CERTIFICATE OF INSURANCE (099)
THIS CERTIFICATE IS ISSUED S A MATTER OF INFORMATION ONLY AND CONFERS
NO AIOHTS UPON THE CERTIFICATE HOlDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POlICIES BELOW.
ML Rodgers & Cummings Insurance Inc.
P.O. Box 5148
Clearwater, Fl. 33518
COMPANIES AFFORDING COVERAGE
TERRA EXCAVATING
13400 PINE STREET
LARGO, FL. 33540
A South Carolina Insurance Co.
. Planet Insurance Co.
C Scottsdale Insurance Co.
D FCCI
COMPANY E
LETTER
TYPE OF INSURANCE
POLICY NUMBER
POliCY EFFECTM
DATE (MMIllO/VY)
POLICY EXPIRATION
DATE (MM/DOIVY)
LIABILITY LIMITS IN THOUSANDS
EACH
OCCURRENCE
INSURED
. .
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 THE TERMS, EXCLUSIONS, AND COND!~ i
TIONS OF SUCH POLICiES.
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISESIOPERATlONS
UNDERGROUND
EXPlOSION & COlLAPSE HAZARD
PROOUCTSICOMPLETED OPERATIONS
CONTRACTUAl
INDEPENDENT CO~'TRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
SMP4488095
7-15-86
BODILY
INJURY $ $
7-15-87 PROPERTY
DAMAGE $ $
81 & PO $ 500 $ 500
COMBINED
PERSONAL INJURY $ 500
tml. Y
IIWlY $
(PER PEJlS()j)
tml. Y
7-1-87 III.UlY $
(PER AIXIlENT)
PFlOPERTY
DAMAGE $
500
1-15-87
STATUTORY
1-1-87 $ 100 (EACH ACCIDENT)
$ 500 (DISEASE,POlICY LIMIT)
$ 100 (DISEASE,EACH EMPLOYE
AUTOMOBILE LIABILITY
X Al4Y AUTO
X AlL OWNED AUTOS (PRIV, PASS,)
B X ALl OWNED AUTOS (OTHER THAN)
PRIV, PASS,
X HIRED AUTOS
NON-owNED AUTOS
GARAGE LIABILITY
EB0502l14
7-1-86
EXCESS~~I~Y,
X UMBRELLA FORM
OTHER THAN UMBRELLA FORM
UMB022768
7-15-86
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
4601
1-1-86
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSlVEHICLES/SPECIAL ITEMS