CERTIFICATE OF INSURANCE (072)
Baylis. Insurance AgencYJ Inc.
P.O. Box 150506
OrlandoJ Fl 32808
COMPANIES AFFORDING COVERAGES
THARP PLUMBINGSYSTEMSJ INC.
2677 Mercy Drive
OrlandoJ Fl 32808
COMPANY AWest American Insurance Company
LETTER
COMPANY B FCCI Self-Insurers Fund
LETTER
COMPANY C I nternat ional Ins. Company
Lf HE R
COMPANY 0
L [TTE R
NAME AND ADDRESS or INSURED
COMPANY E
LETTER
This is to certify that policies of Insunlnce"steeI below have been issued to the insured named above and are in force at this time. 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.
COMPANY TYPf OF INSURANCE POLICY NUMBER POLICY
LETTER EXPIRATION DAlE
GENERAL LIABILITY $
BODIL Y INJURY $
A a COMPREHENSIVE FORM XPO 1~ 1;6 94 3/01/86
[J{ PREMISES-OPERATIONS CEIVED .
PROPERTY DAMAGE $ $
o EXPLOSION AND COLLAPSE
HAZARD
~ UNDERGROUND HAZARD
PRODUCTS/COMPLETED
OPERATIONS HAZARD BODIL Y INJURY AND 500 $ 500
1-"" ",.1) IS
~ co,"~w" ",,"'oc, ~, PROPERTY DAMAGE $
BRDAD FORM PROPERTY ; COMBINED
DAMAGE .'
INDEPENDENT CONTRACTORS
PERSONAL INJURY PERSONAL INJURY $ 500
AUTOMOBilE LIABILITY BODIL Y INJURY
(EACH PERSON)
A ~ co."'","',, "" XAW 19 36 94 3/01/86 BODIL Y INJURY
OWNED (EACH ACCIDENT)
HIRED PROPERTY DAMAGE $
BODIL Y INJURY AND $500
NON.OWNED PROPERTY DAMAGE
COMBINED
EXCESS LIABILITY
03/01/36 BODIL Y INJURY AND
C g UMBRELLA FORM 523-4105295 PROPERTY DAMAGE $lJOOO
OTHER THAN UMBRELLA COMBINED
FORM
WORKERS' COMPENSATION
__,._'__._._._m_
B and 1144-00
EMPLOYERS' LIABILITY IDOl 500/ ~QDACClD(NTl
OTHER
A PHYSICAL XA~~ 19 36 94 03/01/86 COMPo DED -$100.
DAMAGE COLL, DED -$100.
DESCRIPTION OF OPERATIONSIlOCATlONSNEHICLES
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof. the issuing com-
pany will endeavor to mail 3.0--- days written notice to the below namedcate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the pan. .
NAME AND ADDRESS OF CERTIFICATE HOLDER
City of Clearwater
112 S. Osceola Ave.
Clearwater, FL. 33516