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CERTIFICATE OF INSURANCE (035) COMPANIES AFFORDING COVERAGES Peterson Brothers Insurance 29 North Wacker Drive Chicago, Illinois 60606 NAME AND ADDRESS OF INSURED C.R. Pierce Construction Company 6740 Park Boulevard Pinellas Park, Florida 33565RE eEl COMPANY LETTER A Liberty Mutual Insurance BAr onaut Insurance Com an Co. COMPANY LETTER COMPANY C LETTER Fireman's COMPANY 0 LETTER ~lElr E This is to certify that policies of insurance listed below have been issued to the insured named above and are i~ force at this time. Notwithstanding any, require~er:t, ter":1 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 descnbed herein IS subject to all the terms, exclusions and conditions of such policies. COMPANY LETTER TYPE OF INSURANCE POLICY NUMM 15 1985 POLICY EXPIRATION DATE limits of liability in Thousands ( OCC~~~~NCE AGGREGATE GENERAL LIABILITY BODILY INJURY $ $ A ~ COMPREHENSIVE FORM ~ PREMISES-OPERATIONS ~ EXPLOSION AND COLLAPSE H AZA RD ~UNDERGROUND HAZARD ~ PRODUCTS/COMPLETED OPERATIONS HAZARD ~ CONTRACTUAL INSURANCE ~ BROAD FORM PROPERTY DAMAGE Ii] INDEPENDENT CONTRACTORS Ii] PERSONAL INJURY CITY CLERK PROPERTY DAMAGE $ LG1-741-001623-024 12/30/85 BODILY INJURY AND 500 PROPERTY DAMAGE COMBINED PERSONAL INJURY BODILY INJURY $ (EAC H PERSON) BODILY INJURY $ (EACH ACCIDENT) PROPERTY DAMAGE $ 12/30/85 BODIL Y INJURY AND 500 PROPERTY DAMAGE COMBINED BODILY INJURY AND 12/30/85 PROPERTY DAMAGE COMBINED AUTOMOBILE LIABILITY IKJ COMPREHENSIVE FORM IX] OWNED IX] HIRED IX] NON-OWNED A AT1-741-001623-014 EXCESS LIABILITY A IXJ UMBRELLA FORM o OTHER THAN UMBRELLA FORM LE1-741-001623-044 WORKERS'COMPENSAIJON _ and WC90-437-009148 12/30/85 MSF 47] 6] ]1 J2130/85 All Risk~$5,000 Deductible *Includes rental units up to $400,000 per loss. The Certificate Holder isa loss payee and an additi.onal insured under the above policies, but only as their interests may appear. Cancellation: Should any of the above descr.ihed policies be cancelled before the expiration date thereof, the issuing com- pany will endeavor to mail ~ days written notice to the below named certificate holder, but failure to mail such notice shall impose no obligation or liability of any kind upon the company. NAME AND ADDRESS OF CERTIFICATE HOLDER: City of Clearwater P.O. BOX 4748 Clearwater, Florida , 1984