CERTIFICATE OF INSURANCE (068)
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CERTIFICATE OF INSURANCE
This is TO CERTIFY that the described policies. covering in accordance with the terms thereof, are in
force as of the date hereof:
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INSURED:
EVANS PRODUCTS COMPANY917 Collins Avenue, Miami Beach, FL 33141
LIMITS OF LIABILITY
COVERAGE
COMPANY &
POLICY NO.
EXPIRATION
DATE
BODILY INJURY
PROPERTY DAMAGE
Workers'
Compensation
Employers'
Liability
Comprehensive
General
Liability
Nat'l Un. Fire Ins. Co. of Pittsburgh PA 10/1/86
WC 1123369 (CA) WC1123>>Qu(oA1ll States3 Nil
Birmingham Fire Ins. h
of PA 10/1/86 WC11233 Cid~~ID,MD,OR Nil
Nat'l Un. Fire Ins. Co. Bodily Injury & Property Damage
of Pgh PA 10/1/86 G/A9601768 C/S/L $100,000 xs $1,000,000
Chesapeake Ins~~~LTD 10/1/86$900,000 xs_$JQQ,Q_OO ,subject to
CIC100685-' the $1,000,000 aggregate
Nat'l Un. Fire Ins. Co. C/S/L $1,000,000/$1,000,000
of Pgh PA 10/1/86 4687862 xs of $1,000,000/$1,000,000
Products
Completed
Operations
Comprehensive
Automobile
Lillbility
Excess/Umbrella
Liability
Nat'l Un. Fire Ins. Co. Bodily Injury & Property Damage
of Pgh PA 10/1/86 BA9198496 C/S/L $100,000
Chesapeake Ins. Co LTD 10/1/86 $900,000 xs $100,000
CIC100685 C/S/L $l~OOOAOOO xs of $1,000,000
Nat'l Un. Fire Ins. Co. of PA 10/1/86 46~786~
Combined Single Limit: $
Aggregate: $
RE:
This Certificate is issued to:
City of Clearwater
10 South Missouri
Clearwater, FL 33500
This document is furnished for informa~ion only. It does not provide or convey any insurance. Unless specified hereon its issuance
does not make the person or organization to whom it is issued an additional insured under any policy of insurance, It neither
affirmatively nor negatively amends, extends or alters the coverage afforded by the contract of insurance between the insured and
any Company, Amendment, extension or change of such contract can only be effected by endorsement issued by the Company
and attached thereto. . ,.
Should any above described policy be cancell~d:theCompany iS~~ing sa~policy will issue ---1Qdays' ~otice to the holder of
this document, at the address shown herein, but failure to give such notice shall impose no obligation of any kind upon the
Company or the undersigned,
DATED:
October 4, 1985
A~f:~::~~ ·
Ins nee and Risk Management, Inc.
o Washington Pike
Bridgeville, PA15017
ORIGINAL
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