CERTIFICATE OF INSURANCE (170)
'CERTIFICATE OF INSURANCE
I
8
This Certificate is issued as a matterof information only and confers no rights upon the Certificateholder. This Certificate
.oes not amend, extend, or alter the coverage afforded by the policies listed be, low. The policy is subject to change by
,l1dorsement and to assignment and cancellation in accordance with its terms.
This is to certify that the insurance policy(s) numbered below has (have) been issued by this coilipany ahd for the cover-
ages and limits of liability as shown. i
* Cer1Ifica.teholder:
Insured: 060-032-0
CITY OF CLEARWATER
1 0 MISSOURI AVENUE SOlmI
CLEARWATER FL 33515
RALPH HAY PLUMBING
RALPH HAY & STEVEN HAY DBA
4975 44TH AVE N.
ST PEI'ERSBURG FL 33709
GENERAL LIABILITY
Policy Number: 9040306 Effective Date: 09/01/88
'- -~--Cdvetages:--
Commercial General Liability - Occurrence
Limits of Liability:
General Aggregate: $1,000,000
Personal & Advertising Injury: $500,000
Medical Expense (Anyone person): $5,000
AUTOMOBILE OR GARAGE LIABILITY (No Fault is provided if required by Statute)
Policy Number: 9040306 Effective Date: 09/01/88 Expiration Date: 09/01/89
Vehicles Covered:
All Autos
Hired Autos
Non owned Autos
Limits of Liability:
Bodily Injury and Property Damage Combined: $500,000 Each Accident
UMBRELLA LIABILITY
Policy Number: 9040307 Effective Date: 09/01/88
Limits of liability:
Bodily Injury and Property Damage Combined: $1,000,000 Each Occurrence
WORKERS COMPENSATION
Policy Number: 9041088 Effective Date: 09/01/88
Limits of liability: STATUTORY
Employers Liability Limits:
''-- --- . _-BodilyJnjuryby-Accident: $500,ODO Each Accident
Bodily Injury by Disease: $500,000 Polley Limit
Expiration Date: 09/01/89
Products Comp Ops Aggregate: $1,000,000
Each Occurrence: $500,000
.
Expiration Date: 09/01/89
$1,000,000 Aggregate
Expiration Date: 09/01/89
$500,000 Each Employee
30 days written notice will be given to the Certificateho/der named above if during the term of such pollcy(s),
cancellations or changes occur which affect this certificate.
.
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PRESIDENT
IL-F-14 (05-88 C)
?:rJj,1~~L
SECRETARY
FEDERATED MUTUALl!l!ftl!!.~.l!!ft
INSURANCE COMPANY r""..ftI/4, ...,
5883 Glen, ridge Dr NE f' "'5 URANC'Er-.
Atlanta. GA 30328 n "
C! c,;' ~k.. jllqnt+ JOI.3/1($