CERTIFICATE OF INSURANCE
;M~~SH'I\
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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.
PRODUCER
MARSH
ATTN: ANGELA D, WILLIAMS
PH: 404/995-2762/FAX: 404/760-5638
3475 PIEDMONT ROAD
SUITE 1200
ATLANTA, GA 30305
o 1548--CAS-
COMPANIES AFFORDING COVERAGE
COMPANY
A AMERICAN PROTECTION INS CO
INSURED
. BELLSOUTH CORPORATION INCL.
BELLSOUTH BUSINESS SYSTEMS
ROOM 15A01
1155 PEACHTREE STREET, NE
ATLANTA, GA 30309-3610
COMPANY
B LUMBERMENS MUTUAL CASUALTY
COMPANY
C
COMPANY
o
\~'()~~WAGES' 0
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, LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDDIYYI DATE (MM/DDIYY)
B GENERAL LIABILITY 5AA059221-00 12/01/01 12/01/02 GENERAL AGGREGATE $ 3,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 1,000,000
CLAIMS MADE o OCCUR PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
$ 1,000,000
$ N/A
B AUTOMOBILE LIABILITY F5D056029-00 12/01/01 12/01/02 $ 2,000,000
COMBINED SINGLE LIMIT
B X ANY AUTO F5D056030-00 12/01/01 12/01/02
B ALL OWNED AUTOS F5D056031-00 12/01/01 12/01/02 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 ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND 5BR084815-00 12/01/01 12/01/02 X
EMPLOYERS' LIABILITY
A 5BR084816-00 12/01/01 12/01/02 1,000,000
-- THE PROPRIETOR/" - ,- - ---. -, --
A INCL 5BR084817-00 12/01/01 12101/02 EL DISEASE-POLICY LIMIT 1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EACH EMPLOYEE $ 1,000,000
HER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS)
CERTIFICATE HOLDER IS AN ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR.
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CITY OF CLEARWATER
CITY MANAGER
P.O. BO X4748
CLEARWATER, FL 34618-4748
SHOULD ANY OF THE ~OLlCIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EX~IRATION DATE THEREOF.
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL ---3.ll DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALLIM~OSE NO OBLIGATION OR
LIABILITY OF ANY KIND U~ON THE INSURER AFFORDING COVERAGE. ITS AGENTS OR RE~RESENTATIVES,
MARSH USA INC.
BY: Walter Gilstrap
. ;: i r.1,..~t'199)
V~4~
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PLEASE REvm~tTHEENCLOSED
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