CERTIFICATE OF INSURANCE
\"1:.1 i II~-IL.J.\ 11:. UI- h~;;)UHAl~l,t;
.JQSISTATE FARM FIRE Af'lD CASUALTY COMPANY, Bloomington, illinois
DSTATE FARM GEN~AL INSURANCE COMPANY, Bloomington, illinois
Insures the following policyholder for the coverages Indicated below:
POLICY PERIOD
Effective Date : Expiration Date
!Xk Comprehensive i
90-BL-4180-2 General L1abllltv 8/2/94: 8/2/95 (;";]
........ ....h_h._h __ ______ ____ __ __ ___.___ ___ .____ _ ___ _,__ _:1____________ ._h_ _ _.._.,.. ..... _ __ --I ________._.. ____ __ ______ ~ Dual Limits for.
o Manufacturers and : Each Occurrence
. _ ___ ______.__ __ __ _ _ __ _____ __ _ _.__ _ __ _ ._. _ _ ~~_~!~~~~C?~~_~I_~~)~~y.__ _... _. ._.._ _.. _____ _ _ _ _ _ _ _ _ -t-- __ ___ ___.__ _ ____ ____.. Aggregate
o Owners, Landlords, i
.. h _ _. h _ no __ _ __ _ _ _ _, _ no _ __ __ _ _. _ _ ____.. ~~~..~ ~1.l~1.l!~. ~I~~!~'!Y. _.. _. . ___. _ _ _ _ __ _ _. _ __ no _ _..t__ __. _. _ _ __ no __ _ ___ _ ___
This certifies that
Name of policyholder
Address of policyholder
Location of oPerations
AVVITIONAL INSURED:
S e.c.tio 11 II
POLICY NUMBER
This Insurance Includes:
POLICY NUMBER
90-BL-4180-2
I
CARTER COMMUNICATIONS INC
POBOX 3025
rIFARWATFR, Fl 34630-8025
FLORIDA
CITY OF CLEARWATER
P 0 80X 474~
CLEARWATER, FL 34630
TYPE OF INSURANCE
LIMITS OF LIABILITY
BODILY INJURY
$ 300 pOO
$ 600,000
PROPERTY DAMAGE
'0 Products - Completed Operations
o Owners or Contractors Protective Liability
o Contractual Liability
o Professional Errors and Omissions
o Broad Form Property Damage
o Broad Form Comprehensive General Liability
Each Occurrence $
Aggregate.
BODILY INJURY AND
PROPERTY DAMAGE
TYPE OF INSURANCE
POLICY PERIOD
Effective Date Expiration Date
D Combined Single Limit for:
Each Occurrence
Aggregate
CONTRACTUAL LIABILITY LIMITS (If different from above)
BODILY INJURY
BUSINESS POLICY
8/2/94
8/2/95
Each Occurrence
PROPERTY DAMAGE
Each Occurrence
Aggregate
EXCESS LIABILITY
D Umbrella
o Other
:~ )]:~ffW
AU~ 1 0 1994
,
,
BODILY INJURY AND PROPERTY DAMAGE
(Combined Single Limit)
ach Occurrence $
Aggregate $
Part 1 STATlJTORY
Part 2 BODILY INJURY
Each Accident
Disease Each Employee
Disease - Policy Limit
o Workers' Compensation
and Employers Liability
THIS CERTIFICATE OF INSURANCE IS NOT A CONTRACT OF INSURANCE AND NEITHER AFFIR
ALTERS THE COVERAGE APPROVED BY ANY POLICY DESCRIBED HEREIN.
Name and Address of Certificate Holder
. CITY OF CLEARWATER
RISK MANAGEMENT OFFICE
POBOX 4748
CLEARWATER, FL 34630
Fll-99,'" 0 _, &-91 Po1ntod In U,S,A,
UGG I E
RECEIVED
AUG 1 2 1994
CITY CLERK DEPT.
AGENT
1'0"
AIlQllld: 8.,1994
Dot.
r....~.... 1214-00