lease or any extension thereof. 4. Lessee agrees to maintain said premises during the term hereof in good condition, free and clear of all weeds, trash and rubbish, and to make such repairs as shall be necessary from time to time in the opinion of the City Manager of the City of Sanford, to keep said premises in a good state of repair and safe for public use. 5. Lessee shall as a condition predecent to this lease install at its own expense a chain link fence not less than five feet in height around the perimeter of the premises. 6. Lessor may terminate this Lease at any time by giv- ing Lessee notice in writing thirty (30) days in advance of the termination date, and upon the giving of said notice, Lessee agreea to deliver and give up said premises in at least as good condition as the same is now, and to pay to Lessor any and all outstanding costs and charges which may be owed, and to further pay Lessor any sums necessary to restore said premises to its present con- dition in the event Lessee fails so to do. 7. Lessee covenants and agrees to make no offensive or illegal use of said premises or to do anything or allow any- thing to be done thereon which could in any way constitute a nuisance, or in any way disturb the peace and dignity of the community and to use the premises as a children's playground and for no other purpose. 8. Lessee agrees to pay promptly when due the costs of all utilities, utility service, sewer, water and electrical charges, or other charges lawfully assessed against said premises. R 9. In the event it becomes necessary for either party to this lease to retain any attorney and resort to the Courts to enforce their rights, the prevailing party shall be entitled to recover reasonable attorney's fees and allowable court costs from the losing party. In the event Lessor shall not have terminated this Lease as is herein provided, Lessee shall be entitled to renewals thereof for additional one -year periods upon giving notice in writing to the City thirty (30) days in advance of the end of such term. The parties hereto warrant and agree that this Lease shall not be recorded amongst the Public Records of Seminole County. IN WITNESS WHEREOF, this instrument has been executed in the names of the parties hereto by their duly authorized officers and their respective seals affixed. CITY ZN ORD, FLORIDA BY MAYOR ATTEST: CIERK TABERNACLE OF PRAYER FOR ALL PEOPLE BY: ATTEST: I Signed and sealed in the presence of: ,4uto INSURAKE DECLARATIONS s1'ECI( js " PART TWO A`.' tt.cl rt5 Vod i AGENCY 0 4AL.LACL: 12017 POLICY NUMBER 814 612 2 U 1.i 2 3 7 2 INSURED SA TAL OF eRAYL:R STREET CITY& 950 W. 13TH 5T. STATE SANFORD FL 1 ❑ Individual [_f Partnership "Corporation ENTITY: ❑ Fraternal Organization ❑ Other: Location of Premises as follows, or "Same as above Occupancy of Premises 1. 1. CHURCH 2. 2. 