CERTIFICATE OF INSURANCE (6)
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PRODUCER
Long & Co., Inc.
P. O. Box 14958
Clearwater, FL 34629-4958
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
Travelers Insurance Company
INSURED
COMPANY B
LETTER
Tampa Bay Community Development
P. O. Box 12216 Corp.
Clearwater, FL 34616
~~~~~NY C
COMPANY D
LETTER
~~~~:Y E
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
-INOICATEfr, NOTW1'fHSl"AN01NG ANY REOliIREMENT, TERM OR CONDITION OF ANY CONTRACT OROTHERDOCUMENTWITHRESPECT TO WHfCHTAIS
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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
A
CLAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo
135015C167
3/1/95
GENERAL AGGREGATE $, 000 , 000
PRODUCTS-COMP/OP AGG. $1, 0 0 0 , 00 0
PERSONAL & ADV. INJURY $1, 000 , 000
3 / 1 / 9 6 EACH OCCURRENCE $ 1 , 0 0 0 , 0 0 0
FIRE DAMAGE (Anyone fire) $ 5 0, 000
MED. EXPENSE (Anyone person) $ 5 0 0 0
COMBINED SINGLE
LiMIT
$
ALL OWNED AUTOS
BODILY INJURY
(Per person)
$
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LiABiLiTY
WORKER'S COMPENSATION
AND
$
$
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
$
$
EMPLOYERS' LIABILITY
'$
DISEASE-POLiCY LiMIT $
DISEASE-EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TlONSNEHICLES/SPECIAL ITEMS
Q~TI, ATE
City of Clearwater
Attn. Pat Fernandez
Economic Development Dept.
P. O. Box 4748
Clearwater, FL 34618-4748
CANCELLATION
AQ~f):~J..S (?~
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAll1L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAilURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF AN IND UPON THE CO Y, ITS AGENTS OR REPRESENTATIVES.