CERTIFICATE OF INSURANCE (203)
14m 'It
\IDRKERS' COm'SATIO~ ~Sl
ID\lI.\l\iERED BY flllill
PRODUCER
455
kOGERS & ASSGCIATtS INSURANC~.IN
P.O. bUX 1747
PALM HARbOR. FL 34602 1747
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO
RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EX-
TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ATTENTION CERTIFICATE HOLDER: If you have any questions,
please contact CHERYL CGOK at 1-800-226-3224,
2601 Cattlemen Road, Sarasota, FL 34232
COMPANIES AFFORDING COVERAGE
INSURED
RODGERS bROTHERS SERVICES. INC.
1731 CLEARwATER LARGG RGAD
CLEARWATER. FL 34616 0000
Company Letter A FCCI/SELF INSURERS FUND
Company Letter B:
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOT WITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
. BEISSUEDeR MAY PERTAIN,THEINSURANCE AFFOflOeD8YTHE POLICtES1>ESCRIBED HEREIN IS SUBJECT"TO ALL THE TERMS,-EXCWSIONS, AND CONDI~- .
TIONS OF SUCH POLICIES.
CO
LTR
TYPE IN INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE D OCCURRENCE
OWNER'S & CONTRAcroRS PROTECTIVE
GENERAL AGGREGATE
PRODUCTS-COMPfOPS AGGREGATE
PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE
FIRE DAMAGE (ANY ONE FIRE)
MEDICAL EXPENSE (ANY ONE PERSON)
AUTOMOBILE LIABILITY
ANY Aum
ALL OWNED Aums
SCHEDULED Aums
HIRED Aums
NON-OWNED Aums
GARAGE LIABILITY
CSl
$
BOOllY
INJURY
1f[~SON) $
BODilY
INJURY
lrJ61DENT) $
PROPERTY
DAMAGE
EXCESS LIABILITY
EACH
OCCURRENCE
arHER THAN UMBRELLA FORM
A
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
71~~11B91-001-001 01/01/90
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS Db A:
CLEAR~ATER (CITY OF)
10 MIS~UURr AVENUE SLOTH
P.O. dOX 474d/FINANCE 0EPT.
CLEARWATER, FL 3461d 0000
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
PIRATION DATE THEREOF, THE ISSUEING COMPANY WILL ENDEAVOR TO 10 DAYS WRIT-
TEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAIWRE TO MAIL
SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE
COMPANY. ITS AGENTS OR REPRESENTATIVE.
AUTHORIZED REPRESENTATIVE
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