CERTIFICATE OF INSURANCE (015)
~~6~M~~~ ~~~~H & ASSOC ,~"li::CE1VD.D
CLEARWATER FLORIDA 33518
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NAME AND ADDRESS or INSURED
RAYNOR COMPANY
9111 130TH AVENUE
LARGO FL 33543
crry CLER',
NORTH
AFFORDING COVERAGES
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A
B
C
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COMPANY E
LF~TFR
MTr.HI~AN MU.T.llAL-_
APR 16
,trOY ATrn\:l
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time, Notwithstanding any requirement, term or condition
of any contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the
terms, exclusions and conditions of such policies,
rYPE OF INSlIRANCI
POLICY NUM8ER
A
GENERAL LIABILITY
ISR~T 86-4-88479-3
[XJ COMPREHENSIV!: f _;,1"~',1
[X] PREMISIS...(WUU, r :~,',<
o [XPLOSION ANI'") COL:j,PSf.
HAZARD
DUNDEE1GROUND l~t\lAH,'
[X] PRODUCTS/COMPU.TI')
OPEllATIONS HAlAm,
OOCON1FlACTUAL INSURANCE
fVl'lJflOAD FORM PROPERTY
lLJ DAMAGE
[X] INDEPENDENT CONTflACTORS
00 PEilSONAl INJURY
A
AUTOMOBILE LIABILITY SRMG 43-4-88479-2
IX] COMPREHENSIVE
IX] OWNED
IX] H I flED
IX] NON.OWNED
fORM
A
EXCESS LIABILITY
SRMG 29-4-88479-5
IX] UMBRELLA FORM
o OTHER THAN UMBflELl/,
FORM
A
WORKERS' COMPENSATION SRMG-CP-31-0-H8479-1
and
EMPLOY~;=~~IABILlTY"'1 . .... .'
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
I'OLI C'Y
'XIJII,ATlON DillE
Limits of Liability in Thousands (000)
_...___u.... - =_+ ~~1=L~1~~~ AGI;f1!I,A II
BODILY,NJUI!Y I $ 500
I
04/01/85
PROrTHrv I"^,,'.~:,
100
-. _._...n... .., ......."...._1'__.
EKHil' Y IN ~I~~' ..,'~I-'I
PROP! f-(: \,' r ',\~.1/\(;F $
(,,:)II,1FlI i,d [
IN.llIHY
04/01/85
H()[)IL Y 11'0
(F_^l: H pr ~IN
BODILY IN!I fi',
(EACH ACI:IIJENT,
PHOP[llf Y [' t,~.li'd:;!
I
.t. ..._.. .... ...--.-.. -
i04/01/85
!
El()[)IL y' Ir'~_ !RY /\ND
f'''Of'llllY I:AMA(;r
~"Ct\,1HIt\,i :':
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HU[lll Y IN ",Jf,h ,'L,'W
PI-~(')~)r Hr" 'r\~,~ :'.CE
(\)M~<!r>.l
04/01/85
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the ISSUing corn
pany will endeavor to mail ~ days written notice te thE helow named certificate holder, but failure to
mail such rlotice shall impose no obligation or liability of ~Jrly "Irlll upon the company
NP,ME AND ADDRESS or CfRT IF ICA IT HOL DEfl
CITY OF CLEARWATER
LEGAL DEPARTMENT
1200 OSC~LOA AVE
CLEARWATER FLORInA 33515
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