3. _ Insurance is provided with respect to those premises described above and with respect to those coverages and kinds of property for which a specific limit liability is shown, subject to all of the terms of th policy includ forms and endorsements made a part hereof: Coinsurance LIMIT OF LIABILITY SECTION I — PROPERTY COVERAGE Percentage Loc. No. Bldg. No. Loc. No. Bldg. No. Loc. No. Bldg. No. Appllaabk Building(s) (Insurable Value $ _ 1 so - $ 100 0 000. $ $ Personal Property of the Insured 80 $ 50"000. $ $ Personal Property of Ot $ $ _ $ D - $ $ $ V 1 Add'I. Coy. (Specify) S Deductible: $ SEE 14P0 each occurrence. $ aggregate each occurrence. If no deductible stated above, the deductible shall be $100 each occurrenc $1,000 aggregate each occurrence. 0 Add'I. Coy. (Specify) N 2. $ $ $ SE:TluN 11- LIABILITY COVERAGE SCHEDULED COMPREHENSIVE [] LIMIT OF LIABILITY Bodily Injury Liability $ each occurrence $ aggregate products liability Property Damage Liability $ each occurrence $ aggregate Single Limit Bodily Injury- Prope Damage Liability $ 10 0 00 0 . each occurrence $ 1 U 0 . 00 0, aggregate Premises Medical Payments $ 1,00 e ach person $ 2 each accident Add') Coy. (Specify) $ SECTION III— CRIME COVE L J As state in th endorsement, m par of this Policy, if indicated by x Name STATE BA14K OF FOREST CITY Mortgagee: Street P ' O t3 0 X 3117 " ( Ci ty & State_ FOREST CITY, F.L. _ 3275 -.1. r` zi - - - - Code p - - -- -- -- - -- - Forms and Endorsements made part of this Policy: tinsert No. and Edition Date) MP 0010(7 -77), MP0012(5 -81), MP0336(2 -82), 26072, 17310, 17321 Date of Issue— Countersigned by_.. ��,��� -- - - -__ - -- - - - - -- - - - - - -- -- - Agent 20 In consideration of the premium and of the statements made in the above Declarations, insurance is provided the Named Insured subject to all the terms of this polio including forms and endorsements made a part hereof LAJ ALIT ❑ AUTO. OWNERS (MUTUAL) INSURANCE COMPAl' ❑ OWNERS INSURANCE.COMPAIt.,IY 11 PROPERTY- OWNERS INSURANCE. COMPANY CITY S /`, F Q Li _ PR EMIUM TE 2 17 822 J1 7 8 12:01 A.M. STANDARD TIME AT LOCATION OF INSURED PROPERTY Provisional Premium: $ 639. ❑ Audited N Non - Audited Z Code 32 7_1 1 _ - -- _ 114S_ T_I_ T_ U_T_I [_] Municipality [] Institution 17112(1 -79) CIW OF SANFORD, FLORIDA No. 820 Dat Au, 2 5, 1 9_g 12 Received of Tgberr_acle of Pia er for ,� All People $ IoC0 One and no/7 00------------------------------- - - - - -- Dollars - For Leese of Vacant Property at 906 sal. 1'th • for priwte park. l.uF;ust 24, 1 82 thin , august 23, 1 83. 1- 01- 6!- -"0 -5 J -, 1 III IT. T arim, Jr. j 1 E CITY TAX COLLECTOR Celery City Printins Co., Sanford, . 9 7 1 14584 l E t ry . - F • l E ®YD- WALLACE MSMANCE AGENCY 114 S. FALM%r_ I` .O iWENUE SANFORD, FLORIDA 32771 TO: F DATE: 3-25-92 Auto - owners Insurance SUBJECT: Sanford Tabernacle of Prayer Policy #814612 20192372 Lakeland, FL Ekps 2-17-93 L Effective today, please add the following location under Section 11: 906 W. 13th Street, Sanford, Florida - vacant lot 50' frontage - 95' depth and show City of Sanford, P. 0. Box 1774, Sanford, FL 32771 as additional insured. Also, increase S/L Bodily Injury - Property Damage liability to $300,000/300,000. Many thanks for your assistance. cc: City of Sanf ord Robert James