CERTIFICATE OF INSURANCE (25)
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MARSH USA INC. .;;,,",.... .. CERTIFICATE OF INSURANCE
CERTIFICATE NUMBER
NYC-001133201-02
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
MARSH USA INC. NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
1166 AVENUE OF THE AMERICAS, 40TH FLOOR POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
NEW YORK, NY 10036-2774 AFFORDED BY THE POLICIES DESCRIBED HEREIN,
TEL: 212-345-3259 COMPANIES AFFORDING COVERAGE
FAX: 212-345-4725/4268
ATTN: VIVIAN EDWARDS COMPANY
01042 -GTE-all-01-02 MOBIL TX VA FL A ZURICH AMERICAN INS.CO
INSURED COMPANY
"GTE MOBILNET OF TEXAS B NIA
DBA VERIZON WIRELESS
ATTN: PAM ANDREWS COMPANY
300 MCLAWS CIRCLE, STE 201 C
WILLIAMSBURG. VA 23185-5648
COMPANY
D
COVERAGES This certificate supersedes and replaces any previously issued certificate for the policy period noted below. 1 ..'
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 BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES, LIMITS SHOWN
MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE IMMIDDIYYj DATE IMMIDDIYYI
A_ ~EN.E~~~_L1~IIJ!"~_____,,_ GLO 2!UI~_372-00 ____ 06/30/02 06/30/03 nFNF=RAl TE $ 2,000,000
- --------- ._----_._---~-_.---
X COMMERCIAL GENERAL LIABILITY PRODUCTS. COMP/OP AGG $ INCLUDED
..' I CLAIMS MADE 0 OCCUR PERSONAL&ADVINJURY $ 2,000,000
- OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 2,000,000
FIRE DAMAGE (Anyone fire) $ 50,000
MEDEXP(~one~l $ 10.000
AUTOMOBILE LIABILITY $
- COMBINED SINGLE LIMIT
i-- ANY AUTO
i-- AlL OWNED AUTOS BODILY INJURY $
(Per person)
i-- SCHEDULED AUTOS
I-- HIRED AUTOS BOOIL Y INJURY $
(Per lICCident)
I-- NON-OWNED AUTOS
I-- PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
I-- ........ ,...c:."..:
I-- ANY AUTO OTHER TltAN AUTO ONLY:
I-- EACH A......IDENT $
AGGREGATE $
EXCESS UABlLITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND I TORY LIMITS I 10l~' ',:'0...:,
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $
.... - THE PROPRIETO"R/- RINCL -- " -._- - _.-- - -- . . - -- fl"- -,--
EL OlSEASE-POLICY LIMIT
PARTNERSlEXECUTIVE EL DISEASE-EACH EMPLOYEE $
OFFICERS ARE: EXCL
OT"~R
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAlITEMS (LIMITS MAY BE SUBJECT TO DEDUCTIBLES OR RETENTIONS)
RE: COUNTRYSIDE CELL SITE,
CERTIFICATE HOLDER IS ADDITIONAL INSURED (EXCEPT ON WORK COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED TO THE
EXTENT AND LIMITS REQUIRED BY CONTRACT.
CERTIFICATE HOLDER . CANCELLATION
..
SHOULD ANY OF 1llE POlICES DESCRIBED HEREIN BE CANCEu.ED BEFORE THE EXPlhATlON DAlE THEREOF,
THE INSlMEA AFFOAIlI'tCl COVERAGE WL1. ENDEAVOR TO IlWl. ---3.0 DAYS WRIT1EN NOTICE TO THE
CITY OF CLEARWATER CERTF1CAlE HOl.IlER NAMED HEREIN, BUT FAILURE TO....IL SUCH NOl1CE SHAll IMPOSE NO DeUGATlON OR
P.O. BOX 4748
CLEARWATER, FL 34618-4748 LIAIIIl.ITY OF ANY KIND UPON THE "'SURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES.
ATTN: CITY MANAGER
MARSH USA INC. JIGf\w- b......
ley: Steven Becker
n. ............'...., ,':. -- 11111(9/99) ,-'-~. ~- ..-...~.. - .. VAUD AS OF: 06126102
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