CERTIFICATES OF INSURANCE
10-17-2000 11 :57AM
FROM PROFESSIONAL UNDRWTR 2488558711
P.2
......
ACORD.
PRODUCER
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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
Inc
Professional Underwriters,
P.o. Box 3139
Farmington Hills, MI 48333
Robert L. Coleman
PhoneNo. 248-855-3322 Fax No,
INSURED
COMPANY
A
Lumbermans MUtual Casualty Co.
COMPANY
B
American Protection Mutual
Wade-Trim, Inc,
4919 Memorial Bwy" Suite 200
Tampa, I'L 33634
.....~.. ...
THIS IS TO CERTIFY THAT THE POUCIES OF
INDICATED, NOTWITHSTANDING ANY REQUIREMENT,
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TJ-fE
EXCLUSIONS AND CONDITIONS OF SUCH POUClES, lNfTS
COMPANY
C
CNA Insurance Company
COMPANY
o
; ..>:.;;:..
...... .;..... ....... ..;.. .......
BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
E AFFORDED BY THE POUClES DESCRIBED HEREIN IS SUBJECT TO AU THE TERMS,
HOWN MAY HAVE BEEN REDUCED BY PAlO CLANS.
co
LTR
TYPE OF INSURANCE
POllCY NUl BER
POlICY EFFECTlVE POUCY EXPIRATION
DATE (MMIOD/V"I) DATE (t.AMIODIYV)
LIMITS
GENERAL LIABilITY GENERAl. AGGREGATE $ 2,000 ,000
~
A X COMMERCIAL GENERAL LIABILITY 3MH 788146-0'\ 10/01/00 10/01/01 PRODUCTS. COMP/OP AGG $ 2,000,000
'-- U CLAIMS MADE [!] OCCUR PERSONAL & NJV INJURY $1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $1,000,000
f--
FIRE DAMAGE (Anyone firw) S 500,000
f-
MED EXP (Anyone person) $ 10,000
AUTOMOBILE LIABILITY
- F3D 038281-0P COMBINED SINGLE LIMIT S 1,000,000
A X ANY AUTO 10/01/00 10/01/01
-"-
_ ALL OWNED AUTOS 90DlL Y INJURY $
SCHEDULED AUTOS (Per petSOn)
-
HIRED AUTOS BOOIL Y INJURY
- $
NON-OWNED AUTOS (Per acoidenl)
f--
PROPERTY DAMAGE S
GARAGE UABlUTY AUTO ONLY. EA ACCiDeNT $
""-
ANY AUTO OTHER THAN AUTO ONLY: ..
f--
EACH ACCIDENT $
-
AGGREGATE $
EXCESS LIABIUTY EACH OCCURRENCE $12,000,000
A ~ UMBRELlA FORM 3SX 124575-0 P 10/01/00 10/01/01 AGGREGATE $12,000,000
OTHER THAN UMBRelLA FORM i $
WORKERS COMPeNSATION AND I WC STATU. IO~.i,}:
i X TORY LIMITS
EMPLOYERS LIABILITY i s500,OOO
I EL EACH ACCIDENT
THE PROPRIETOR! I 10/01/00
B I PARTNERSlEXECUTIVE f!1INCL 3BR 014778-0~ 10/01/01 EL DISEASE - POLICY LIMIT S 500,000
,
OFFICERS ARE: EXCL i EL DISEASE - EA EMPLOYEE $ 500,000
OTHER I
C ARCH/ENG PROF LIAS AD 1333326047 10/01/00 10/01/01 EA, CLAIM 10,000,000
CLAIMS MADE BASIS DKD. AS S~ 011 icr AGGREGATE 15,000,000
DESCRIPTION OF OPERATlONSIl.OCATlONSIVEHICLESlSPeClAlITEMS
PROJECT NAMII:: 5-YEAR ENGINEER OF m:::ORD CONTRACT,
'~~~J'tr'~AIg:H~t~~'...'
. .............,....
. ........,......... .
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..;..:.;.............. .
CLEARWA
H~..................-'~~J~~',L/\....\(..,..;...<i ..
SHOULD E III!Iive ~SB~. TH. E
." '"---~ " """ " ... . " i' . .
EXPlRAllON D ~"" ,TH~ ~ ~ "\" WILL ENDEAvoA .
30 DAYSW ~~OLDERNAMEDTOTHElEFT.
- .~'\. '\.. ,~"" \'
BUT FAILURE TO MA. Il L M "" ~BLIGATIONOR LIABILITY
'\. '\' "" ,,\ '\,.,
OF ANY KINO UPON THE colllPl'lN" . :5AGE SENTATlVES.
AUTHORIZED REPRESENTATIVE '.\\ '\ ~ ~.\\\ "'~\. "
R~ert L, Coleman
....;.................. · ......: ... ...."ACO~P<;9RffiRAm19ltl~
CITY OF CLEARWATER, I
PUBLIC WORKS ADMINISTRATION
ATTN: ALICE I
100 SOUTH MYRTLE AVENUE I
CLEARWATER, FL 33758
A99RD25-S(1~r.............. ..... ....i ...... ............... ........... ..
