CERTIFICATE OF INSURANCE (19)
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:::: ISSUE DATE (MM/DDIYY)
.... 06/16/97
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PRODUCER
JOHNSON & HIGGINS OF CONNECTICUT, INC.
FOURSTAMFORDP~
107 ELM STREET, 6TH FLOOR
STAMFORD, CT 06902-3851
ATIN: LISA NEWMAN
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
INSURED
GTE MOBILNET OF TAMPA INCORPORATED
GTE CORPORATION
5303 COMMERCE PARK BLVD.
TAMPA, FL 33610
A TIN: BOB KERSTEEN
COMPANY A NATIONAL UNION FIRE INSURANCE COMPANY
LETTER
COMPANY B
LETTER N/A
COMPANY C
LETTER N/A
COMPANY D
LETTER N/A
COMPANY E
LETTER N/A
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DDIYY)
LIMITS
A GENERAL LIABILITY RMGL 113-50-91
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCUR.
OWNER'S & CONTRACTOR'S PROTo
07/01/97
07/01/00
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED.EXPENSE(Anyoneperson) $
5,000,000
5,000,000
5,000,000
5,000,000
50,000
10,000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
COMBINED SINGLE $
LIMIT
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE
WORKER'S COMPENSATION
AND
EMPLOYERS' LIABILITY
EACH ACCIDENT
DISEASE--POLlCY LIMIT
$
$
DISEASE--EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO RETENTIONS)
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WHERE REQUIRED BY CONTRACT'S
INDEMNITY PROVISIONS. AS RESPECTS COUNTRYSIDE CELL SITE.
CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER, FL 34618-4748
A TIN: CITY MANAGER
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE T~ MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KI PON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENT Tr/E
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