INSURANCE CERTIFICATE ENGINEERED RECYCLING SYSTEMS INC. (2)
CERTIFICATE OF INSURANCE
9/20/78
Revised
This certifies that the State Automobile Mutual Insurance Company has issued, to the insured named herein, policies of insurance which provide coverage as indicated
below. Such policies are subject to the provisions, conditions and limitations contained therein.
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41.7"H. BUS\"'~
STAlE. AUTOMOBILE MUTUAL
IISURANCE COMPANY
- OF COLUMBUS, OHIO
IDate
In the event of cancelation of any policy described below in the schedule, the party to whom this certificate is issued will be notified in writing in the manner pro-
vided in the policy. Ten (l0) days' notice will b6 given unless otherwise indicated herein:
Name & Address Of Party To Whom This Certificate Is Issued
Name & Address of Insured
PO Box 4748
2575 Harn Blvd.
-of"'::,' -
Clearwater, FL
Clearwater, FL
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B. fled Engineered Farming
us mess 0 nsur
location of Operations or Premlses- state Road 580 (North of), Clearwater, FL
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TYPE OF INSURANCE liMITS OF LIABILITY POLICY EXPIRATION
NUMBER DATE
Workmen's Compensation As provided by law of the State of
(J2] Designates Insurance Afforded or Hazard $ EACH DCGURRENCE*
Excludedl Bodily Injury liability and $ AGGREGATE*
D~"~' J Property Damage liability *Total Limit tor Bodily injury and Prop~
erty Damage Liability combined
Excluding Completed
l ~ Comprehensive []I Operations and
GI
EA General Liability Products liability $ 300,000 EACH OCCURRENCE GA9l5950 9/20/78
NB o Owners', landlords' and Tenants' Liability Bodily Injury liability $ 300,000 AGGREGAH:
EI o Excluding Structural Allerations
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AI o Manufacturers' and Contractors' Liability
LT o Excluding Independent Contractors Property Damage $ 50,000
Y EACH OCCURRENCE
o Contractual Liability liability $ 50,000 AGGREGATE
o Completed Operations and Products liability
ADDITIONAL INSURED: CITY OF CL TF.R
o Comprehensive Automobile liability Bodily Injury Liability $ EACH PERSON
A l o Basic Automobile Liability $ EACH OCCURRENCE
U I
TA Property Damage Liability $ EACH OCCURRENCE
DB Automobile(sl SpeCified Below $ EACH PERSON
M1 Bodily Injury Liability
Dl $ EACH OCCURRENCE
B 1 Property Damage liability $ EACH OCCURRENCE
IT
ly
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AUTO Automobile(s) Specified Below
P Encumbrance-Lass is payable as -interest may appear to the IACV Actual Cash Value)
HD named insured and: (See reverse side) Car No. Comprehensive Collision Fire Theft
YA $ Deductible $ $ $ $
SM Loss Payee-Name $
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CG Address
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S Car No. Year of Model Trade Name Body Type Serial, Motor or Identification No.
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Autho~presentative
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