Co., Inc. P.O Box 2726, Birmingham, AL 35202 Reorder No. RJF072ML DUPLICATE AFljf0 terS PAGE 001 SMP LIABILITY DECLARATIONS - SCHEDULED INSURANCE COMPANY LANSING, MICHIGAN 48909 AGENT BOYD - WALLACE INSURANCE AGENCY 12017 114 S PALMETTO AVE SANFORD FL 32771 INSURED SANFORD TABERNACLE OF PRAYER INC ADDRESS 950 W 13TH ST SANFORD FL 32771 POLICY CHANGE CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES. RENEWAL PREMIUM TERM 02 -17 -84 TO 02 -17 -85 POLICY NUMBER 814612 20192372 POLICY PERIOD FROM 12 =01 A.M. 02 -17 -84 TO UNTIL CANCELLED EFFECTIVE DATE OF CHANGE : MO - - -- DAY - - -- YR - - -- LIMITS OF LIABILITY COMBINED SINGLE LIMIT BODILY INJURY & PROPERTY DAMAGE MEDICAL PAYM EACH PERSON -- PREMIUM CLASSIFICATION -CODE- LOCATION BASIS PREMISES - OPERATIONS FLORIDA ID 0020 CODE 65150 -1 VACANT LAND- EXCLUDING REAL ESTATE DEVELOPMENT PROPERTY MEDICAL PAYMENTS ADDITIONAL INTEREST 906 W 13TH ST SANFORD FL ID 0025 CODE 82115S -1 DAY NURSERIES INCL COMPLETED OPERATIONS ID 0010 CODE 86612 -1 CHURCHES INCL COMPLETED OPERATIONS INCL PARSONAGE 950 W 13TH ST SANFORD FL MEDICAL PAYMENTS PRODUCTS - COMPLETED OPERATIONS EXCLUDED EXCEPT AS PROVIDED UNDER PREMISES OPERATIONS CLASSIFICATIONS ISSUED 1 -12 -84 26666 (6 -80) $1,000 RATES PREMIUM BI PD BI PD FRONTAGE PER LINEAR FOOT 50 .1230 -NC 6 INC .0150 1 1 INC AREA PER 100 SQ FT 540 17.8690 NC 96 INC APEA PER 100 SQ FT 4,004 4.8550 :NC 194 INC 1.4010 56 7� CASUALTY $300,000 EACH OCCURRENCE $300,000 AGGREGATE $25,000 EACH ACCIDENT ADDITIONAL INTEREST ENDORSEMENT Policy Number 20192372 It is agreed that such insurance as is afforded by the policy for bodily injury or property damage lia- bility shall also apply to each interest named herein as an insured, but only with respect to such liability arising out of the specific interest indicated. The inclusion herein of such additional interest or interests shall not operate to increase the limits of the Company's liability. Name and P.O. Address Interest City Of Sanford PO ?fox 1778 Sanford, FL. 32771 Lessor Form 2684 (11-74) ,4iuto- fawners PAGE 002 SMP LIABILITY DECLARATIONS — SCHEDULED INSURANCE COMPANY LANSING, MICHIGAN 48909 RENEWAL PREMIUM TE 02 - -84 TO 02 -17 -85 AGENT BOYD— WALLACE INSURANCE AGENCY 12017 114 S PALMETTO AVE POLICY NUMBER SANFORD FL 32771 814612 20192372 INSURED SANFORD TABERNACLE OF PRAYER INC POLICY PERIOD FROM 12:01 A.M. 02 -17 -84 ADDRESS 950 W 13TH ST TO UNTIL CANCELLED SANFORD FL 32771 POLICY CHANGE a CROSS OUT OLD INFORMATION AND WRITE IN THE CH AN GE S. EFFECTIVE DATE OF CHANGE : MO - - -- DAY - - -- YR - - -- CONTRACTUAL AS DEFINED IN THE POLICY — ALL OTHERS EXCLUDED PROTECTIVE IF ANY SUBJECT TO AUDIT OLT TERR 06 COUNTY 59 INSURED IS — CORPORATION ENDORSEMENTS: 2684 26153 ISSUED 1 -12 -84 2000000354 COVERAGE PREMIUM TOTAL LIABILITY PREMIUM 354 INC 354 26666 (6 -80) — CASUALTY C47N auto- Owners INSURANCE COMPANY LANSING, MICHIGAN 48909 AGENT BOYD - WALLACE INSURANCE AGENCY 12017 114 S PALMETTO AVE SANFORD FL 32771 INSURED SANFORD TABERNACLE OF PRAYER INC ADDRESS 950 W 13TH ST SANFORD FL 32771 POLICY