CERTIFICATE OF INSURANCE (024)
Morrison Dulfer Agency
5841 Margate Blvd.
Margate, FL 33063
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOMlA TION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFOAOED BY THE POLICIES BELOW,
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY .
INSURED LETTER
COMPANY C
Schaffer Corp. , Inc. LETTER
P.O. Box 16176 COMPANY D
Plantation, FL 33319 LETTER
E
INA
AUG 30 1984
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 SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DOIYY) DATE (MM/DOIYY) AGGREGATE
BODILY $ $ 300
INJURY 300
PROPERTY $ $
8/31/84 8/31/85 DAMAGE 50 50
BI & PO $ $
COMBINED
PERSONAL INJURY $
BODILY
INJURY
(PER PERSON)
BODILY
INJURY
8/31/84 8/31/85 (PER ACCIDENT)
PROPERTY
DAMAGE
BI & PO $
COMBINED
BI & PO $
COMBINED
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISEs/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
GO-60-9870-8
AUTOMOBILE LIABILITY
X ANY AUTO
AlL OWNED AUTOS (PRIV. PASS.)
AlL OWNED AUTOS(~~~J.Rpl'rsN)
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
CAL 709670
EXCESS LIABILITY
UMBRElLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' ~ITY
NWC C22982928
5/01/84
5/01/85
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlSPECIAL ITEMS
City of Clearwater
10 South Missouri
Clearwater, FL 33519