CERTIFICATE OF INSURANCE (3)
Allstate@
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J CERTIFICATE OF INSURANCE I
EJ ALLSTATE INSURANCE COMPANY D ALLSTATE INDEMNITY COMPANY D ALLSTATE TEXAS LLOYDS
THIS CERTIFICATE IS ISSUED 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.
CERTIFICATE HOLDER NAMED INSURED
Name and Address of Party to Whom this Certificate is Issued Name and Address of Insured
CITY OF CLEARWATER ATTN PINELLAS COUNTY ARTS COUNCIL
EARL BARRETT ENGINEERING DEPT 501 CENTRAL AVE
PO BOX 4748 SAINT PETERSBURG
CLEARWATER FL 33758-4748
FL 33701-3727
This is to certify that policies of insurance listed below have been issued to the insured named above subject to the expiration date indicated be-
low, notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate may be issued or
may pertain, The insurance afforded by the policies described herein is subject to all the terms, exclusions, and conditions of such policies,
TYPE OF INSURANCE AND LIMITS
Policy Effective Expiration
COMMERCIAL GENERAL LIABILITY Number 49 649518 Date 10101/99 Date 10101100
Limit Amount
GENERAL AGGREGATE L1MIT(Other than Products-Completed Operations) $ 1,000,000
PRODUCTS-COMPLETED OPERATIONS AGGREGATE LIMIT $ 1,000,000
PERSONAL AND ADVERTISING INJURY LIMIT $ 500,000
~~AC-+lOC-C-tl RRENCE'L-1Ml--'f --.------..._- .----,~-_.._---._-"--_.-- ----.----- . ~. $ 500,000
PHYSICAL DAMAGE LIMIT $ 50,000 ANY ONE LOSS
MEDICAL EXPENSE LIMIT $ 5,000 ANY ONE PERSON
WORKERS' COMPENSATION & Policy Effective Expiration
EMPLOYERS' LIABILITY Number Date Date
Coverage Limits
WORKERS' COMPENSATION STATUTORY - applies only in the following states:
BODILY INJURY BY ACCIDENT $ EACH ACCIDENT
EMPLOYERS' BODILY INJURY BY DISEASE $ EACH EM PLOYEE
LIABILITY BODILY INJURY BY DISEASE $ POLICY LIMIT
Policy Effective Expiration
AUTOMOBILE LIABILITY Number 49 649518 Date 10/01/99 Date 10/01/00
Coverage Basis Limits
ANY AUTO OWNED AUTOS HIRED AUTOS Combined Single Limits of Liability
BODILY INJURY & PROPERTY DAMAGE~ 500,000 I EACH ACCIDENT
SPECIFIED AUTOS X NON-OWNED AUTOS Split Liability Limits
Bodily Injury Property Damage Each
OWNED PRIVATE PASSENGER AUTOS $ PERSON
OWNED AUTOS OTHER THAN PRIVATE PASSENGER $ $ ACCIDENT
UMBRELLA LIABILITY Policy Number Effective Date Expiration Date
EACH OCCURRENCE I GENERAL AGGREGATE I PRODUCTS-COMPLETED OPERATIONS AGGREGATE
$ I $ I $
OTHER(Show Policy Effective Expiration
type of Policy) Number Date .~DalfL . ..- - . -- '-. "--- - ------ ,-_.._-------,-- .-
. . .- -
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONSISPECIAL ITEMS
CANCELLATION
Number of days notice FRANK L MASSARO SR 08/11/99
Authorized Representative Date
Should any of the above described policies be cancelled before the expiration date, the issuing company will endeavor to
mail within the number of days entered above, written notice to the certificate holder named above, But failure to mail such
notice shall impose no obligation or liability of any kind upon the company, its agents or representatives,
U10523-2
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YOU'RE IN GOOD HANDS WITH ALLSTATE@ /]- ('~ -
BU114-2
SEE POLICY IN FILE
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