CHANGE CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES. ATTACHED TO AND FORMING PART OF POLICY NUMBER 814612 20192372 POLICY PERIOD FROM 12:01 A.M. 02 -17 -84 TO UNTIL CANCELLED EFFECTIVE DATE OF CHANGE : MO - - -- DAY - - -- YR - - -- IN CONSIDERATION OF THE PREMIUM CHARGED FOR THIS POLICY, IT IS UNDERSTOOD AND AGREED THAT THE MEDICAL PAYMENTS COVCRAG' SHALL N` APPLY TO FUFILS WHILE ATTENDING A SCHOOL, DAY NURSERY AND /OR KINDERGARTEN NOT CONDUCTED PRIMARILY FOR RELIGIOUS EDUCATION AND /OR RELIGIOUS INSTRUCTION. ISSUED 1 -12 -84 26153 (7 -77) - CASUALTY DECLARATIONS PART TWO )i- Owners INSURANCE AGENCY BOYD- WALLACE 12 017 POLICY NUMBER 814612 20192372 INSURED SANFORD TABERNACLE OF PRAYER, INC. STREET CITY & 950 W. 13TH ST. STATE S FL.- - _ - -- --- - -- --- Individual (] Partnership ® Corporation ENTITY: E Fraternal Organization ❑ Other: Location of Premises as follows, or FX 1 Same as above 77 N F] [ AUTO.OWNERS (MUTUAL) INSURANCE CnMAANY OWNERS INSURANCE COMPANY PROPERTY-OWNERS INSURANCE COMPANY CITY SANFORD PREMIUM TERM _�. 2 17 8 2 17 84 12:01 A.M. STANDARD TIME AT L LOCA OF INSURED PROPERTY Provisional Premium: $ 705 [l Audited Non- Audited INSTITUTIONAL. Zip Code 32771 - - -- - - - - - -- - - -- - -. 1_�] Municipality FJ Institution Occupancy of Premises t. ► . 0 MCI 2. 12. 13 �3 O nsurance is provided with respect to those premises described above and with respect to those coverages and kinds of property for which a specific limit of l iability is shown, subject t,, all of the t erms of this policy including forms and endor sements m ade a part hereof: — Cefgwrsnos —. - - - -_ - - - - - -- - LIMIT OF LIABILLTY SECTION t- .^ROPERTY COVERAGE P�Wft" -W- M .. -- eN-Man -'�� ila� ' a .- Applicable 1 1 -. Buildinp(s) (Insurable Value $ ) sa $ hx) $ $ Personal Pr operty of the Insured Personal Property o Others $ — $ _ $ V 1 iAdd'I. Cov. (Specify) S Deductible: $ MP0336 each occurrence. $ aggregate each occurrence. I If no deductible stated above the deduc s hall be $100 each occurrence, $1,000 aggregat each o ccurrence. O Add'I. Cov. (Specify) �NI S ECTI $ 1$ ,I $ I ! , ON I I- LIA BILITY COVE SCH EDULED ( COMPREHENSIVE LIMIT OF LIABILITY SEE SCHEDULE Bodily Injury L $ each occurr g aggregate products liability ' Property Damage Liability $ _- -- each occurr $ — — aggregate -- — Single Limit Bod ily Injury - Property Damage Liability $ each occurrence e, aggregate Premises M edical Payments $ - ea ch per $ each acci dent iAdd'I Cov (Specify) $ $ $ SECTION III - CRIME COVERAGE �- J As stated in the endorsement, made part of this Policy, it indicated by x - - - - -- -- ncC'r rr 't'y _ `Name �t _8 � r�� -vr��- 5 �. eA i Mortgagee: Street P.Q. _BQX 3 /G W . (� a ' e� Iry city & State FOREST CITY FL . 32751 - _ - -- .- - - - ,,5 4) v [&,/)/ I f Forms and Endorsements made part of this Policy: onsert No. and Edition Date 4VO010(1 -83), VIP00120 -33), MP0)3 3i (1 -83), 2GE;G6(6-30) � / Date of Issue _ _2 V4 &3 Countersigned by �. 2 % Agent 200 In consideration of the premium and of the statements made to the above Declarations, insurance is provided the Named Insured subject to all the terms of this policy including forms and endorsements made a part hereof. 11112(1 -79) a �i4'rsto- �zvners PAGE 001 SMP LIABILITY DECLARATIONS - SCHEDULED INSURANCE COMPANY LANSING, MICHIGAN 48909 AGENT BOYD - WALLACE INSURANCE AGENCY 12017 114 S PALMETTO AVE 0 SANFORD FL 32771 INSURED SANFORD TABERNACLE OF PRAYER INC ADDRESS 950 W 13TH ST SANFORD FL 32771 POLICY CHANGE s CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES. RENEWAL PREMIUM TERM 02 -17 - 83 TO 02-17-84 POLICY NUMBER 814612 20192372 POLICY PERIOD FEB. 1 7 9903 FROM 12:01 A.M. 02 -17 -83 TO UNTIL CANCELLED EFFECTIVE DATE OF CHANGE c MO - - -- DAY - - -- YR - - -- LIMITS OF LIABILITY 300,000 COMBINED SINGLE LIMIT BODILY INJURY & PROPERTY DAMAGE Li- 6-t3;-Q 0-0- EACH OCCURRE E 0 AGGREGATE 600 p,04 MEDICAL PAYMENTS $1,000 EACH PERSON $25,000 6 CH ACCIDENT PREMIUM RATES PREMIUM 1 CLASSIFICATION -CODE- LOCATION BASIS BI PD BI PD PREMISES - OPERATIONS FLORIDA ID 0020 CODE 65150 -1 VACANT LAND - EXCLUDING REAL ESTATE DEVELOPMENT PROPERTY 906 W 13TH ST SANFORD FL MEDICAL PAYMENTS ADDITIONAL INTEREST ID 0010 CODE 86612 -1 CHURCHES INCL COMPLETED OPERATIONS INCL PARSONAGE 950 W 13TH ST SANFORD FL MEDICAL PAYMENTS PRODUCTS- COMPLETED OPERATIONS EXCLUDED EXCEPT AS PROVIDED UNDER PREMISES OPERATIONS CLASSIFICATIONS CON1 'RACTUAL AS DEFINED IN THE POLICY - ALL OTHERS EXCLUDED FRONTAGE PER 50 LINEAR FOOT 50 ' .0680 'NC 3 INC .0120 1 1 INC APEA PER 100 SQ FT 4,004 2.9280 :,NC 1.2230 ADDITIONAL INTEREST ENDORSEMENT Policy Number '' " I . ' ' _"'' It is agreed that such insurance as is afforded by the policy for bodily injury or property damage lia- bility shall also apply to each interest named herein as an insured, but only with respect to such liability arising out of the specific interest indicated. The inclusion herein of such additional interest or interests shall not operate to increase the limits of the Company's liability. Name and P.O. Address C r c F P'. 1;aniUT V1. i?7/1 Interest f Form 2684 (11-74) 117 INC 49 t. Uf0- WljerS PAGE 001 INSURANCE COMPANY LANSING, MICHIGAN 48909 AGENT BOYD - WALLACE INSURANCE AGENCY 12017 114 S PALMETTO AVE 0 SANFORD FL 32771 INSURED SANFORD TABERNACLE OF PRAYER INC ADDRESS 950 W 13TH ST SANFORD FL 32771 POLICY CHANGE s CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES 61ZIM4934111FA a61 *41F31_��[�l:b�I�Lta111147 ENDORSEMENT EFF. 02 -17 -83 PREMIUM T 02 -17 -83 T 0 -1 7 - POLICY NUMBER 814612 20192372 POLICY PERIOD FROM 12:01 A.M. 02 -17 -83 TO UNTIL CANCELLED EFFECTIVE DATE OF CHANGE : MO - - -- DAY - - -- YR - - -- LIMITS OF LIABILITY XCOMBINED SINGLE LIMIT BODILY INJURY & PROPERTY DAMAGE $300,000 EACH OCCURRENCE $300,000 AGGREGATE MEDICAL PAYMENTS $1,000 EACH PERSON $25,000 EACH ACCIDENT PREMIUM RATES PREMIUM CLASSIFICATION -CODE- LOCATION BASIS BI PD BI PD PREMISES-OPERATIONS FLORIDA ID 0020 CODE 65150 -1 VACANT LAND - EXCLUDING REAL ESTATE DEVELOPMENT PROPERTY 906 W 13TH ST SANFORD FL MEDICAL PAYMENTS ADDITIONAL INTEREST ID 0010 CODE 86612 -1 CHURCHES INCL COMPLETED OPERATIONS INCL PARSONAGE 950 W 13TH ST SANFORD FL MEDICAL PAYMENTS PRODUCTS - COMPLETED OPERATIONS EXCLUDED EXCEPT AS PROVIDED UNDER PREMISES OPERATIONS CLASSIFICATIONS CONTRACTUAL AS DEFINED IN THE POLICY - ALL OTHERS EXCLUDED FRONTAGE PER 50 LINEAR FOOT 50 .0810 :NC 4 INC .0120 1 1 INC AREA PER 100 SQ FT 4,004 3.4480 NC 138 INC 1.2230 49 * DENOTES CHANGES ISSUED 3 -08 -83 26666 (6 -80) SMP POLICY CHANGE ENDORSEMENT AGENCY BOYD WALLACE Code No. Sol. No. City SANFORD 12017 Date of Change PREMIUM TERM Attached to and forming part of POLICY NUMBER 814612 20192377 8 25 82 2 17 82 2 17 83 INSURED SANFORD TABERNACLE OF PRAYER STREET 950 W. 13TH ST. CITY & STATE SANFORD FL. 32771 It is agreed that this policy is amended as follows: ❑Name of Insured changed. ❑ Coverage is added. ❑ Rates are changed. ❑Address of Insured changed. ❑ Limits of Liability changed. Coverage is changed as described: SECT. II — LIABILITY LIMITS ARE ANENMD TO 300,000/300,,000 SINGLE LIMITS COVERAGE IS ADDED FOR VACANT LAND 65150 -1 ADDITIONAL INTEREST IS ADDED PER ATTACHED 2684 REVISED 26072 IS ATTACHED Section I — Property Coverage Premium Difference Loc. Bldg. New Amount Coverage Description Additional Return No. No. of Insurance $ 1 $ Section II — Liability Coverage Premium Difference Coverage Description Limits of Liability Additional Return SCHEDULED ❑ COMPREHENSIVE ❑ Bodily Injury Liability $ each occurrence $ aggregate products liability $ $ Property Damage Liability $ each occurrence $ aggregate $ T $ Single Limit Bodily Injury- Property Damage Liability $ each occurrence $ aggregate $ $ Premises Medical Payments $ each person $ each accident $ $ Add'I. Cov. (Specify) PREMIUM SUMMARY Additional I � Return Premium Due At Endorsement Effective Date: 8T; 82 $ 11. New Revised Annual Premium: $ 669 8 Z 82 26�i COMPANY: C� AUTO- OWNERS �] HOME- OWNERS Agent Ll OWNERS ❑ PROPERTY OWNERS 17992 (1 -78) MEMORANDUM COPY d va9' we k: 9/8/32 Per the attached ins. coverage On Sanford Tabernacle of Prayer f/ Vacant city owned lot leased to them for a children's playground on W. 13th St. Orig. should go to Henry for "safe" keeping. I have made a copy for our file........ Okay ? ?? mary Is coverage sufficient /correct ? ? ?? $300,000. for ea. L_ separate occurrence. ADDITIONAL INTEREST ENDORSEMENT Policy Number 814612 20192372 It is agreed that such insurance as is afforded by the policy for bodily iniury or property damage lia- bility shall also apply to each interest n a liability arising out of the specific interest or interests shall not operate to increase the Name and P.O. Address CITY OF SANFORD P. 0. PDX 1778 SANFORD.. FL. 32771 med herein as an insured, but only with respect to such indicated. The inclusion herein of such additional interest limits of the Company's liability. Interest LESSOR Form 2684 (11-74) LIABILITY SCHEDULE Page of Pages CHURCHES —INCL. COMPLETED OPERATIONS INCL. PARSONAGE 950 W. 13TH ST. SANFORD, FL. 86612 -1 A 4004 VACANT LAND —EXCL. REAL ESTATE DEVELOPMENT PROPERTY —INCL. ADDT'L. INTEREST 906 W. 13TH