CERTIFICATE OF INSURANCE
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This endorsement mOdil~s such insurance as is afforded by the provisions 01 the po :y relating to the fO\l~;ng:
CO~PREHENSIVE GENERAL LIABILITY INSURANCE
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MANUFACTURERS AND CONTRACTORS' LIABILITY INSURANCE
OWNERS AND CONTRACTORS PROTECTIVE LIABILITY INSURANCE
OWNERS, lANDLORDS AI'ID TENANTS LIABILITY INSURANCE
ADDITIONAL INSURED
(State or Political Subdivi$ions-Permits)
It is agreed that the "Persons Insured" provision includes as an in",red ilny slille or political subdiVIsion thereot deSignated in the schedule below, subject
to the followini: additional provisions:
1. The insur~nce applies only with respect to operations pertormed by or on behalf ollhe named insured lor which the state or political subdivision
has issued a permit.
'2: Thllinsurance does norapply to bOdilYlnjutyor properlY-dama,e
(a) arising out of operations performed for the st te or municipiility, or
(b) included within the completed operations hazard.
3. If the Property Damage liability Coverage is not otherwise aftorded, such insurance shall nevertheless apply wilh respeclto operalions llertormed
by or on behalf of the named insured for which such permit has been Issued subject to lhe limils ot liability stilted herein.
SCHEDULE
Designation ot State or Political Subdivision: city of Clearwater, Clearwater, Florida
limits ot Property Damage Liability
$ 5 0 0 , 000 each occurrence
$500,000 aggregate
Annual Premium $
GL 20 1 ~ 07 66