CERTIFICATE OF INSURANCE FOR 06/09/1995-06/03/1996
'--"'-"-_._-~---'-----'--,-, .-
I'ROl;ll,JCKK
Mutual Insut~ncc
of Clearwater
P.O. Box 1779
Clearwater. FL
34617
John Gay
813-446-6064
Aco~I~.IiIll\__.ill~ll'~~~~:~"""
TRIS CERllPTCATE IS ISSUED AS ~ M^,.l"r~R OF INFORMATION ONLY AND
CONFERS NO RIGHTS urON THE CERTIFICATE IIOLDlm. 'l'ms CERnnCATE
DOES NOT AMEND. EXTEND OR At::rER TilE COVERAGE ^l"FOROEOBY mE
'POLICIES BELOW..
Agel'lcy
COMPANIES AFFORDING COVERAGE
INIlUlll'.D
Marina Dental & Denture
Clinic. P.A.
25 C8u~eway Blvd., $te. 20
cL~arwat~r, FL
34630
COMPANY A Auto Owners
u:rrF.R
COMPANY R
LFITBR
COMPAN\' C
LE'ITER
eOMPAN\. D
Le:rn!k
COMPANY E
LEI'n!K
HilS IS TO CEnnFY THAT nIE POUCIES OF INSURANCE USlED BELOW HAVE BEEN ISSUED TO l1IE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITI1STANDING ANY REQUIREMENT. TERM OR CONDmON Of ,\Ny CONl'RI\CT OR 01Hll.R OOCUl'-1BNT 'hUH F.&PBCT TO WHICH lHIS
CERTIBCATU MA.Y Ill} .ISSUI,I~ OR MAY PERTAIN, HIE INSURANCE AFFORDED BY nm POUCIES DESCPJBED HERElN IS SDB1ECT T<;) Al.L THE TERMS.
EXCLUSIONS AND CONDITIONS OF SUCH POUClES. U~nTS SHOWN MAY lLWIl BEBN REDUCED BY PAID CLAIMS,
co :
LTK:
TIil'E or INSURANCE
POLICY NUMBER
; WlLlCY RIlFECTIVIli' POLICY aXPIRA'tlON
: DATE(MMlDDI\'Y) . PATII: lW>fIDD/n)
LIMITS
: GENERAL LlADILm'
A )(. COMMBRCLA,L GENBRAL llAllILTTY
CLArM~ M AOr.: X : (x',ClJR, '
. OWNER'S.t CONTRACTOR'S PROT,
92-178132-00
06/03/95
06/03/96
:GENBRAL AGGllEGATIl
;PROL>UCTs.c:OMl'i'Ol' AOO.
~, "
: PERSONAL '" ADv, INlUP.Y
AvrOMOBILE L1ABILrrY
1000000
.,,, ..............
EAClI OCCUlUUlNCIl i $ 1000000
, ........"....,,'..
~lll.r, I>AM~(;il(^,\Y '~~ r.",) : $ 50000
: MED. EXFENSE (Any"", pmno..,) ; $ 5000
ANY AUIU
COMOlNED SINGLE
: I.IMIT
!$
AJ.l..1.1WN~:rl Aln()~
Sc:'HF.nUl .F:n Auro.';
: BODILY INIURY
i'~!~l'too)
$
HlIl.ED A VTO~
NON-OWNED AUTOS
. GARAGE LL'JIILTTY
; nOll)!.. Y INJURY
: (pe-r Gooident)
:$
. I>ROJ>TItTY UAAIAGIO
: EACU OCCURRENCE ; $
. UMBREI..LA fORM
OTHER THAN UlmREllA FORM
. AGGRECATE
WOIU(KR'S COMI'KNSA.('ION
: S-fATtilORY LIMn'S
AM>
lOA(:H Al:(:IUI;1H
JiMPlO\'KR.'I'LIABlLlTY
D1SEASIl...POLlCY LIMIT
. DISEASE-EACH l'./vlPLOYF.F.
OTIIIlR
D&BCRlI'IION OF OPERATIONSILOCATIOMlIVBHICl..ll!!/!;lI'ECIAL ll'ltM!!
City of Clearwatet ill h~mcd
as add'l ;nsur~d.
q~):(:rl\IfJ\'rE nm:..))ER
City of Clearwater
H~rbormasters Office
25 Causeway Blvd_
Clearw3ter FL 34630
.CE:r:'E"~JIlG:~~;f.~Nnqfll>:;:;::<:;..:::;.;;::::;::::;:>>::,>:::'::':':':'\'::::::r:::;::r:..'~:::'
: SHOUl]) ANY OF 1}l1j AJ.lOVIl DESCRIBED POUCIES BE CAtK~1iJ.J..llD BBFORB lHB
J UNO 7 1995 IOXPlRA110N DATE TIfEREOF, 'mE rSsutNG COMPANY 'WILL ENDEAVQR 1"0
.. IIWL....1Q.. DAYS W:RIl"rnN NOTICE TO nIE CERTIFlCATEHOLDfm NAMBD TO TIm
CITY CLeRK DlPfL lEFf. BUT FAILURE TO MAlUUCll NonCE SHAU.IMPOSE NO OBUOA TIO,/-! OR.
IIA1)TIJTr OJ" ANY KIND UPON nIE CO Y. ITS AGENTS ORRB:'RI'SBlTAn:vns.
N'l' TIYK" -4 ~
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