CERTIFICATE OF INSURANCE (212)
Bill Williams Agency Inc.
6109 9th Street North
st Petersburg, F 1 33703
I ATE I 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
ISSUE DATE (MM/DD/YY)
3/1/91
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~",".'( _nru,. ".'
PRODUCER
COMPANY A
LETTER
f~~~NY C
MOAC-Continental
Inst. of London und.8 E eEl VED
Royal Insurance Co. MAR 04 1991
CITY CLERK
Auto Owners Insurance Co.
INSURED
Inter-Bay Marine Canst. Co.
Steve Stanford
7950 118th Avenue North
Largo, Fl 34643
f~~~NY B
f~~~NY D
f~~~~NY E
Florida Chamber Fund
COVERAGES
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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
TR DATE (MM/DD/YY) DATE (MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $
Ax COMMERCIAL GENERAL LIABILITY PRODUCTS,COMP/OP AGG. $ 1000
CLAIMS MADE X OCCUR. CLU90309ML100 3/1/91 3/1/92 PERSONAL & ADV. INJURY $ 1000
OWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $ 1000
FIRE DAMAGE (Anyone fire) $ 50
MED, EXPENSE (Anyone person). $
AUTOMOBILE LIABILITY COMBINED !l!NGLE 1000
$
ANY AUTO LIMIT
ALL OWNED AUTOS BODILY INJURY
D 2707617 3/1/91 3/1/92 (Per person) $
X SCHEDULED AUTOS
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY
DOC PROPERTY DAMAGE
X
EXCESS LIABILITY EACH OCCURRENCE
C X UMBRELLA FORM 2707616 3/1/91 3/1/92 AGGREGATE
~__,_, OTHER.TI:IAIILUMBRELLA fORM __'__'___'._.._m,___,___
WORKER'S COMPENSATION STATUTORY LIMITS
03906 12/6/90 12/6/91 EACH ACCIDENT
E AND
DISEASE-POLICY LIMIT
EMPLOYERS' LIABILITY
DISEASE-EACH EMPLOYEE
OTHER
B Hull and $1,000 P&I
- 030190 3/1/91 3/1/92
p & I Hull per Schedule
DESCRIPTION OF OPERATlONS/LOCATlONSIVEHICLES/SPECIAL ITEMS q
Clearwater, Fl. The city of Clearwater & Briley,
additional insureds with respect to this project,
s
CERTIFICATE HOLDER
City of Clearwater
PO Box 4748
Clearwater, FI 34618
CANCELLATION
ACORD 25-S (7/90)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIR'9~N DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL _ 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 M NY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE