CERTIFICATE OF INSURANCE (23)
CERTIFICATE NUMBER
NYC-001133201-08
PRODUCER
MARSH USA INC.
1166 AVENUE OF THE AMERICAS
NEW YORK, NY 10036
Alln: K. HELM/NEWYORK.CERTS@MARSH,COM/212-948-0500
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
01042 -GTE-GAUW-05-06 MOBILN TX VA FL
INSURED
'GTE MOBILNET OF TEXAS
DBA VERIZON WIRELESS
ATTN: PAM ANDREWS
300 MCLAWS CIRCLE, STE 201
WILLIAMSBURG, VA 23185-5648
COMPANY
A AMERICAN HOME ASSURANCE COMPANY
COMPANY
B N/A
COMPANY
C N/A
COMPANY
D N/A
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 BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES,
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MMIDDIYY)
LIMITS
A GENEP.AL LIABILITY RMGL 574-4993
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
06/30/05
06/30/06
GENERALAGGREGRATE
PRODUCTS-COMP/OP AGG
PERSONAL & ADV INJ URY
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
$
5;
$
$
$
$
2,000,000
INCLUDED
2,000,000
2,000,000
50,000
10,000
AUTOMOBILE LIABILITY
ANY AliTO
ALL OWNED AliTOS
SCHEDULED AliTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
$
BODIL Y INJURY
(Per person)
$
BODIL Y INJURY
(per accident)
$
PROPERTY DAMAGE $
GARAGE LIABILITY
ANY AliTO
THE PROPRIETORI
PARTNERS/EXECliTlVE
OFFICERS ARE:
OTHER
INCL
EXCL
AUTO ONL Y- EA ACCIDENT
OTHER THAN AUTO ONL Y:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
$
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
EL DISEASE,POLlCY LIMIT
EL DISEASE-EACH EMPLOYEE
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESlSPECIAL ITEMS
RE: COUNTRYSIDE CELL SITE - CROWN CASTLE SITE BUN #814424
CERTIFICATE HOLDER IS ADDITIONAL INSURED (EXCEPT ON WORK COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED TO THE EXTENT AND LIMITS
REQUIRED BY CONTRACT.
CITY OF CLEARWATER
ATTN: EARL BARRETT
ENGINEERING DEPARTMENT
P,O, BOX 4748
CLEARWATER, FL 33758-4748
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS
WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH
NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER
AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE ISSUER OF THIS
CERTIFICATE.
MARSH USA INC
BY, Sleven Becker
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