CERTIFICATE OF INSURANCE (063)
Suncoast Insurance Associai;EiSc ~c.
1408 N. Westshol:j5 io1~.i. tu'l~ n008
Tarrpa., Florida J3'3t>tr/
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
J\)l 24: 196'5
COMPANY A
LETTER Thited states Fide1it & Guarant Co.
COMPANY
LETTER \ha. Trans. B1drs. Assn Self-Ins. Fund
COMPANY C
LETTER
C1annac M3.rine Cons~tV.o:C~y
P. o. Box 1547
pine11as Park, 'Florida 33565
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
POLICY EFFECTIVE
DATE (MM/oolYY)
POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
DATE (MM/oolYY) EACH AGGREGATE
OCCURRENCE
BODILY
INJURY $ $
PROPERTY
DAMAGE $ $
BI & PD $500 $ 500
COMBINED
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNOERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
MP 037020225
11/1/84
11/1/85
PERSONAL INJURY $ 500
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV, PASS,)
ALL OWNED AUTOS (OTHER THAN)
PRIV, PASS,
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
BAP 062500493
11/1/84
11/1/85
BODILY
INJURY
(PER PERSON)
BODILY
INJURY
(PER ACCIDENT)
PROPERTY
DAMAGE
BI & PD
COMBINED
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
81 & PD
COMBINED
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
8-90-191
1/1/85
1/1/86
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
City Of Clearwater
P. O. Box 4748
Clearwater, Florida 33518
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
PIRATIOt1f DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL j U DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Bruce E . Titus