CERTIFICATE OF INSURANCE (145)
ROGER BOUCHARD INSURANCE 1
301 SO. MISSOURI AVE, BOX
CLEARWATER, FL 33518
INC.
6090
Suncoast F'avi ng Inc
800 Anclote Road
Ta\-pon SP\- i ngs
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33589
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2/01/88
THIS CERTIFICATE IS ISSUED AS AoMATTER 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
OMPANY A
ETTER
I.,.,
OMPANY B
ETTER
FCCI
AUTO OWNERS I~<ANCE COMPANY
c
D
E
THIS IS TO CERTIFY THAT POLICIES OF INSURAACE LISTED B BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED,
NOTWITHSTANDING ANY-REQUIREMENT.TER ... ....... .. ..OFANY CQNTRACJQI'IJ)1].j!;RDOC.Ut.i!ENT WITH RESPE~T TO WJ!I.Qi.IH.ISC.EB.T!E!CAIfMAY _
BE iSSUED OR MAYPE-RTAIN, THE INSURANCE AFFORDED BY THE POLICIES OeSCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI.
TIONS OF SUCH POLICIES,
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
X PRODUCTS/COMPLETED OPERATIONS
X CONTRACTUAL
X INDEPENDENT CONTRACTORS
X BROAD FORM PROPERTY DAMAGE
X PERSONAL INJURY
X
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS)
ALL OWNED AUTOS (~~~JRpl~~N)
HIRED AUTOS
NON-OWNED AUTOS
GARAGE L1ABI L1TY
:20370945
:20137013
EXc:.El?~ lJAQILlJ'Y
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
7-18-1934
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
CITY OF CLEARWATER
P.OBOX 4740
CLEARWATER, FL 33518
POLICY EFFECTIVE
OATE iMM/OO/VY)
12/31/87
12/31/87
POLICY EXPIRATION
DATE iMM/DDNYI
LIABILITY LIMITS IN THOUSANDS
OCCG~~~NCE AGGREGATE
12/31/88
BODILY
INJURY
$
$
PROPERTY
DAMAGE $ $
131 & PD $
COMBINED
1,000,
PERSONAL INJURY $
BODILY
INJURy
12/31/88 IPER PERSON) $
BODILY
INJURY
(PER ACCiDENTI $
I F'ROPERTY
i DAMAGE $
_.
I ~ll & PD
t:OMBINED t, 000 ,
--T--.=-.-~._- .... . ~ [$-- -
g~t~I~E~
STATUTORY
$ 100, (EACH ACCIDENT)
$ 500, (DISEASE-POLICY LIMIT)
$ 100,1 (DISEASE EACH EMPLOYEE)
$
1/01/98 12/31/88