CERTIFICATE OF INSURANCE (110)
r", ,~,} / ri ...) ./ !:::! ."}
At TAMURA, MARSH & ASSOC.. INC.
[) .0 _ B UX (,(:~::CI
CLEARWATER, FLORIDA 33518
I' HOt~[: : ( e:l :') ) '/ :3;i -;i (. ;:i 1
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
CONSTRUCTION CO. INC.
.1 :5/I,Cl5
FLORIDA 33681-3405
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
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 CONDI.
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE POLICY NUMaER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
OATE (MMlOOIYY) DATE (MM/DDIYY) EACH
OCCURRENCE AGGREGATE
GENERAL LIABILITY BODILY
COMPREHENSIVE FORM L.,CiL.,l\OUt.j.4631 1 ~?/ ~?/ C:(;; I ~?l/ ~?,/ [:.?' INJURY $ 'if'j $
, ,
V PREMISES/OPERATIONS PROPERTY
UNDERGROUND DAMAGE $
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL BI & PD $ $
COMBINED
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY PERSONAL INJURY $
AUTOMOBILE LIABILITY BODILY
ANY AUTO INJURY $
0IBA?0647::.l10 ~.~) / .1. ~? / E:: "7 :...s / .1 ~? / :::::::::: (PfR PfRSON)
ALL OWNED AUTOS (PRIV PASS) BOOIL Y
ALL OWNED AUTOS (OTHER THAN) INJURY $
PRIV PASS, (PfR ACCIDEND
HIRED AUTOS PROPFRTY
NON-OWNED AUTOS DAMAGE $
GARAGE LIABILITY
BI & PD
COMBINED $ )(1
' ,
EXCESS-llAt5ItITY -
UMBRELLA FORM BI & PD $
COMBINED
OTHER THAN UMBRELLA FDRM
WORKERS' COMPENSATION
AND ::);:)143056[:016 .1 :?/~?/ :;:1(:1 l~?/;'?/E:'.7 (EACH ACCIDENT)
EMPLOYERS' LIABILITY (DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLESlSPECIAL ITEMS
CITY OF CLEARWATER
f' C: D OXl'7 /~ :::
C: 1.... E: l\ H l~.j l\ "r! :. F~:: r' L.. () H I IJ /~i :"~;S :".:5 E; .1 Cl....-Ij. )' 4 Fi