CERTIFICATE OF INSURANCE (039)
PRODUCER
Gu1fway Insurers of Port Richey Inc
12701 U.S. Hiway 19, Suite B
Bayonet Point, Fla. 33567
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 BEl-OW.
COMPANIES AFFORDING COVERAGE
COMPANY A All iance Insurance Company
LETTER
INSURED
COMPANY 8
LETTER
Robert F. Rodeghier dba
Portable Welding Specialists
13808 Gene Rossi Ave.
Hudson, Fla. 33567
COMPANY C
LETTER
COMPANY D
LETTER
E
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
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 SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
OATE (MMIDO/YY) OA TE (MM/OO/YY) AGGREGATE
BODILY $ 300, $
INJURY
12/27/84 2/27/85 PROPERTY
DAMAGE $ 100, $ 100 ,
BI & PO $ $
COMBINED
GENERAL LIABILITY
COMPREHENSIVE FORM
X PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
ESA GL 10344
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PASS.)
ALL OWNED AUTOS .(OTHER THAN)
PRIV. PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
PERSONAL INJURY $
BODilY $
INJURY
IPER PERSON)
BOOIl Y
INJURY $
(PER ACCIDENT)
PROPERTY $
DAMAGE
BI & PO $-
COMBINED
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
~~t~~ED $
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY
$
$
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
City of Clearwater
P.O. Box 4749
Clearwater, Fla. 33518