ST. SANFORD.. FL. 65150 -1 B 50 MEDICAL PAYMENTS 86612 -1 PRODUCTS — COMPLETED OPERATIONS INCLUDED A 3.016 .018 121. INCL. B .073 .008 4. INCL. 44. TOTAL 169. INCL. 1 26072 (6 -77) Attached to and forming part of POLICY NUMBER 814612 20192372 Rates Premiums CLASSIFICATIONS & LOCATIONS CODE Premium Bases B. 1. P. D. Bodily Injury Property Damage Premises — Operations — Products — (a) Area (Sq. Ft.) (a) Per 100 Sq Ft. Completed operations — Contractual (b) Frontage (b) Per Linear Foot Independent Contractor (c) Remuneration (c) Per $100 (d) Number Insured (d) Per Unit (e) Cost (e) Per $1 0 PREMISES — OPERATIONS (f) Receipts (f) Per $ 1, ,000 (g) Sales (g) Per $1,000 CHURCHES —INCL. COMPLETED OPERATIONS INCL. PARSONAGE 950 W. 13TH ST. SANFORD, FL. 86612 -1 A 4004 VACANT LAND —EXCL. REAL ESTATE DEVELOPMENT PROPERTY —INCL. ADDT'L. INTEREST 906 W. 13TH ST. SANFORD.. FL. 65150 -1 B 50 MEDICAL PAYMENTS 86612 -1 PRODUCTS — COMPLETED OPERATIONS INCLUDED A 3.016 .018 121. INCL. B .073 .008 4. INCL. 44. TOTAL 169. INCL. 1 26072 (6 -77) ttt`OmOlVnerS PAGE 001 INSURANCE COMPANY LANSING, MICHIGAN 48909 AGENT BOYD - WALLACE INSURANCE AGENCY 12 -017 114 S PALMETTO AVE SANFORD FL 32771 INSURED SANFORD TABERNACLE OF PRAYER INC ADDRESS 950 W 13TH ST SANFORD FL 32771 POLICY CHANGE : CROSS OUT OLD INFORMATION AND WRITE IN THE CHANGES. SMF LIABILITY DECLARATIONS - SCHEDULED RENEWAL PREMIUM TERM 02 -17 -86 TO 02 -17 -87 POLICY NUMBER BOYD- WALLACE 814612 20192372 INSURANCE AGENCY POLICY PERIOD 114 S. Palmetto Ave. FROM 12:01 A.M. 02 -17 -86 Sanford, FL 32771 TO UNTIL CANCELLED EFFECTIVE DATE OF CHANGE = MO - - -- DAY - - -- YR - - -- LIMITS OF LIABILITY COMBINED SINGLE LIMIT BODILY INJURY & PROPERTY DAMAGE $300,000 EACH OCCURRENCE $300,000 AGGREGATE MEDICAL PAYMENTS $1,000 EACH PERSON $25,000 EACH ACCIDENT PREMIUM RATES PREMIUM CLASSIFICATION -CODE- LOCATION BASIS BI PD BI PD PREMISES - OPERATIONS FLORIDA ID 0020 CODE 65150 -1 VACANT LAND - EXCLUDING REAL ESTATE DEVELOPMENT PROPERTY MEDICAL PAYMENTS ADDITIONAL INTEREST 906 W 13TH ST SANFORD FL ID 0025 CODE 82115S -1 DAY NURSERIES INCL COMPLETED OPERATIONS ID 0010 CODE 86612 -1 CHURCHES INCL COMPLETED OPERATIONS INCL PARSONAGE 950 W 13TH ST SANFORD FL MEDICAL PAYMENTS PRODUCTS - COMPLETED OPERATIONS EXCLUDED EXCEPT AS PROVIDED UNDER PREMISES OPERATIONS CLASSIFICATIONS FRONTkGE PER LINEAR FOOT 50 .0990 '.NC 5 INC .0130 1 1 INC AREA PER 100 SQ FT 540 19.4010 :.NC 105 INC AREA PER 100 SQ FT 4,004 5.7110 NC 229 INC 1.7960 72 ISSUED 2 -07-86 26666 (6 -80) let CASUALTY RZA ADDITIONAL WEREST ENDORSEMENT Policy Number 20102372 It is agreed that such insurance as is afforded by the policy for bodily injury or property damage lia- bility shall also apply to each interest named herein as an insured, but only with respect to such liability arising out of the specific interest indicated. The inclusion herein of such additional interest or interests shall not operate to increase the limits of the Company's liability. Name and P.O. Address City PO :�o : Sanford, I'L 32771 Interest Lessor Form 2684 (11 -74)