CERTIFICATE OF INSURANCE (122)
THIS CERTIFICATE IS ISSUED f~~~~!~~I~~~A~O~ !N~Y~~ ~o~F~~~IGHTS UPON THE CERTIFICATE HOLDER
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES LISTED BELOW. .
NAME AND ADDRESS OF AGENCY
.
1,,#
INS CO OF N AMERICA
JOSEPH U.
601 SWANN
TAMPA, FL
MOORE,
AVE
INC.
COMPANIES AFFORDING COVERAGES
COMPANY
LETTER
A
B
C
D
E
LIBERTY MUTUAL
33606
COMPANY
LETTER
(813)2t)1-2699
NAME AND ADDRESS OF INSURED
INTER-BAY MARINE
CONSTRUCTION CO
7950 118TH AV N
L.ARGO FL
COMPANY
LETTER
COMPANY
LETTER
33543
COMPANY
LETT ER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time. Notwithstanding any requirement. term or con-
dition 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.
COMPANY
LETTER
TYPE OF INSURANCE
POLlCY NUMBER
POLlCY
EXPIRATION DATE
GENERAL LIABILITY
BODILY INJURY
$
$
A
PROPERTY DAMAGE $
$
x
X
X
X
X
X
COMPREHENSIVE FORM
PREMISES-OPERATIONS
EXPLOSION AND COLLAPSE
HAZARD
UNDERGROUND HAZARD
PRODUCTS/COMPLETED
OPERATIONS HAZARD
CONTRACTUAL INSURANCE
BROAD FORM PROPERTY
DAMAGE
INDEPENDENT CONTRACTORS
PERSONAL INJURY
MFCD14842007
OJ/Ol/88
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
B
and
EMPLOVoEA'S UABtl-lTV-
OTHER
MARINE P ~ I
1351402984015
06/13/87
PERSONAL INJURY
AUTOMOBILE LIABILITY
OWNED
BODILY INJURY
(EACH PERSONl
BODILY INJURY
lEACH OCCURRENCE)
COMPREHENSIVE FORM
HIRED
PROPERTY DAMAGE
$
NON.QWNED
BODIL Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
EXCESS LIABILIty
UMBRELLA FORM
OTHER THAN UMBRELLA
FORM
BOD I L Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
WORKER'S COMPENSATION
A
HU700013
03/01/88
1,000
ESCRII'TION OF OPERATIONS/LOCATIONSIVEHICLES
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail 30 days written notice to the below named certificate holder, but failure to
mail such notice shall impose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER
'-
; . 1 r'-~
I '
CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER, FL
33518
MW 1 9. 87