CERTIFICATE OF INSURANCE (081)
-- - qertificate of Insurance I
THIS CERTI FICATE IS ISSUED 4A MATTER OF INFORMATION ON L Y AND CON FERS NO R , 'I1T5 UPOI\: THE CER TI F IC/\ TE HOUlEr"
THIS CERTI FICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AF FORDED BY-THE POLlCI ES LISTED BE LOW
NAME AND ADDRESS OF AGENCY
JOSEPH U. MOORE, INC. COMPANIES AFFORDING COVERAGES
601 SWANN AVE RECEIVED COM PAr-.. v A
TAMPA, FL LETTER INS CO OF N AMERICA
33606 COMPAN'''- B
(813)251-2699 LETTER U S F ~ G
NAME AND ADORESS OF INSURED 18 _ C
MAR co~Po.r"\J'(
INTER-BAY MARINE LETTER LIBERTY MUTUAL
CONSTRUCTION CO COMPAN" 0
7950 118TH AV N LETTER . UNDERWRITERS @ LLOYD
LARGO FL 3354~ CLERK. CO M PAr--.; y~' E
IT . LETTER .~
I
-1-
This is to certify that policies of insurance listed belo,w have been issued to the insured named above and are In forc" at tllis tlfne, Notwithstanding any requirement, term or co,,~
dition of any contract or other document with respect to which this certificate may be issued or may pertain, the ",surance affolded by the policies described herein is sIJbJeC110
all the terms, exclusions and conditions of such policies.
COMPANY
LETTER
TYPE OF INSURANCE
POLICY NUMBER
~':h.'C'f
[~PIPA1'CN DAH
EACH
OCCURRENCE;
A(il.REG/l, T
GENERAL LIABILITY
t-IC~)I L.Y INJURY
MFCD06900550
03/01/87
PREMISES-OPERATIONS
EXPLOSION AND COLLAPSE
HAZARD
UNOERGROUND HAZARD
PRODUCTS/COMPLETED
OPERATIONS HAZARD
CONTRACTUAL INSURANCE
BROAD FORM PROPERTY
DAMAGE
INOEPENDENT CONTRACTORS
Pf--l(Jf'f.RT"l' U.AMA(;E
ILJ[)ILY INJUF~Y AND
;ll~OPf:RTV OA'ViAGE
COMBINED
s
1000
1000
PERSONAL INJURY
PEHSONAL INJURY
BAP076285165
03/01/87
~~()[)Il 'I INJURY
r; ACt-l PERSON)
8U[)ILY INJURY
'1:'AU.j OCCURRENCE)
f-'HOPERTY DAMACiE
SOUll,Y INJURY AND
PROPERTY DAMA(iE
COMBIf\iU)
1000
BO[);l.Y INJURY AND
PROP[RTY DI),MAGE
CUMBINED
WORKER'S COMPENSATION
C
and
EMPLOYER'S LIABILITY
OTHER
1351402984015
06/13/86
03/01/87
03/01/87
500
500
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 ANO ADORESS OF CERTIFICATE HOLDER
CITY OF CLEARWATER
~' "
P.O. BOX 4748
CLEARWATER, FL
33518
", ..r,I_' _ ".._.'. '~."'''' .....~.. .'... .t.,.. '.J ~.