CERTIFICATE OF INSURANCE (104)
Lawrence united Corporation
2085 us 19 N, Suite 104
Clearwater,FL 33575
INSURED
Couch Construction
615 Jasmine Ave.
Suite I
Tarpon Springs, FL
33589
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
COMPANY A Fidelity & Casualty
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT 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 CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNOERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PASS.)
ALL OWNED AUTOS (OTHER THAN)
PRIV ' PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
37C8458911 868
OTHER
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES/SPECIAL ITEMS
City of Clearwater
Purchasing Division
PO Box 4748
Clearwater,
POLICY EFFECTIVE POLICY E~PIRA TION LIABILITY LIMITS IN THOUSANDS
OATE (MMIOOIYY) OA TE (MMlOOIYY) EACH
OCCURRENCE
BODILY
INJURY $ $
PROPERTY
DAMAGE $ $
BI & PO $ $
COMBINED
PERSONAL INJURY $
BODILY
INJURY $
(PER PERSON)
BODilY
INJURY $
(PER ACCIDENT)
PROPERTY
DAMAGE $
BI & PO
COMBINED $
BI & PO $
COMBINED
2-20-86 (EACH ACCIDENT)
2-20-87 (DISEASE-POLICY LIMIT)
(DISEASE,EACH EMPLOYEE