CERTIFICATE OF INSURANCE (265)
.. .......:1:":11,.1'/::.. .. . ..
MARSH C.E.R;EJFICATE OFINSU'RAN.CE CERTIFICATE NUMBER
....... ... CHI-001470699-06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
701 Market Street, Suite 1100 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
St. Louis, MO 63101 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
Attn: stlouis.certrequest@marsh.com 212-948-0811 COMPANIES AFFORDING COVERAGE
COMPANY
JOOOOO-ALL -ALL -08-09 , A ST. PAUL FIRE & MARINE INSURANCE COMPANY
INSURED COMPANY
FiberLight, LLC B N/A
3655 Brookside Parkway, Suite 550
Alpharetta, GA 30022 COMPANY
C
COMPANY
0
COVERAGES This certificate supersedes andreplac~anypreviously issued certificate for the policy periodr'joted below. 3
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES, AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDIYY) DATE (MM/DDIYY)
A GENERAL LIABILITY TE01202096 05/09/08 05/09/09 GENERAL AGGREGATE $ 2,000,000
-
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 2,000,000
- ~ CLAIMS MADE 0 OCCUR
~ PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
-
FIRE DAMAGE (Anyone fire) $ 1,000,000
MED EXP (Anyone person) $ 10,000
AUTOMOBILE LIABILITY I<tCEI VED $
- COMBINED SINGLE LIMIT
ANY AUTO
-
- ALL OWNED AUTOS MAY 19 008 BODILY INJURY $
SCHEDULED AUTOS (Per person) ..
~
- HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS Of FlCIAl RECOI DSAND (Per accident)
-
- lE ;ISLATIVE SRV ts DEPT PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
r-- ,
f---- ANY AUTO OTHER THAN AUTO ONLY;
EACH ACCIDENT $
r--
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMl'EN'SATlON AN'D .. .. I T~~~I~I~s I lor.!:!, .
EMPLOYERS' LIABILITY ER
EL EACH ACCIDENT $
THE PROPRIETOR! RINCL EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE; EXCL EL DISEASE-EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
Re: Right of way - Franchise
Subject to all policy terms, conditions and exclusions, the City of Clearwater is included as additional insured on the above General Liability Policy ONLY as
required by written contract and as respects to building access license agreement.
CERTIFICATE HOLDER CANCELLATION ..
. ~E~ SHOULD ANY OF THE POliCIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
"'''. I- i: -"'\ \ - ,
l.-..-of"""Il. ~ \ '. ,l THE INSURER AFFORDING COVERAGE WilL ENDEAVOR TO MAIL -----3{) DAYS WRITTEN NOTICE TO THE
City of Clearwater JW''''' ("-~ \.. -. ~ V .~r"" ~ CERTIFICATE HOlDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBLIGATION OR
a political subdivision thi.~. ''''~ . ...
State of Florida LIABILITY OF AWf KINO UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
112 S. Osceola Avenue 1 "-n .,\ ISSUER OF THIS CERTIfiCATE
Clearwater, FL 33756 i 'Iv :) ):1; ,ij
t..('}~'" AUTHORIZED REPRESENTATIVE
\'.~ ~d ~o..O~
M.",h USA Inc.
"j:. t~ BY: Alfred A, Peterfeso
r ; l _.t:'p.,f~' V'/~
," '-~ON2T(-{llCT im
.... '''_ II' I~ :"'-.. MM1(3/02) VALID AS OF:05/08/08
MARSH ..:........ .>.>.. . .... ...."...... . ,.........>.,., . ....
... ~I;RTIFICATE OF INSURANCE CERTIFICATE NUMBER
,>. . CH 1-001576356-12
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
Marsh USA Inc. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
701 Market Street, Suite 1100 POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
St. Louis, MO 63101 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
Attn: stlouis.certrequest@marsh.com 212-948-0811 COMPANIES AFFORDING COVERAGE
COMPANY
)00000-ALL-ALL-08-09 A ST. PAUL FIRE & MARINE INSURANCE COMPANY
INSURED COMPANY
FiberLight, LLC B THE CHARTER OAK FIRE INSURANCE COMPANY
3655 Brookside Parkway, Suite 550 COMPANY
Alpharetta, GA 30022
C
COMPANY
D
COVERAGES .. This certificate superSedes and replaces any previously issued certificate for the policy period notedbelo"V. 2 .,
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDNY) DATE (MM/DDNY)
A GENERAL LIABILITY TE01202096 05109/08 05/09/09 GENERAL AGGREGATE $ 2,000,000
e-
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 2,000,000
L o CLAIMS MADE [8] OCCUR PERSONAl & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
f--
FIRE DAMAGE (Anyone fire) $ 1,000,000
MED EXP JAny one person) $ 10,000
A AUTOMOBILE LIABILITY TE01202096 05/09/08 05/09/09 $ 1,000,000
f-- COMBINED SINGLE LIMIT
A X ANY AUTO TE01202097 05/09/08 05/09/09
f--
f-- ALL OWNED AUTOS REC EIVED BODILY INJURY $
SCHEDULED AUTOS (Per person)
f--
X HIRED AUTOS BODILY INJURY $
f-- MAY 1 9 2008 (Per accident)
X NON-OWNED AUTOS
f--
X !compo Deductible $1000 PROPERTY DAMAGE $
X (:::ollision Deductible $1000
GARAGE LIABILITY 'U' ~ ,1\., II"\L ..' I ~._ AUTO ONLY - EA ACCIDENT $
f-- lEGISlATIVE SRVCS DEPT ,..... ...,...,...
f-- ANY AUTO OTHER THAN AUTO ONLY: ." .
EACH ACCIDENT $
f--
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
-- __. OD:!ER TI-lb.p.J Ilb.IIR~EII' A, FORM . ' - ~---- -'- --- "., -,. -.,--'-- -, " .$.
B WORKERS COMPENSATION AND HHUB3171M39608 05/09/08 05109109 I ?vx~!;'! A TU- I I Ud~ ..,
EMPLOYERS' LIABILITY X TORY LIMITS
EL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR! ~INCL EL DISEASE-POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTIVE $
OFFICERS ARE: EXCL EL DISEASE-EACH EMPLOYEE 1,000,000
OTHER
DESCRIPTION OF OPERATIONSILOCATJONSNEHICLES/SPECIAL ITEMS
City of Coral Gables is included as additional insured on the above General Liability Policy and Automobile Liability Policy as required by written contract and
as respects to building access license agreement.
CERTIFICATE HOLDER CANCELLATION
NOILJnL:ENO::! S; '~r:' :)1l8111d
. SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
~:J.-;'tHn'=i' L .:' I .1') THE INSURER AFFORDING COVERAGE WIll ENDEAVOR TO MAll --.30 DAYS WRmEN NOTICE TO THE
City of Coral Gables CERTIFICATE HOlDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
City Hall C I W~\l
405 Biltmore Way ,. LIABILITY OF ANY KINO UPON THE INSURER AFFORDING COVERAGE. ITS AGENTS OR REPRESENTATIVES. OR THE
Coral Gables, FL 33134 ISSUER OF THIS CERTIFICATE
03^i ;83~ J~ORIZED REPRESENTATIVE ~o..O~
rsh USA Inc.
: Alfred A. Peterfeso
MM1(3/02) VAUD AS OF:05/08/08