CERTIFICATE OF INSURANCE (3)
ACORD..
j"'\.C:mri+I\EI.....~A."tt.."'E..I.......I\^DI 1\1<"">1 klOiilSA. rirr:ib 'SD' ....... .... DATE (MM/DDNY)
~~~lq~1ft\.~~g.....~gg.'\J'''Q'''''I''\M>",~~i~i> 11/20/97
'" THIS CERTIFICATE IS ISS~D AS A 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 POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
~:~:J.b.~R~.
The Connelly Insurance Group
630 Chestnut street
P.O. Box 2456
Clearwater FL 33757-2456
Maureen Connelly
Phone No. 813-461-6044 Fax No. 813-442-7695
INSURED
COMPANY
A
Hartford Insurance Group
COMPANY
B
Great American Insurance Co.
Lee Arnold, Jr & Herbert Brown
DBA Arnold-Brown Properties
121 North Osceola Avenue
Clearwater FL 34615
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NA Q}4.B VE FOR THE POLICY PERIO
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU' f\!~:. S
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI , IS":s.CJB
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDNY) DATE (MMIDDNY)
LIMITS
GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY 21UUCLE7585
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
11/01/97
GENERAL AGGREGATE $1,000,000
11/01/98 PRODUCTS - COMP/OP AGG $1,000,000
PERSONAL & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 300,000
MED EXP (Anyone person) $ 10,000
11/01/98 COMBINED SINGLE LIMIT $ 1,000,000
BODILY INJURY $
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY.
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $ 5,000,000
11/01/98 AGGREGATE $ 5,000,000
$
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
------ ~- CO -X WNED mros..___ __.___-._
A
21UUCLE7585
11/01/97
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
B X UMBRELLA FORM UMB867662302
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETORI -INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
OTHER
A Property Section 21UUCLE7585
11/01/97
- - -EL DISEl'iSE -o-POLlCYLlMIT
EL DISEASE - EA EMPLOYEE
11/01/97
11/01/98
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED.
CITY074
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRES JIV
CITY OF CLEARWATER
ATTN: EARL BARRET
PUBLIC WORKS ADMINISTRATION
PO BOX 4748
CLEARWATER FL 55/~a-~'~~
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