CERTIFICATE OF INSURANCE (2)
'..,.'........................-.....,','
... .................,......."....
..','. .6. ....111.
...... lUll... ....
'.:.:.:.:.:::.:.:.:::,:.:.:.:.:.:,',:,:,:,:,:,:,:,:.:-:-:.:.:-:.:.:.:.:.:.:.:.:.:':.:.:.:.:.:.:.:.:.:.:.:.:..,.
/../...../1........................................,",','" ~~i(~;'/~i
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
'ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
ER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
Paul Fire & Marine
INSURED
Tampa Bay
18167 U S
Suite 400
Clearwater, FL 34624
Manufacturers Ins. Co
COMPANY
CSecurity Ins of Hartford
THIS IS TO CERTIFY THAT THE POLICES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCYPERIOD
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 CONDITIONS OF SUCH POLICIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE LICY EXPIRATION
DATE (MM/DD/YY) DATE (MM/DD/YY)
LIMITS
A GENERAL LIABILITY RP 06642429
X OMMERCIAL GENERAL L1ABILI
CLAIMS MADE [X] OCCUR
WNER'S & CONTRACTOR'S PRO
06/30/97 06/30/98 GENERAL AGGREGATE $2 000 000
PRODUCTS-COMP/OP AGG $2 000 000
PERSONAL & ADV INJURY $1 000 000
EACH OCCURRENCE $1 000 000
FIRE DAMAGE (Anyone fire) $1 0 0 0 0 0 0
ME D EXP (Anyone person) $5 0 0 0
A AUTOMOBILE liABiliTY
X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
CA06609242
06/30/97 06/30/98
COMBINED SINGLE LIMIT $1, 000 , 000
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
A EXCESS LIABILITY
UMBRELLA FORM
RP06642429
06/30/97 06/30/98
AUTO ONLY -EA ACCIDENT $
OTHER THAN AUTO ONL Y:
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $3 0 0 0 0 0 0
AGGREGATE $3 000 000
$
GARAGE LIABILITY
ANY AUTO
B WORKERSCOMPENSATlONAND
EMPLOYERS' LIABILITY
7CQ60920609
'-1.--.-' ~-.-.,-,--
05/U1/97 05/01/98
OTHER THAN UMBRELLA FORM
THE PROPRIETOR/ X INCl
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL
C OTHER
Professional
Liability
PL700323
06/30/97 06/30/98
STATUTORY LIMITS
EACH ACCIDENT $1 000 000
DISEASE-POLICY LIMIT $1 000 000
DISEASE -EACH EMPLOYEE $1 0 0 0 , 000
$2,000,000 each claim
$2,000,000 aggregate
DESCRIPTION OF OPERATIONS/LOCATIONSlVEHICLES/SPECIAL ITEMS
Professional Liability is written on a claims made basis and reported.
Contractor Pollution Legal Liability included
ACQRP~lSf~/
......"""..........................
.... . ......................-.--.
.9>
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANYWILLENDEAVOR TO MAIL
.3..0....- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRESENTATIVES.
AU~RIZED REPRESENTATIVE
:1\,."- .--<...&.- & .
,l......,....,...,.,.,.,.,...,....,.,.,.,.,.,.,.,.,.,.'.'.'.'.'.'.'.'.'.'.
~..R~ACQRQCQ~eoRAriQNj,~~...
City of Clearwater
%public Works Administration
100 South Myrtle Avenue
Clearwater, FL 33756