CERTIFICATE OF INSURANCE (216)
CERTIFICATE OF INSURANCE:
PRODUCER
Bill Williams, Ross & Assoc.
3754 Central Avenue
st. Petersburg, FL
33711
PHONE 813 -327 -0621
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
SUllcoast
P.O. Box
Ozona FL
34660
COMPANY LETTER A Auto Owners Insurance
,"' '''~'''',"..".<.r~_..;'___.'~'''' ~. ______________________________________________________________________
Excavati~J~- ~~ M.!10 [~,~ ---~~~-~-----:~-~~~--------------------------------------------
838 . . t LETTER C
, MAR 16 1992 -
INSURED
o
r. l~' .'/- ~
> COVERAGES <==================~~..==~~~....~_' ~r~~ =====================================================================
THIS IS TO CERTIFY THAT POtn:T!'S""'tlr"rNSURANCE !JI-9'PED-BBLOW 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.
i
L...
LETTERD
LETTERE
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFF
- DATE
POLICY EXP
DATE
LIMITS
GENERAL LIABILITY
GENERAL AGGREGATE
B [X] COMMERCIAL GEN LIABILITY
PROD-COMP/OP AGG.
] CLAIMS MADE [ X] OCC.
Binder 27076894 03/15/92 03/15/93 PERS.' ADV. INJURY 1,000,00
[X] OWNERS'S , CONTRACTOR'S
PROTECTIVE
EACH OCCURRENCE
FIRE DAMAGE
(ANY ONE FIRE)
50,000
MED. EXPENSE
(ANY ONE PERSON)
5,000
AUTOMOBILE LIAB
COMB. SINGLE LIMIT 1,000,00
[ ] ANY AUTO
[ ] ALL OWNED AUTOS
A [X] SCHEDULED AUTOS
[X] HIRED AUTOS
[X] NON-OWNED AUTOS
[ ] GARAGE LIABILITY
[ ]
890212 20112461 03/15/92 03/15/93
BODILY INJURY
(PER PERSON)
BODILY INJURY
(PER ACCIDENT)
PROPERTY DAMAGE
EXCESS LIABILITY
A [X] UMBRELLA FORM
[ ] 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
--- ------------------------------- ---------------------------
OTHER
B CONTRACTORS EQUIP
B BUILDERS RISK
I STATUTORY LIMITS
EACH ACCIDENT
DISEASE-POL. LIMIT
DISEASE-EACH EMP.
Binder 573248
IMC 514982
03/15/92 03/15/93
06/07/91 06/07/92
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
Only
~'fRUJ!: AVE STORM
State of Florida Operations
> CERTIFICATE BOLDER <===============================> 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-
PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30
DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT
= FAILURE TO MAIL SUCH NOTICE SHALL IMPO _ 0 ~ATION OR LIABILITY OF
ANY KIND UPON THE COMPANY, ITS AGE 'OR PRESENTATlVES._~
= AUTHORIZED REPRESENTATIVE