CERTIFICATE OF INSURANCE (204)
At~ttltJ.~ .CERTIFIC)-I'I;6AmINSUFlANCE
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PRODUCER
Bill Williams Agency, Inc.
6109 9th Street No.
St. Petersburg, FL 33703
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
f~~~~NY A
COMPANIES AFFORDING COVERAGE
Owners Insurance Co.
CODE
SUB-CODE
INSURED
Suncoast Excavating, Inc.
P.O. Box 838
Ozona, FL 34660
f~~~~NY B
Auto-Owners Ins~~~cc; EC~ 'V E D
FCCI
f~~~NY C
f~~~~NY D
MAR 14 1990
f~~~~NY E
COVERAGES. . (....'PYlM ERK
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED~ELfORYHE 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 CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE .POLICY EXPIRATION ALL LIMITS IN THOUSANDS
TR DATE (MM/DD/YY) DATE (MM/DD/YY)
A~ERAL LIABILITY 894612 20397194 03-15-90 03-15-91 GENERAL AGGREGATE $2,000
$1,000 j
COMMERCIAL GENERA';{IABILlTY PRODUCTS-COMP/OPS AGGREGATE
$1,000 , -,
CLAIMS MADE . OCCUR, PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE $1,000
$50
MEDICAL EXPENSE (Anyone person) 5
$
AUTOMOBILE LIABILITY COMBINED $1,000
SINGLE
ANY AUTO LIMIT
ALL OWNED AUTOS BODILY
B X 890212' 20112461 03-15-90 03-15-91 INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY
X INJURY $
NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY PROPERTY
DAMAGE $
EXCESS LIABILITY 03-15-90 03-15-91
B X 892112 71526499
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
$ (EACH ACCIDENT)
C AND 06503 01-01-90 12-31-90
$ (DISEASE-POLICY LIMIT)
EMPLOYERS' LIABILITY $ (DISEASE-EACH EMPLOYE
OTHER $1000 Deductible
A Contractor's Equip. 894612 20397194 03-15-90 03-15-91
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS
Laura Street Drainage Improvement (87-15)
CERTIFICATE HOLDER
City of Clearwater
P.O. Box 4748
Clearwater, FL 34618
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPI~ON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
EW~
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