CERTIFICATE OF INSURANCE (2)
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DATEIMM/DD/VV). .
Rebsamen Insurance/LRK
1500 Riverfront Drive
P. O. Box 3198
Little Rock, AR 72203-3198
(5011 661-4829
INSURED
12/09/02
THIS CERTIFICATE IS ISSUED AS A MAHER OF INFORMATION
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
ALLTEL Wireless Holdings, LLC
d/b/aALLTEL Corporation
P. O. Box 2177
Little Rock, AR 72203
COMPANY
~ Cincinnati Insurance Company
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 ,TERMOR CONDITION OF ANY CONTRACT OROTHERDOCUMENTWITHRESPECTTO WHICHTHIS
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 (MMlDD/YY) DATE (MMlDD/YY)
LIMITS
A GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
X Contractual
COP0686800
1/01/03
1/01/04
GENERAL AGGREGATE $
PRODUCTS.COMP/OP AGG $ 2,000,000
PERSONAL & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 1,000,000
MED EXP (Anyone person) $ 5,000
COMBINED SINGLE LIMIT $
1,000,000
BODIL Y INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
A AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
COP0686800
1/01/03
1/01/04
GARAGE LIABILITY
ANY AUTO
A EXCESS LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE .PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
A Commercial Property
CCC4428700
1/01/03
AUTO ONLY. EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
1/01/04 EACH OCCURRENCE $ 5,000,000
AGGREGA TE $ 5,000,000
$
L_...
EL DISEASE.POLlCY LIMIT $
EL DISEASE-EA EMPLOYEE $
1/01/04 Direct Risk
COP0686800
1/01/03
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS
Re: McMullen Booth (FL0182) City's "DelOra Park Water Tank." Certificate Holder is included as Additional Insured ATIMA.
CERllF'ICAIE HOlPER
City of Clearwater ill
Attn: Earl Barrett
Real Estate Services Ygr.
P. O. Box 4748
Clearwter, FL 33758-4748
..................................
~:::::~:)~n::::"=::~):m:~
OEC203X2 ~
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPAN'l" WILL ENDE~VOR TO MAIL
RTIFICATE HOLDER NAMED TO THE LEFT,
~'\J71~tJJ~ .&~ward
::::.)~)j:.)~~~AC6.RP.:cOiIiii:tjfiQN]9jif
CERTIFICATE: 005/0011 00655
PRODUCER
MARSH (USA) INC.
1601 ELM STREET
2100 THANKSGIVING TOWER
DALLAS, TX 75201
CYNDIE NUNN 214/849 - 5119
62219--ALL TE-03-04 W IREL
CERTIFICATE NUMBER
HO U-000461421-01
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
COMPANY
A LIBERTY MUTUAL FIRE INSURANCE COMPANY
INSURED
ALL TEL WIRELESS HOLDINGS, LLC
dlbla ALL TEL CORPORATION
ONE ALLIED DRIVE
LITTLE ROCK, AR 72202
COMPANY
B
COMPANY
C
COMPANY
D
~bytfRiA:<i'E!
::-:=lli:,"J~"i:t:1NTIt#i,~:~~~:~':,:m~~,t",
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO +'fPEGf-IN&U RANC-E ,-~ " - -- -..p Q.UC.~--N.l.U.I.aER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
l.TR -OATE'(MMlDlllYyr 'lrATE-(MM1DD IYY} ---- --- --------
G ENE R AL LIABILITY GENERAL AGGREGATE $
COMMERC~LGENERALL~B~ITY PRODUCTS-COM~OPAGG $
CLAIMS MADE D OCCUR PERSONAL & ADV INJURY $
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
$
AUTOMOBILE LIABILITY $
COMBINED SINGLE LIMIT
ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONL Y:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND
-'fiiPLO YER S 'LtASlITfY -~-'_._'. --:--..
A WA264D005098013 (OED) 01/01/03 01/01/04
A THE PROPRIETORI X INCL WC2641005098023 (RETRO) 01/01/03 01/01/04
PARTNERS~XECUTNE
OFFICERS ARE: EXCL
0 R
~ U WI ~
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/SPECIAL ITEMS
CITY OF CLEARWATER
ATTN:EARLBARRETT
REAL ESTATE SERVICES MGR.
P.O. BOX 4748
CLEARWATER, FL 33758-4748
SHOULD ANY OF THE POliCIES DESCRIBED HEREIN BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE Will ENDEAVOR TO MAil ___3..Q DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN. BUT FAilURE TO MAil SUCH NOTICE SHAll IMPOSE NO OBliGATION OR
liABiliTY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Rex Cook
fl,-/ Grn.