CERTIFICATE OF INSURANCE (150)
PRODUCER
Ken Herndon and Associates, Inc.
600 Bypass Drive Suite 116
Clearwater, Florida 34624
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
Amerisure Insurance Co.
INSURED
Raynor Company
9111 130 Avenue North
Largo, Florida 34643
COMPANY B
LETTER
Michigan Mutual Insurance Co.
COMPANY C
LETTER
COMPANY D
LETTER
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,
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 CONDI-
TIONS OF S~CH POLICIES,
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER "OLr, EFFECTIVE POLICY EXPIRATION
DATE (MM/DDiYY) DATE (MM/DD/YY)
SRMGCPP0276126 GENERAL AGGREGATE
f'RODUCTS-COMPIOPS AGGREGATE
PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE
FIRE DAMAGE (ANY ONE FIRE)
MEDICAL EXPENSE (ANY ONE PERSON)
4/1/88 4/1/89 CSL $
SRMG434H4928200
BOOIL Y
INJURY
(PER PERSONI $ 250
BODILY
INJURY
rcEC~DENT) $ 500
PROPERTY
DAMAGE $ 100
EACH
OCCURRENCE
~RMc:r.ITOn110600 .._ 4/1/88 4/1189 -$ 5,000 $_5,000____
STATUTORY
SlUfG3B4H49281 4/1/88 4/1/89 $ 100 (EACH ACCIDENT)
$ 500 (DISEASE-POLICY LIMIT)
$ 100
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCURRENCE
OWNER'S & CONTRACTORS "ROTEClVE
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
City of Clearwater Legal Department
1200 Osceola Avenue
Clearwater, Fl. 33515
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX,
PIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESE "ATIVE
. . .... ......