CERTIFICATE OF INSURANCE - #ATL 000192312 00
.. . -c ..... ...... ..
MARSH USA IN'C. ,. C E RTI FJCATE OFJ~S UR~NCE CERTIFICATE NUMBER
1 ATL-000192312-00
PRODUCER THIS CERTIFICATE IS ISSUED AS" MATTER OF INFORMATION ONLY AND CONFERS
Marsh USA Inc, NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
3475 Piedmont Road N,E. POLICY, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
Atlanta, GA 30305 AFFORDED BY THE POLICIES DESCRIBED HEREIN,
Attn: ANGELA D. WILLIAMS 404-995-2762 COMPANIES AFFORDING COVERAGE
--
COMPANY
001548--CAS- A HARTFORD FIRE INSURANCE CO
INSURED COMPANY
BELLSOUTH CORPORATION INCL. B HARTFORD CASUALTY INS CO
BELLSOUTH TECHNOLOGY SERVICES
ROOM 15A01 COMPANY
1155 PEACHTREE STREET, NE C TWIN CITY FIRE INSURANCE CO
ATLANTA, GA 30309-3610
COMPANY
D
COVERAGES .... .......... ... ..... This certificate supersedes and replaces any previously issued certificate. ~ 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 IMMIDDfYY) DATE (MMIDDIYY)
A GENERAL LIABILITY 20 CSE J42031 12/01/00 12/01/01 GENERAL AGGREGATE $ 3,000,000
-
X COMMERCIAL GENERAL LIABILITY PRODUCTS. COMP/OP AGG $ 1,000,000
t ~ CLAIMS MADE ~ OCCUR PERSONAL & ADV INJURY $ 1,000,000
I--- OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 1,000,000
MED EXP (Anyone person) $ N/A
A AUTOMOBILE LIABILITY 20CSEJ42032 - AOS 12/01/00 12/01/01 $ 2,000,000
~ COMBINED SINGLE LIMIT
X ANY AUTO
-
- ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
-
~ HIRED AUTOS BODILY INJURY $
NON.OWNED AUTOS RECE (Per accidenl)
- IVED
PROPERTY DAMAGE $
GARAGE LIABILITY Ul:C o 8 2000 AUTO ONLY - EA ACCIDENT $
- .... ....... ............... ..
- ANY AUTO OTHER THAN AUTO ONLY:
RISK MAN ~GEMENT EACH ACCIDENT $
-
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
=1 UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
B WORKei<$i;OMPElffl"AfiON' AND"- - ZOWNJ42030 - DED:tAOS) . .. m l2/01/0(f 12/01/01 --- WCSTA.U-;t'loTH. .> .'.
EMPLOYERS' LIABILITY X I TORY LIMITS ER
C 20WBRP37910 - RETRO (MA, WI) 12/01/00 12/01/01 EL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR! RINCL EL DISEASE-POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EACH EMPLOYEE $ 1,000.000
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLESISPECIAL ITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS)
CERTIFICATE HOLDER IS AN ADDITIONAL INSURED AS THEIR INTEREST MAY APPEAR.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF.
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAll ----3..0 DAYS WRITTEN NOTICE TO THE
CITY OF CLEARWATER CERTIFICATE HOLDER NAMED HEREIN. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
CITY MANAGER
P.O, BO X4748 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES,
CLEARWATER, FL 34618-4748
MARSH USA INC.
BY: Walter Gilstrap V~ .()~
...... ... .................... >. ....... '. MM1(9/99) .' VALID AS OF: 12/04/00
c(! ~ l<l S k ( q~ SVC.
I
CITY OF CLEARWATER
Interdepartmental Correspondence
TO:
FROM:
GENERAL SERVICES
Susan Stephenson, Document & Records Supervisor
CO PIE S: l.rJii~~,i"
SUBJECT: See Below for Action Required - Contract Item - FINAL
DATE:
12/01/2000
This is to inform you that the below listed item is close to
expiration or may already have expired. This is the last notice
you will receive. PLEASE LET US KNOW THE CURRENT STATUS.
Thank you.
Item requiring action: INSURANCE EXPIRATION.
Party: BELLSOUTH MOBILITY, INC.
RENT SPACE ON TOWER LOCATED AT NE WATER
WATER POLLUTION CONTROL PLANT
Due: 12/01/2000
RECEIVED
DEe 0 4 2000
RISK MANAGEMENT
File No: 20-047-00
Date:
/
/
Action taken:
Has item been paid or finalized?
YES
NO
(circle one)
NEW Expiration/Action date:
/ /