CERTIFICATE OF LIABILITY INSURANCE (3)
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Rebsamen Insurance/LRK
1500 Riverfront Drive
P. O. Box 3198
Little Rock, AR 12203-3198
(5011 661-4829
INSURED
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12/04/01
THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORM A TION
ONL Y 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
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COMPANY
A
Cincinnati Insurance Company
ALLTEL Wireless Holdings, LLC
d/b/a ALLTEL,Corporation
P. O. Box, 2111
L i tt I eRock, AR 12203
COMPANY
B
COMPANY
C
THIS IS TO CERTIFY THA T THE POLICIES OF INSURANCE LISTED BELOW HA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICA TED,NOTWITHST ANDING ANY REQUIREMENT, TERMORCONDITIONOF ANY CONTRACT OR OTHERDOCUMENTWITHRESPECTTOWHICHTHIS
CERTIFICA TE MA Y BE ISSUED OR MA Y PERT AIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
A GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
COP0686800
1/01/02
1/01/03
GENERAL AGGREGATE $
PRODUCTS.COMP/OP AGG $ 2,000,000
PERSONAL & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone tire) $ 1,000,000
MED EXP (Anyone person) $ 5,000
COMBINED SINGLE LIMIT $
1,000,000
BODIL Y INJURY $
(Per person)
BODIL Y INJURY $
(Per accident)
PROPERTY DAMAGE
A AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON. OWNED AUTOS
COP0686800
1/01/02
1/01/03
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGA TE $
1/01/03 EACH OCCURRENCE $ 5,000,000
AGGREGA TE $
$
lt01/03
$ 100,000
EL DISEASE.POLlCY LIMIT $ 500,000
EL DISEASE.EA EMPLOYEE $ 100,000
1/01/03 All Risk Replacement Value
A EXCESS LIABILITY CCC4428100-02 1/01/02
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
uA WORKElfS-COI\JlPENSATIlWANo- . 'KC190'92lmO "'- 1/017lJ2'
EMPLOYERS' LIABILITY
THE PROPRIETOR/ INCL
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
OTHER
A Commercial Property CPP06868000 1/01/02
Coverage Including EDP
DESCRIPTION OF OPERATIONSILOCATIONSIVEHICLES/SPECIAL ITEMS
Re: McMullen Booth (FL0182) City's "Del Oro Park Water Tank." Certificate Holder is included as Additional Insured ATIMA.
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City of Clearwater
Attn: Earl Barrett
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Real Estate Services Mgr.
P. O. Box 4148 I
I
Clearwter, FL 33158-4148
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OR REPRESENTATIVES.
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CERTIFICATE: 004/001/ 00655