CERTIFICATE OF INSURANCE (023)
Morrison-Dulfer Agency
5841 Margate Blvd.
Margate, Fl. 33063
NAME AND ADDRESS OF INSURED
Schaffer Corp.
P.O. Box 16176
Plantation, Fl.
33318
COMPANIES AFFO DING COVERAGES
COMPANY A RECEIVED
LETTER INA
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named aboye and are in force at this time. 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 conditions of such policies.
TYPE OF INSURANCE
GENERAL LIABILITY
A
IZI COMPREHENSIVE FORM
[Xj PREMISES-OPERATIONS
D EXPLOSION AND COLLAPSE
HAZARD
D UNDERGROUND HAZARD
i:XI PRODUCTS/COMPLETED
OPERATIONS HAZARD
D CONTRACTUAL INSURANCE
D BROAD FORM PROPERTY
DAMAGE
[i] INDEPENDENT CONTRACTORS
D PERSONAL INJURY
A
AUTOMOBILE LIABILITY
[i] COMPREHENSIVE FORM
DOWNED
D HIRED
D NON-OWNED
EXCESS LIABILITY
D UMBRELLA FORM
D OTHER THAN UMBRELLA
FORM
A
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES
POLICY NUMBER
I'OLICY
EXPIRATION DATE
limits of liability in Thousands ( 00)
EACH
OCCURRENCE
BODILY INJUPY
GLPGO 4782628
8/31/84
PROPERTY DAMAGE
i $ 300
I
I 50
r,-_u
~
300
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
PERSONAL INJURY
CAL 482948
BODILY INJURY
(EACH PERSON)
BODILY INJURY
(EACH ACCIDENT)
50
$
8/31/84
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
NWCC22982928
15/1/85
$
100
300
$
Cancellation: Should any of the above deSC?~~POlicies be cancelled before the expiration date thereof, the Issuing com-
pany will endeavor to maiilO @ays written notice to the below named certificate holder. but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
I "M' ." ""'" oc """'CO" "ow,"
City of Clearwater
! 10 South Missouri
I Clearwater, Fl. 33519
I
i
DATEISSUED June 1~, 1984