CERTIFICATE OF INSURANCE (8)
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MA.RSH :'1'::"> Ce'rtTIFICATE OFINSUR.ANCi! CERTIFICATE NUMBER
NYC-000588652-01
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, NEW YORK 10036-2774 AFFORDED BY THE POLICIES DESCRIBED HEREIN.
TEL: 212-345-3259 COMPANIES AFFORDING COVERAGE
FAX: 212-345-4725/4268
ATTN: VIVIAN EDWARDS COMPANY
BELL -PRIME-180-2002 A AMERICAN HOME ASSURANCE COMPANY
INSURED COMPANY
VERIZON WIRELESS PERSONAL COMMUNICATIONS B N/A
LP d/b/a VERZION WIRELESS
180 WASHINGTON VALLEY ROAD COMPANY
BEDMINSTER, NJ 07921 C N/A
COMPANY
D N/A
COVERAGES < 0
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. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION L1M ITS
'TO .. _"U_ n_. ',. -DATE .1MM/DD/YV}. ,. OAT" IMMIOOJYVl. ------.- _.,- ---, .-
A GENERAL LIABILITY RMGL 480-5706 06/30/03 06/30/04 GENERAL AGGREGATE $ 2,000,000
f--
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMPIOP AGG $ INCL.
f-- ~ CLAIMS MADE 0 OCCUR $
PERSONAL & ADV INJURY 2,000,000
f--
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 2,000,000
f--
FIRE DAMAGE (Anyone fire) $ 500,000
MED EXP (Anv one oerson) $ 10,000
AUTOMOBiLE LIABILITY $
f-- COMBINED SINGLE LIMIT
f-- ANY AUTO
f-- ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
f--
f-- HIRED AUTOS BODILY INJURY $
(Per accident)
f-- NON.OWI\jED AUTOS -. .-. -. .
f-- PROPERTY DAMAGE $
G ARAG E L1ABI L1TY AUTO ONLY. EA ACCIDENT $
r-- ',,',.
ANY AUTO OTHER THAN AUTO ONLY: .
r--
EACH ACCIDENT $
-
AGGREGATE $
EXCESS LIABiLITY EACH OCCURRENCE $
==] UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
~., .Jil/.oRKERS ~O..MElliSATlQJi.AND____ ~--- ~-_. -'.-"--- .--------- - --~----- -, .."--------"--- ,+. ~\.:.STATU.;+ 10TH. >... .....i. ..i. ,.'.
EMPLOYERS' LIABILITY 'f TORYllMITS " ,. ER
EL EACH ACCIDENT $
THE PROPRIETOR! R INCL EL DISEASE.POLlCY LIMIT $
PARTNERSIEXECUTIVE
OFFICERS ARE: EXCL EL DISEASE.EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
THE CERTIFICATE HOLDER IS ADDED AS AN ADDITIONAL INSURED AS RESPECT TO THEIR INTEREST IN THE INSURED'S TWO (2) EXISTING
RADIO COMMUNICATIONS TOWERS AT THE CITY'S N.E. WATER POLLUTION CONTROL PLANT, 3290 SR. 580 AND McMULLEN BOOTH RD AND
1400 YOUNG STREET, AND ONE (1) WATER TANK LOCATED AT KINGS HWY RECREATION CENTER, 1751 KINGS HWY (#085109-2) cc: GIGI PLATT
@ PRIMECO COMMUNICATIONS L.P., FAX (813) 615,4902
CERTIFICATE HOLDER '. ','.,' CANCELLATION "':.>' ..' ....,... ",..'..,. ."','
,.,..,..: ',',.'...
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL ----3..0 DAYS WRITTEN NOTICE TO THE
CITY OF CLEARWATER CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
ATTN: SUSAN STEPHENSON, CITY CLERK
P.O. BOX 34618 LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
CLEARWATER, FL 34618 ISSUER OF THIS CERTIFICATE
MARSH USA INC.
BY: Steven Becker ~~ b.......
.'. MM1(3102) VALID AS OF: 06/24/03
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