CERTIFICATE OF INSURANCE (13)
JOHNSON & HIGGINS OF CONNECTICUT
TWO STAMFORD PLAZA
281 TRESSER 8LVD.
STAMFORD. CT 06904.2006
ISSUE DAn; (MMIOOIYY)
~~. ~:, 08/11/95
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CI:RTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES 6ELOW,
COMPANIES AFFORDING COVERAGE
INSURI!D
GTE MOBILNET OF TAMPA INCORPORATeD
GTE CORPORATION
600 N. WESTSHORE BOULEVARD
TAMPA, FL 33609
ATTN: 80B KERSTEEN
COMpANY A
umER LUMBERMENS MUTUAL CASUALTY COMPANY
=~ B N/A
COMPANY C
lSTIliR NI A
COMPANY 0
L..EllE'I Nt A
COMPANY E
umER N/A
::.,rs: !";li!:!~:a:.~~~.::e.~~t:"I,..; ~~t!f <-!;t.~. ~~I'>~~'ti I;{~*>-:~;S:i': ~ ")oI'0:4.s.*!>(~ t ~', ;~:~ j~~$..l!~~~:!ti~.e<<>'~j('i:;f::..:~:""i':.:; : :(;a~1:f;:~>>~'i"~ ;=o:""~:~&: ~'~f!i'~:~ ~~,:~~~~~. ...~!I'C' ~<<.,.*~' ; <>>>X~ ;':'\OI~~~: ':.l.~<.:<~.:-;(o,~ ~~:'*>;"~:' '0',):'
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THIS IS TO CERTlrt THAT THE POLICIES OF INSURANCE LISTED. BELOW HAVE BeEN ISSUED TO THE JNSURED NAMED ABOVE FOR THe POLICY PERIOD
INDICATED. NOTW'JTHSTANDIN() ANY REQUIREMENT, TERM 01=1 CONDITION Of' ANY CONTRACT O~ OTHER OOCUMENT WITH RESPECT TO WHicH THIS
CERTIFICATE MAYsE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POL.ICIES DESCRISED HEREIN IS SUBJECT TO AI.L THE TERMS,
EXCLUSIONS ANO CONortloNS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN F1IWUCEO BY PAID CLAIMS.
CD
LTIl
lVPE OF INSURANCl!
POLICY NUMBE;R
POUCY EffECTIVl! POUCY E)(PlRATION UMITS
DA tt (MWtJO/VYl DAn (MMIOOIYY)
07/01/95 UNTIL GENERALAGGREOATe . 1,000,000
CANCELED PROOUCT9-COMPIOP AGO. $ 1,000,000
PERSoNALlIo AOV. INJURY $ 1,000,000
I!ACH OCCURFlENC& . 1,000,000
F.I~ DAMAGE '" Villi "111) $ .. 50,000
MEO.IOO'ENSC IAnyont Iltl'*On S 10,000
COMIIINED SINGle .
UMIT
1I00lL Y INJUFIY S
(Ptll*tCn)
00011. Y INJURY .
(P&' *<:Qld.nI)
PFlOPliRlV DAMM~ S
EACH OCCVRReNCE $
AllaR;/JATi $
STAWTOflY UMI1'S
.~ ACClOENT s
OISEAse~POuCY UUIT s
DISEASE-EACH ItMPLOYEE S
A OENERAI.UA81UTV 3Yl945140.01
X COMMERCIAL QIONERAL UA8IUTY
CLAIMS MADE [!] OCCUR.
OWNEA'S & CONTRACTOR'S PROT.
X CONTRACTUAL L1ABILllY
AUTOMOIllILE LIARIUN
IWY AUTO
AU.. OWNED Autos
SCHEOUI.CO AUTOS
HIREO AUTOS
NON-OWNED AUT09
GARAGE l.IA8lUTY
El(C!8$ UADIUrv
UMBREllA FORM
OlJolER THAN UMBR&LLA FOAM
WORKIJ'I'$ COMPENSAnON
ANIl
EMPLOYERS"UA8IUTY
OTHER
{ll!$CRlpnON DF OPI!IlATION$lLOCATIONSNIlHICLUl&....CIAL ITEMS ecRTI f I CAT I! HOLDER I S NAMED AS AOO I fI ONAL INSURED WIlERE aEOUI RED BY CONTRACT IS
INDEMNITV PROVISIONS. AS RESPECTS C~TRYSIDE CELL SITE.
::O:Emit!iQA~::~'jb:';;t.'t~t:f~~~~>:;~, I,! "';~~~;;:.;~a~ij;:*~:;:~~ ;:4t:~*" ,r::c:.. ;~~r.~~ ;~),:J::::;~;~~;$~fi~~:~~:;h::j~~it .~~[;: :/ ":~A...ilSf(;~ ;. f.~r.~:~ii..' :j ,y;~~~~;~>>~~~~c;!~l),::S<<)e. ~: l ~ t 1~!~\:t:X~:e:~~~~;:~~~~~t, ;e;~<< :.~;~~j:.::~;~:;-:~.;:;.
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!~;~ SHOULD AtoN OF THE AElOVE DESCRIBED POLICIES BE CANCI!'UeO BEFORE THE
!~!I EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
~J. MAIL ~ DAYS WJ:\ITTEN NOTICE TO THI:: CERTIFICATE HOLDER NAMED TO THE
!~ LEFT. BUT FAILURE TO MAIL. SUCH NOTICe SHALL IMPOSE NO OBLIGATION OR
~t LIABILITY OF AN NO UPON THE COMPANY, Irs AGENTS OR REPRESENTAlIVES.
~i AUTHOJ'llZED REPRE ~T1VE ~~
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CITY OF CLEARWATER
P.O. BQX4746
CLEARWATER. FL 348184748
A TTN: CITY MANAGER