CERTIFICATE OF INSURANCE (125)
Rodgers & Cumnings Insurance,
P.O. Box 5148
Clearwater, FL 34618
INSURED
Terra Excavating
13400 Pine Street
Largo, FL 33540
. .
Inc.
9/24/87
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,
COMPANY A
LETTER
COMPANIES AFFORDING COVERAGE
Transpo
COMPANY B
LETTER
Transcontll1eIlta
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
IHISJ5-TO-CERIIEYTHAI-2OUCIES-DFlNSURANCELlSTEDBELOWJiAIIEBEENISSUED TO THE ,INSURED NAMED ABQVE FOR THEPOLICY .PERIODJNDICATED,.._ _
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
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERA liONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
X PERSONAL INJURY
AUTOMOBILE LIABILITY
X ANY AUTO
X ALL OWNED AUTOS (PRIV PASS,)
X ALL OWNED AUTOS (OTHER THAN)
PRIV. PASS.
X HIRED AUTOS
X NON-OWNED AUTOS
GARAGE LIABILITY
EXCESS' LIABILITY
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
POLICY NUMBER
200555397
600555380
400556381
200555328
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
City of Clearwater
Building Dept.
Occupational Licensing
10 So. Missouri Ave.
Clearwater, FL 33516
POLICY EFFECTIVE
DATE (MM/DDNY)
4/1/87
4/1/87
4/1/87
4/1/87
POLICY EXPIRATION
DATE (MM/DDNY)
4/1/88
4/1/88
4/1/88
LIABILITY LIMITS IN THOUSANDS
EACH AGGREGATE
OCCURRENCE
BODILY
INJURY $ $
PROPERTY
DAMAGE $ $
BI & PD $ 500 500
COMBINED $
PERSONAL INJURY $
BODilY
INJURY
(PER PERSON) $
BODilY
INJURY
(PER ACCIDENT) $
PROPERTY
DAMAGE $
81 & PD _5JJ{t __
CbMBiNED$
~~t~I~ED $