CERTIFICATE OF INSURANCE (26)
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MARSH USA INC. --: CERTIFICATE OFi' lSURANCE CERTIFICATE NUMBER
NYC-001133201-02
PRODUCER ", THIS CERTIFICATE IS ISSUED'Aoo'1I 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
1042 -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 L1M ITS
LTR DATE IMMIODIYY) DATE (MMIODIYY)
-A_ ~ER~!'~A!I~!,,_~____,__ illQ..2984372-00 06/30/02 06/30/03 "'''''''''4' T" $ 2,000,000
- , ' .----.- ~----.---------
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ INCLUDED
I CLAIMS MADE D OCCUR PERSONAL & ADV INJURY $ 2,000,000
OWNE~S&CONTRACTO~SPROT EACH OCCURRENCE $ 2,000,000
-
FIRE DAMAGE (Anv one firel $ 50,000
MED EXP (Anv one ~\ $ 10,000
AUTOMOBILE LIABILITY $
...-- COMBINED SINGLE LIMIT
>-- ANY AUTO
>-- AlL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
>--
I-- HIRED AUTOS BOOIL Y INJURY $
(Per ec:ddenl)
I-- NON-OWNED AUTOS
I-- PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
I-- ,.',':';'::'~',
I-- ANY AUTO Oll-lER THAN AUTO ONLY: ",
I-- ~A"'.w A~~IDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
OTHER ll-lAN UMBRELLA FORM $
WORKERS COMPENSATION AND I TORY LIMITS I TOl~ " "
EMPLOYERS' LIABILITY
EL EACH ACCIDENT $
I, ", ll-lEPROPRIETORl R:NCL ,- - ',- ,- - :s- - _. __h____
EL D1SEASE-POLICY LIMIT
PARTNERSlEXECUTIVE EL DISEASE-EACH EMPLOYEE $
OFFICERS ARE: EXCL
nH~R
DESCRIPTION OF OPERATlONSILOCATIONSNEHICLESISPECIAL ITEMS (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 'OlE POLICIES DESCRI8ED HEREIN BE CANCELLED BEFORE THE EXPIhATION DATE THEREOF.
THE INSURER AFFORDING COVERAGE WI.I. ENDEAVOR TO MAIl --3.0 DAYS WRITTEN NOTICE TO 'OlE
CITY uF CLEARWATER CERTFlCATE HOLDER NAMED HEREIN, BUT FAILURE TO.....L SUCH NOTICE SHALl. ~E NO OBLIGATION OR
P.O. BOX 4748
CLEARWATER, FL 34618-4748 LIAlIlI.rTY OF ANY KIND UPON 'OlE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES,
ATTN: CITY MANAGER
MARSH USA INC. JIlbt"- b......
BY: Steven Becker
.....,..':-,' ~.... . 11111(8/98) ., .. ..-...v~ .. . ' .YAUD AS OF: 06l26I02 ...:'
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