CERTIFICATE OF INSURANCE (048)
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,
ML Rodgers & Cummings Ins., Inc.
P. O. Box 5148
Clearwater, FI.
Phone: (813) 461-6111
COMPANIES AFFORDING COVERAGE
INSURED
G. E. Lee Electric Inc., &
G. E. Lee & Rosemary Lee &
G. E. Lee Enterprises, Inc.
4211 49th St. N.
St. Petersburg, Fl. 33714
COMPANY A South Carolina Insurance Co.
LETTER
COMPANY B
LETTER American National Fire Insurance Co.
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
OA TE (MM/DDNY) DATE (MM/DDIYY)
GENERAL LIABILITY BODILY
COMPREHENSIVE FORM INJURY $ $
PREMISES/OPERATIONS PROPERTY
UIPu......lllIliI.. CAP 4260443 DAMAGE $ $
EXPLOSION & COLLAPSE HAZARD 1-15- 5 1-15-86
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL BI & PD $ 500 $
COMBINED
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY PERSONAL INJURY $
AUTOMOBilE LIABILITY BOOILY
INJURY $
ANY AUTO (PER PERSON)
ALL OWNE~ AUTOS (PRIV PASS) CAP 4260443 1-15- 5 1-15-86 BOOIL Y
ALL OWNED AUTOS (OTHER THAN) INJURY
PRIV PASS. (PER ACCIDENT) $
HIRED AUTOS
PROPERTY
NON-OWNED AUTOS DAMAGE $ 500
GARAGE LIABILITY
BI & PD
COMBINED $
EXCESS LIABILITY
-"-,_.--_._,-,-,--- --
UMBRELLA FORM PRO 6948603 BI & PD $
1-15- 1-15-86 COMBINED 1,000
OTHER THAN UMBRELLA FORM
STATUTORY
WORKERS' COMPENSATION
AND $ lEACH ACCIDENT)
EMPLOYERS' LIABILITY $ IDISEASE-POLlCY LIMIT)
$ ,DISEASE-EACH EMPLOYE )
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Electrical Contractor
City of Clearwater
P.O. Box 4748
Clearwater, Fl. 33518