CERTIFICATE OF INSURANCE (034)
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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:
EVANS PRODUCTS COMPANY. 6917 Collins Avenue. Miami Beach. FL 33141
INSURED:
LIMITS OF LIABILITY
Comprehensive
General
Liability
COMPANY & EXPIRATION
POLICY NO. DATE BODILY INJURY
Nat'l Un. Fire Ins. Co. of PittsburghJ PA 10/1/85
WC 112 3946 (All States) WC 112 3945 \California)
Birmingham Ins. Co. Statutory
WC 112 4084 (Oregon) Each
FCCI Fund 71858160101 (FL)Accident$ 100.000 Nil
Nat'l Un. Fire Ins. Co. Bodily Injury and Property Damage
of Pittsburgh, PA .1 C/S/L $500.000/$500.000
PROPERTY DAMAGE
COVERAGE
Workers'
Compensation
Employers'
Liability
Nil
GLA 960 1588
f(j! 1 J 85 .
Products
~.
Completed
Operations
Comprehensive
Automobile
Liability
Nat'l Un. Fire Ins. Co.
of Pittsburgh, PA
Bodily Injury and Property Damage
C/S/L $500.000
BA 9 19 8128
10/1/85
Excess/Urn brella
Liability
Combined Single Limit: $
Aggregate: $
RE:
This Certificate is issued to:
City of Clearwater
10 South Missouri
Clearwater, FL 33500
This document is furnished for information 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 cancelled, the Company issuing said policy will issue _days' notice 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.
12/19/84
DA TED:
DEe 28 1984
urance and Risk Management, Inc.
U.S. Steel Building
59th Floor
Pittsburgh, PA 15219
RECEIVED
CITY CLERK
ORIGINAL
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