CERTIFICATE OF INSURANCE (112)
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BAYLIS INSURANCE AGENCY~
F' . (J" E:CJ X 1 ;:i() 50 f.:)
ORLANDO, FL. 32858
INC.
This certificate is issued
matter of information only
confers no rights upon the
certificat0 holder.
This certificate does not
amend, extend or alter the
coverage afforded bv the
policiE~~; bF;"lo\^,J.
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THARP PLUMBING SYSTEMS,
(;,e:~:; \tol I L.f"IE:r;: ("~\)E:..
ORLANDO, FL. 32808
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COVERAGES I
This is to certify that policies of insurance listed below have been issued to
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COMPANIES AFFORDING COVERAGE
WEST AMERICAN INSURANCE COMPANY
FCCI SELF INSURERS FUND
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GENERAL LIABILITY
Comprehensive Form
Premises/Operations
Explosion & Collapse Hazard
Underground Hazard
Products/Completed Operations
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Independent Contractors
Broad Form Property Damage
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Type of Insurance
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Policy Number Effective
Liability Limits IN THOUSANDS
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AUTOMOBILE LIABILITY
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All Owned Autos (Priv.. Pass.)
All Owned Autos (Other Than)
(P1"'iv. Pass.)
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Garage Liability
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Other Than Umbrella
Liability Limits IN
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B WOhKERS' COMPENSATION AND EMPLOYERS' LIABILITY
Liability Limits IN THOUSANDS: # 01144-0
Workers' Compensation --Stat~tory
Employers' Liability --Edch Accident
--Disease --Policy Limit
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Lidbility Limits IN THOUSANDS:
Description of Dperations/Locations/Vehicles/Specidl Items
Certificate Holder
1::iCCJF~~D es
Should any of the above described polici s
be cancelled before the expirdtion date
thereof, the issuing compdny will endea r
to mail :1.0 days written notice to the
certificate holder named to the left, bu
failure to mail such notice shall lmpose
no obligation or liability of dnv kind
upon the company, its aqents or
r~pI'_~~iet'\'~atj.v?s~
CITY OF CLEARWATER
112 S. OSCEOLA AVENUE
CLEARWATER, FLORIDA 335:1.6
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