CERTIFICATE OF INSURANCE (9)
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PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY 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
JOHN L. WORTHAM & SON, L.L.P.
P.O. BOX 1388
HOUSTON, TEXAS 77251-1388
072443-00012-2003A-000027
INSURED
VRP/GWP
1/2
COMPANY
A AMERICAN HOME ASSURANCE
CROWN CASTLE GT COMPANY, llC
510 BERING DRIVE, SUITE 500
HOUSTON, TX 77057
COMPANY
B
COMPANY
C
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_CONDlTIONS-OF SUCH-POllCIES.-LlM1TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAiMS;
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE IMMIDDIYYI DATE (MM/DDIYYI
A GENERAL LIABILITY Gl4570453RA 01/01/02 01/01/03 GENERAL AGGREGATE
COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $
CLAIMS MADE W OCCUR PERSONAL & ADV INJURY
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE
FIRE DAMAGE (Anyone firel
M ED EXP (Anyone person)
A AUTOMOBILE LIABILITY CA4575580RA (TX) 01/01/02 01/01/03
CA4575579RA (O/S) 01/01/02 01/01/03 COMBINED SINGLE LIMIT
A ANY AUTO
X ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS IPer 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
OTlffR THArilJMElB!;LLA.EOBM
A WORKERS COMPENSATION AND WC4550237 01/01/02 01/01/03 X STATUTORY LIMITS
A EMPLOYERS' LIABILITY WC4551896 (CALIFORNIA) 01/01/02 01/01/03
EACH ACCIDENT
THE PROPRIETOR/ X INCL DISEASE - POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL DISEASE - EACH EMPLOYEE
OTHER
2,000,000
2,000,000
1,000,000
1,000,000
100,000
5,000
1,000,000
1,000,000
1,000,000
1,000 000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIALlTEMS CERTI F I CATE HOLDER IS INCLUDED AS AN ADD IT I ONAll NSUREDUNDER GENERAL AND AUTOMOBilE
liABiliTY POLICIES WHEN REQUIRED BY WRITTEN CONTRACT BUT ONLY WITH RESPECT TO: COUNTRYSIDE/BU#814424
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U SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
I
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
:-, 3 I 2DO!
CITY OF CLEARWATER ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
ATTN: EARL BARRETT, ENGINEERING DEPT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
P. O. BOX 4748 CITY Of CLEARWATER OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES.
CLEARWATER, Fl 33758-4748 .--E~~UC~~0~~~H_'-:~ '::~~TR'\TIQ~ A Hl;2:P:J!TWortham & ~n ofof .
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