CERTIFICATE OF INSURANCE (21)
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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.
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PRODUCER
J&H MARSH & MCLENNAN INC.
FOURSTAMFORDP~
107 ELM STREET, 6TH FLOOR
STAMFORD, CT 06902-3851
A TTN: LISA NEWMAN
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
INSURED
GTE FLORIDA BUSINESS CONNECTIONS
GTE CORPORATION
1907 U.S. HIGHWAY 301 N.
MC: FLG1-470
TAMPA, FL 33619
ATTN: SUSAN PERRY
COMPANY B
LETTER
N/A
NATIONAL UNION FIRE INSURANCE COMPANY CO. OF PA
COMPANY C
LETTER
INSURANCE COMPANY STATE OF PENNSYLVANIA
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
d1NDTCATED; NOTWITHSTANDTI'-K.DUW REQUIREMENT, TERM OR CONDITION ~Y 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
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE (MM/DDIYY) DATE (MM/DDIYY)
07/01/98 07/01/99 GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
MED.EXPENSE(Anyoneperson) $
07/01/98 07/01/99 COMBINED SINGLE $
LIMIT
BODILY iNJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
EACH OCCURRENCE $
AGGREGATE $
I n7/ntt. ,no --G7/G4/99-----..--
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EACH ACCIDENT $
DISEASE..POLlCY LIMiT $
DISEASE--EACH EMPLOYEE $
TYPE OF INSURANCE
A GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [KJ OCCUR.
OWNER'S & CONTRACTOR'S PROTo
RMGL 113-50-91
A AUTOMOBILE LIABILITY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
X SELF-INSURED - PHYSICAL DMG.
RMCA 143-95-79
RMCA 143-95-80
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
10,000,000
10,000,000
5,000,000
5,000,000
50,000
10,000
5,000,000
C
"----.-..----.- .----."-.--....--.----.--,---.-- ~.-RMV'.JG_M7--07_7-1-{A~
WORKER'S COMPENSATION
RMWC 347-07-72
RMWC 347-07-73
RMWC 347-07-74
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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 TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
mi: LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
:;:.:.: AUTHORIZED REPRESENTATIVE Q, rr)(;t.~IJ'-:--'''''''-' ..
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS (LIMITS MAY BE SUBJECT TO RETENTIONS)
CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED WHERE REQUIRED BY CONTRACT'S INDEMNITY PROVISIONS.
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THE CITY OF CLEARWATER POLICE DEPARTMENT
645 PIERCE STREET
CLEARWATER, FL 34616
dTT./ _d..o..RElC M81tlBBD4
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500,000
500,000
500,000