CERTIFICATE OF INSURANCE (215)
CERTIFICATE OF INSURANCE:-I
PRODUCER
Bill Williams, Ross & Assoc.
3754 Central Avenue
st. petersburg, FL
33711
PHONE 813-327-0621
I
OP ID KL 03/13/92
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 BELOW.
COMPANIES AFFORDING COVERAGE
Suncoast Excavating, Inc.
P.O. Box 838
Ozona FL
34660
COMPANY LETTER A Auto Owners Ins.1P'.::IftC'fi
. ._,~ '.."" fr~ J.
----------------------------------------------,------~~1r.--~----------
COMPANY LE'l"l'ER B CIGNA ,. 1;':,,1 lS '!
---. '--"'~
INSURED
~~~~~~~~~::~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~::~~~~~El~i~2~~~~~~~~~
COMPANY LE'l"l'ER D ;
-----------------------------------------------~~~~:-~~------~~.:;-~-----
COMPANY LETTER E (' ..: f (', r.. ..., Dc" .
r>I __ _....
> COVERAGES <======================================================m=================================~~~=~~~=.===========
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 TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
-~ "LTR -
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF I POLICY EXP
DATi!: -- - DATE
LIMITS
GENERAL LIABILITY GENERAL AGGREGATE 2,000,00
------------------- --------------
B [Xl COMMERCIAL GEN LIABILITY PROD-COMP/OP AGG. 1,000,00
[Xl OWNERS'S & CONTRACTOR'S
PROTECTIVE
EACH OCCURRENCE
1,000,00
1 CLAIMS MADE [X 1 OCC.
Binder 27076894 03/15/92 03/15/93 PERS. & ADV. INJURY 1,000,00
FIRE DAMAGE
(ANY ONE FIRE)
50,000
MED. EXPENSE
(ANY ONE PERSON)
5,000
AUTOMOBILE LIAB COMB. SINGLE LIMIT 1,000,00
[ 1 ANY AUTO
[ 1 ALL OWNED AUTOS
A [Xl SCHEDULED AUTOS
[Xl HIRED AUTOS
[Xl NON-OWNED AUTOS
[ 1 GARAGE LIABILITY
[ 1
890212 20112461 03/15/92 03/15/93
BODILY INJURY
(PER PERSON)
BODILY INJURY
(PER ACCIDENT)
PROPERTY DAMAGE
EXCESS LIABILITY
A [Xl UMBRELLA FORM
[ 1 OTHER THAN UMBRELLA FORM
EACH OCCURRENCE 1 , 000, 00
892112 71526499 03/15/92 03/15/93 ------------------- --------------
AGGREGATE 1 , 000, 00
WORKERS' COMP
AND
EMPLOYERS' LIAB
lS~ATUTORY LIMITS
EACH ACCIDENT
DISEASE-POL. LIMIT
DISEASE-EACH EMP.
OTHER
B CONTRACTORS EQUIP
B BUILDERS RISK
Binder 573248
IMC 514982
03/15/92 03/15/93
06/07/91 06/07/92
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Only
LAURA S!fRBBT DRAIRAGB IMPROVBJIBRT (87-15)
State of Florida Operations
> CERTIFICATE HOLDER <===============================> CANCELLATION <============================================================
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER FL
34618
ACORD 25-S (7/90)
= SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
= PlRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30
= DAYS WRITTEN NOTICE TO THE CERTIFICATE H~R NAMED TO THE LEFT, BUT
= FAILURE TO MAIL SUCH NOTIC:~~SE NO OBLIGATION OR LIABILITY OF
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