CERTIFICATE OF INSURANCE
ROrX;ERS & ClMITNGS INSURANCE, INC.
P. o. Box 5148
Clearwater, Florida 33518
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW,
COMPANIES AFFORDING COVERAGE
ALVIS HAULING, INC.
1932 Oro Court
Clearwater, Florida 33546
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
lETTER
COMPANY D
lETTER
COMPANY E
LETTER
AEl'NA CASUALTY AND SURETY
EMPIDYERS SELF INSURER'S FUND
"'
. ~~I~~T1~;:~ril~ ~~~T~~~~~~~~~~~~:~~C~~ciNT~~J~~Lg:':N\V~~~i~~~~~J~:r~ 6~~~~N~A~~~ ~:~:i~0:OT~~ic~L~~i;~~~~?~I~~li:1~y ~
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THEPOUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSlONS, ANDCONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
.
POLICY EFFfCTM
OA TE IMMIllllIYY)
POlICY fXP1RATION
DATE IMwoorm
LIABILITY LIMITS IN THOUSANDS
OCCG~~NCE AGGREGATE
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISEs/OPERA nONS
UNOERGROUNO
EXPLOSION & COLLAPSE HAZARD
PRODUCTSlCOMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT COf;TRACTDRS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
BODIL Y
INJURY
$
$
02300112358 CCA
7/17/87
/17 /88
PROPERTY
DAMAGE
$
$
BI & PD $ 500
COMBINED I '
$1,000,
PERSONAL IN.IURY $
AUTOMOBILE LIABILITy
ANY AUTO
AlL OWNED AUTOS (PRIV PASS)
AlL OWNED AlITDS (~WJRp~;N)
HIRED AUTOS
NON OWNED AUTOS
GARAGE L!,I\BIUr.
BOOtl V
It'-lURY
I:::::: I $
I DAMAGE ! S
I Bi & P:J i
I COMS,"ED I s
--r--.
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
830 5387
4/01/87
I
!
I
8/31/88
I
I
I ,
! Bi e. r::: I.,..
I COMBINED I ;j)
t-----"- I
STATUTURY f
ISlOO lEACH ACCiDENT)
~--~
~5QQ (DISEASE-POLICY LIMIT)
i $100 (DiSEASE-EACH EMPLOYEE)
-i
I
!
I
i$
I
I
E
OTHER THAN UMBRELLA FORM
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS
RC>IX;ERS & CUM-ITNGS INSURANCE, INC.
P. O. Box 5148
Clearwater, Florida 33518
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
ALVIS HAULING, INC.
1932 Ora Court
Clearwater, Florida 33546
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
AETNA CASUALTY AND SURETY
THIS IS TO CERTIFY THAT POLICIES OF It~SURANCE 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 wrni RESpECT TO WHICfiTH,ISCfRTJF'i;ATF; Mil.':
8EISSUEO 0~MAY-PERTA1N; THE INSURANce-AFFORPEOBY THE POliCIES DESCRIBED HEREIN IS SUDJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI.
TIONS OF SUCH POLICIES.
Col
LTR
! GENER4L UABILITY
Aoq COMPREHENSIVE FORM
: X I PI1EMISESlOPERATlONS
R UNDERGROUND
i EXPLOSION & COLLAPSE H.\ZARO
I PROOUCTSlCOMPLETED OPERA nONS
~ CONTRACTUAL
1-...i
RIINOEPft,/DENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
H PERSONAL INJURY
I AUTOMOBILE LIABIUTY
r-:
! I ANY AUTO
n ~.LL OWNED AUTOS (PRIV, PASS,)
rH ALl OWf,ED AUTOS ('OTHER THA~~)'
. PRIV PASS
i HIRED AUTOS
H NON-OWNED AUTOS
H GARAGE L1ABllIW
--1
I
TYPE OF INSURANCE
POliCY Ef"err.,;;
[,ATE (MMI:JOIYf1
LIABILITY LIMITS IN THOUSANOS
POliCY EXPIRATION
Oil', 'MWOO/YY1
POLICY NUMBER
EACH
OCCURRENCE
AGGREGATE
BODIL Y
INJlJR~
$
$
1$
02300112358 CX'A
7/17/87
I
17/17 /88
I
i
1$1,000,
PROPERTY
DAMAGE
$
i
iBI & PD I, $ ,
COMBINED 500,
I
PERSONAl. INJURY
1$
i
BOO,!
IIUHi
IPER PERSIJ!li $
BOOlY
I/;JiJRY I
{?fR .:.::i::iiJE,\1, $ j
PROPERTY
DAMAGE $
4----_
Si & PO i I
CO,,"I>INFD I <l: I
i:..+-' .
Is
I
! EXC!:SS L1AB!LlTY
n UMBRELLA FOAM
H OTHER THAN UMBRELLA FORM
, ,
81 & PQ I'
COMBiNED $
i
:
I
I
~/31/88
I
(DiSEASE-POLICY L1MITI
iOISEASE-EACH EMPLOYEEl
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
4/01/87
830 5387
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS
Job: pioneer Western