CERTIFICATE OF LIABILITY INSURANCE (3)
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THIS CERTIFICATE IS1SSLJED ASA MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS 'CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLlC1ESBELOW.
COMPANIES AFFORDING COVERAGE
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PRODiJCER
Oakes &. Associates Insurance
4111 Land 0' Lakes Blvd. #108
Land 0' LakesP'L 34639
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iNSiJRED
COMPANY
A A~to Owners Insurance Co.
COMPANY
B
RClpert&: Pa.tsy Smith
12220 Garden Lake Circle
OdessaPL 33556
COMPANY
C
COMPANY
o
CPVI:~A$~S
THIS I.S TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED FOR POLICY PERIOD
INDICATED,. NOTWlTI1ST ANDING ANY REOUIREMENT., n;RM QR CONDITioN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICi\TEMAY BE ISSUED OR MAY PERTAIN.THEiNSiJRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO. ALL THE TERMS,
EXCLUSIClNSAND CONDITIONS OF SUCH POUCIESLIMITS SHOWN MAY HAVE BEEN REDUCED BY PAlO CLAIMS
if-"" TYPE OFINSU~~NCE I ,_..... POLICY NUMBER -..----- Pg;i~~~::g~~ Pg~;l(~~:'~N -_..~- LlMiT~'
GENERAlllAlllLiTY I
COMMERCIAL GENEAAl LIABILITY 865812 79185725
~:] CLJ\IMSMADE ~J<;lCCUR
OWNER'S &CONTRACTOR'SPROT
A
07/21/08
07/21/09
RAL AGGRE..~~!!',,_.J$ 3 00 ~..
PRODUCTS .. COMPIOPA~,~..j..$
ONAL & ADV INJURY $
~-"'". ----- ,,-""'-~,=,,~--,~
LEACH OCCURR~~.~~,..$~~Q..QQ...O
~IRe DAMAGE (Anyone fire) .. ..~,..,__...._
MED EXP (Anyone person! $ 500
AUTOMOBILE LIABILITY
..JANY AUTO
; I' ALL OWNED AUTOS
r: ':~~~~~~~:UTdS
r"l NQN;OwNEDAUtOS
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COMBINED SINGLE LIMIT
BOOIL I' INJURY
(pur pelton)
BOOIL Y INJURY
(Per accldunl)
PROPERTY DAMAGE
L1AlliL1TY
AGGREGATE
EACH OCCURRENCE
_..........----------.~..,~","",
AGGREGATE
AUTO ONLY.. EA ACCIDENT
OTHER THAN AUTO ONLY
iJMBRELLAPORM
OTHER JHANUMBRELLA.~ORM
WOR~EIl$qOMPENSI\ TIClN .ANO
EMPLOYllR$' llAllIL1TY
THEPROPRIETORl INCL
PARINERSIEXECiJTlVE
O~FICERSARE EXCL
OTHER
$
...." ...~___.m_._._~_""
EL DISEASE.. POLICY LIMIT $
~_~^,~~~......V" __
EL DISEASE." EA EMPLOYEE $
DESCRIPTION O~ OpeRATlONSILOCATIONSJVEHICj.,ESisP!'CIAL ITEMS
UOa<:rlils sec. 17-20, TWP.27s., R!ille. 171.., Hillsborough County
CERrIF.1CfX'ff!:l1pLDER." ..
:' CANP~~J;A.TIQN:':......
CLEARWA
SHOULD ANY OF THE ABOVE OESCRIBED POLICies SE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THe ISSUING COMPANY Will ENDEAVOR TO MAIL
..1.2- DAYS WRITTEN NOTice TO THE CERTIFICATE OER NIIMED TO THE LEFT,
TO MAIL SUCH NOTICE SHALL IMP se N 0 lGA TlON .OR LIABILITY
SENTATIVES
City o.f Clearwater
En!illineering Dept.
Attn: Earl Barrett
P.O. Box 4748
Clearwat.er FL 33758
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