..,',....'........................................-.........,...,.......... ................ .............. .,..,......" ......,..
t~~.II~IIIIIIIII~IIIII~IIIIIIIIIIIIIII~~~~~~
EADOWBROOK INS GROUP
6600 TELEGRAPH ROAD
OUTHFIELD MI 48034
10 02 99
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
PRODUCER
COMPANY A RELIANCE INSURANCE CO
LETTER
COMPANY B
INSURED LETTER
ADE-TRIM GROUP, INC, COMPANY C
5251 NORTHLINE RD, LETTER
,0, BOX 10 COMPANY D
:AYLOR, MI 48180 LETTER
COMPANY E
LETTER
q9M~~~~'~:u<U;,:2i@;; .,).<>d .... ........
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN issLJED TO THE INSURED NAMED ABOVE FOR THcPOL/CyuPERIOD
~fFW~T62t~~I~~fJ~~rbN8l~YR~SW~~~~11~~~~C~oA~~g~'btt:g~~~~~~I~~J g~S<6TR~~~dW~~E~~~ lfJ~~E~1-St6~I(~~~~~J~IS
EXCLUSIONS AND CONDITIONS OF SUCH POL/viES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
TE (MMJDDIYY) DATE (MMIDDIYY)
BINDER29835 0/01/99 0/01/00 GENERAL AGGREGATE $ 2 000 00
MMERCIAL GENERAL LIABILITY PACDUCTS-COMP/OP AGG, $ 2 000 00
LAlMS MADE [iJOCCUR. PERSONAL & ADV, INJURY $ 1 000 00
OWNER'S & CONTRACTOR'S PACT, EACH OCCURRENCE $ 1 000 00
FIRE DAMAGE (Anyone fire) $ 1 000 00
MED,EXP, (Anyone person) $ 5 00
BINDER29816 0/01/99 0/01/00 COMBINED SINGLE
LIMIT $ 1 000 00
ALL OWNED AUTOS BODILY INJURY
(Per person) $
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident) $
PROPERTY DAMAGE
$
BINDER29837 0/01/99 0/01/00 EACH OCCURRENCE $
OTHER THAN UMBRELLA FORM
WORKER's.COMPENSATIE)N. BINDER29836 10lQ_1/~9 1 Q/_0_1{OQ
-'.---'--------'-'-- ---. -
AND
DISEASE-POLICY LIMIT
EMPLOYERS' LIABILITY
DISEASE-EACH EMPLOYEE
OTHElpROPERTY BINDER29835 0/01/99 0/01/00
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! r~:J I'; (6' I.' [I W I~
,',
r; lit) l_~J
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! I .:
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS ! ) ~ r l OCT -8 1999
i ~ i L i i
E: 4919 MEMORIAL HWY, STE #200, TAMP:A, FL L__h_.____._.___
CITY OF CELARW:ATER
ATTN: ALICE
PUBLIC WORKS ADMIN
100 SOUTH MYRTLE AVE
CLEARWATER FL 33758
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL..3..Cl- 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,
AUTHORIZED REPRESENTATIVE
At~OI!I.~
........,.,"""',..,......,"""',........,........................-.."...,.---...."'.'.".."""'.,,','.'....---.-...........-.-. ,',',',...."..,',...,....-.-.-.-.-,............
...m..........................................E......................................1.................................ili..........................I............p...................,..... G.......................7J.........................m.....................11........................... m.............................F..............................,.....1\1................................ it.JIIA,.6~>~~RiS~ ISSUE DATE (MM/DDiYY)
....................................<.............. WADET,.,8. 10/01/97
% ....................... 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.
PRODUCER
Professional Underwriters, Inc
P,O. Box 3139
Farmington Hills, MI 48333
Robert L, Coleman
248-855-3322
COMPANIES AFFORDING COVERAGE
INSURED
COMPANY A
LETTER
The Hanover Insurance Company
COMPANY B
LETTER
COMPANY C
LETTER
Wade-Trim, Inc,
4919 Memorial Hwy" Suite 200
Tampa FL 33634
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT THE 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,
___E~c...U!SJONS AND CONDITIONS OF SU.C!:I P.oLlCIES, L1MITSliHOWN II4AY HAVF AE'I'N RI'1)UCEj;LB'(P:6Jl.1~C!AJMS,..::c~._~~,~.~. .
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE IMM/DD/VY)
LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE
OWNER'S & CONTRACTOR'S PROT,
GENERAL AGGREGATE
PRODUCTS-COMP/OP AGG,
PERSONAL & ADV, INJURY
EACH OCCURRENCE
FIRE DAMAGE IAny one fireJ
MED, EXPENSE (Anyone person) $
AUTOMOBILE LIABILITY
A X ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
AHH 3504373
10/01/97
10/01/98
COMBINED SINGLE
LIMIT
BODILY INJURY
(Per person)
BODILY INJURY
IPer accident I
AND
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
EMPLOYERS' LIABILITY
DISEASE- POLICY LIMIT
DISEASE- EACH EMPLOYE:
OTHER
A AUTOMOBILE
PHYSICAL DAMAGE
AHH 3504373
10/01/97
10/01/98
$250 DED,
$500 DED,
COMP,
COLLISION
DESCRIPTiON OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
CANCELLATION
"EVIDENCE OF INSURANCE ONLY"
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DAl'lS:':FH~REOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL_ DAYS ~~,~O"E ~~A'" HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAI1:S....~-Nd'rI~E ~'l.\~~~ OBLIGATION OR
LIABILITY OF ANY KIND UPON' '~MPANy),~tr? AoQE~~ PRESENTATIVES,
" ~", \ '., '\ '"
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