CERTIFICATE OF INSURANCE
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STAlE AUTOMOBilE MUTUAL
ISURANCE COMPANY
- OF COLUMBUS. OHIO
INSURANCE
aDate
CERTIFICATE OF
8-30-79
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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.
In the event of cancelation of any policy described below in the schedule, the party to whom this certificaI~ is issued will be notified in writing in the manner pro-
vided in the policy. Ten (l0) days' notice will be given unless otherwise indicated herein:
Name & Address Of Party To Whom This Certificate Is Issued
Name & Address of Insured
City of Clearwater, Office of City Clerk
Engineered Recycling Systems, Inc.
P. O. Bo~ 4748
2575 Ham Blvd.
Clearwater, Florida
Clearwater
Florida
33516
Business of Insured
location of Operations or Premises
Farm Operations
Florida
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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
tQ Designates Insurance Afforded or Hazard $ EACH OCCURRENCE~
Excludedl Bodily Injury liability and $ AGGREGATE*
D Mult,-Penl Property Damage liability *Totol limit for Bodily Injury and Prop-
erty Damage Liability combined
EXCluding Completed
L ill ".",,"~ ,. J LI Operations and
GI
EA General liability Products liability $300,000. EACH OCCURRENCE CIP 982 46 9-20-80
NB o Owners', landlords' and Tenants' liability Bodily Injury liability ~l1.i.QOO . AGGREGATE
EI o Excluding Structural Alterations
RL
AI o Manufacturers' and Contractors' liability
LT o Excluding Independent Contractors Property Damage $100...000.
Y EACH OCCURRENCE
D Contractual Liability liability $ 100 000. AGGREGATE
o Completed Operations and Products liability
o Comprehensive Automobile liability Bodily Injury Liability $ EACH PERSON
A L o Basic Automobile liability $ EACH OCCURRENCE
UI
TA Property Damage liability $ EACH OCCURRENCE
OB Automobile(s) Specified Below $ EACH PERSON
MI Bodily Injury liability
OL $ EACH OCCURRENCE
B, Property Damage liability $ EACH OCCURRENCE
r T
Ly
E
AUTO Automobile(s) Specified, Below
p Encumbrance-loss 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 $
IA
CG Address
AE
L
S Car No_ Year of Model Trade Name Body Type Serial, Motor or Identification No.
C
AH
UE RECEIVED
TO
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CITY CLERK
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LOSS PAYABLE CLAUSE
loss Of damage, if any, under this Insurance shall be payable as interest may -appear to the person or organization named on the reverse side as
Loss Payee and this insurance as to the interest of the Bailment lessOf, Conditional Vendol, Mortgagee or other secured party or Assignee of Bail-
ment lessor, Conditional Vendor, Mortgagee or other secured party (herein called the lienholder) shall not be invalidated by any act or neglect of
the Lessee, Mortgagor, Owner of the within described automobile or other Debtor nor by any change in the title or ownership of the property;
provided, however, that the conversion, embezzlement or secretion by the Lessee, Mortgagor, Purchaser or olher Debtor in possession of the
property insured under a bailment lease, conditional sale, mortgage or- other security agreement is not covered under this insurance, unless speci~
fically insured against and premium paid therefor; and provided, also, that in case the lessee, Mortgagor, Owner or other Debtor shall neglect to
pay any premium due under this insurance the lienholder shall, on demand, pay the same.
Provided also, that the lienholder shall notify the company of any change of ownership or increase of hazard which shall come to the knowledge
of said lienholder and, unless permitted by this insurance, it shall be noted thereon and the lienholder shall, on demand, pay the premium for such
increased hazard [or the term of lhe use thereof; otherwise this insurance shall be null and void.
The company reserves [he right to cancel this insurance at any time as provided by its terms, but 1n such case the company shall notify the lien-
holder when not less than ten days thereafter such cancelation shall be effective as 10 the interest of said lienholder therein and the company shall
have the right, on like notice, to cancel this agreement.
If the named insured fails to render proof of loss within the time grallted in the policy conditions, such lienholder _shall do so within sixty days
thereafter, ill form and manner as provided by this insurOlnce, and further, shall be subject to the provisions of this insurance relating to appraisal
and time of payment and of bringing suit.
W~lencver the company shall pay the Lienholder any sum for loss or damage under this insurance and shall claim that, as 10 the lessee, Mortgagor,
O"Nner or other Debtor, 110 liability therefor existed, the CO:"lipany shall, to the extent of such payment, be thf'feupon letitlly subrogfllcd to all the
righ!'3- of the party to whom such payment shall be made, UilU?r all securities held a,? collateral t9 the debt, or may at its optioll, pay to the lien-
huider the whole principal due or lo grow due on the mortg2ge or other security agreement with interest, and shall t.hereupon receiVEr a full assign-
ll\ent and transfer of the mortgage or other security agreement and of all such other securities; but no subrogatio:l shall impair the right of the
Lienholder to recover the full amount of its claim.
Whenever a payment of any nature becomes due under this insurance, separate payment may be made to each party at interest provided the com-
pallY protects the equity of all parties.
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