CERTIFICATE OF LIABILITY INSURANCE EXPIRES 12-01-02
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November 16, 2001
A CORDTM
PRODUCER
Lockton Insurance Agency of Dallas
717 N. Harwood, Lock Box 27
Dallas, TX 75201
Phone: 214-720-3442
Fax: 214-969-6759
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATES DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
D Fe 0 :3 2/JO'i
COMPANY
A
Pacific Employers Insurance Company
INSURED COMPANY
CITY CLERK DEPARTME r B National Union Fire
BELLSOUTH MOBILITY LLC
CINGULAR WIRELESS LLC COMPANY
, C
5565 GLENRIDGE CONNECTOR, SUITE 1401
ATLANTA, GA 30342 COMPANY
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID
CLAIMS,
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRA nON LIMITS
LTR DATE (MM/OONY) DATE (MM/DDNY)
A GENERAL LIABILITY HOO G2 029672 0 12/1/01 12/1/02 GENERAL AGGREGATE $ 10,000,000
X OMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000
CLAIMS MADE o OCCUR PERSONAL & ADV, INJURY $ 1,000,000
OWNERS' & CONTRACTOR'S PROTo ACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Any One Fire) $
AGGREGATE PER LOCATION MED, EXP, (Any One Person) $
A AUTOMOBILE LIABILITY All States 12/1/01 12/1/02 OMBINED SINGLE LIMIT $ 2,000,000
X ANY AUTO ISA HO 800275 7
ALL OWNED AUTOS ODIL Y INJURY $
SCHEDULED AUTOS Per Person)
HIRED AUTOS ODIL Y INJURY $
NON-OWNED AUTOS Per Accident)
ROPERTY DAMAGE $
GARAGE LIABILITY UTa ONLY - EA ACCIDENT
ANY AUTO THER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
B EXCESS LIABILITY BE8714352 9/10/01 6/1/02 5,000,000
X UMBRELLA FORM 5,000,000
OTHER THANGMBRELLA F0RM-
A ORKERS COMPENSATION AND All Other States 12/1/01 12/1/02
WLR C4 314149 1
EMPLOYERS' LIABILITY WI Only
HE PROPRIETOR! INCL SCF C4 314145 4
ARTNERSIEXECUTIVE
FFICERS ARE: EXCL
B OTHER 612.36.96 9/15/00 3/15/02 LIMIT
ALL RISK PROPERTY
CITY OF CLEARWATER-CITY MANAGER
PO BOX 4548
CLEARWATER, FLORIDA 34618-4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL2Q
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY
KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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