CERTIFICATE OF INSURANCE (208)
CERTIFICATE OF INSURANCE:
I Bill Wi II iams Agency, hie.
, 6109 9th Street N.
St. Petersburg, FL
33703
P~~813-522-3303
I
I
I
I
I
;---------------------------------------------------------------------------:
I
! t,,~ ~~i 1J . ~ . .
NO RIGHTS UPON THE CERTIFICATE H DER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
! T 1
1-----------------------------------------------------1---------------------------------------------------------------------------1
INSURED : COMPANY LETTERA The FI or ida Chamber Fund .
:-~---------------------------------------------~~~1r,,-~))-------:
: LOMPANY LETTER B ,
I ,
;-COMPANY-LETTERc:-------------------------------~~tI~-1--O--t9~l---------;
I ,
1------------------------------------------------------------7--------------j
: COMPANY LETTER D :
:------------------------------------------------~~lr__C:~~~--------:
: COMPANY LETTER E
Inter-Bay Marine Construction
Inc.
7950 118th Avenue North
Largo, FL
34643
:> COVERAGES <=========================================================--================================================~E:=======:
, THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN5b~ED 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 PERTAINi THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO
ALL TERMSl EXCLUSIONS~ AND CONDITIONS OF SUCH POLIC ES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
;---------------------------------------------------------------------------------------------------------------------------------~
.1-8-0-: 'tYPE-{)FINSlJRANGE~---+-, ---f'GbH:-'f--Nl:ll1BER -{ POLiCY EFF: POlffiV-,HP+<~-_ALl__t_mHB_,_m_THOUSANDS
iLTR: : : DATE : DATE : :
;---i--------------------------------:----------------------------;--------------:--------------l---------------------------------:
I : GENERAL L I AB I L I TY : : GENERAL AGGREGATE :
I I
I I
( ) COMMERCIAL BEN LIABILITY :
I
,
[ ] CLAIMS MADE [ ] OCC& :
: PRODS-COMP/OPS AGG. :
1---------------------;-----------;
( ] OWNER'S & CONTRACTOR'S
PROTECTIVE
: PERS. & ADVG. INJURY:
I r l
l-------------~-------!-----------I
: EACH OCCURRENCE: :
, 'l
!---------------------i-----------!
I
I
:
: FIRE DAMAGE
: (ANY ONE FIRE)
1______---------------"-----------
I
[ JANY AUTO i: BODILY INJURY :
[ ] ALL OWNED AUTOS : : (PER F'ERSON) :
[ ] SCHEDULED AUTOS : :---------------------~-----------i
( ] HIRED AUTOS : : BODILY INJURY
( J NON-OWNED AUTOS : : (PER ACCIDENT) ;
[ J GARAGE LIABILITY : :---------------------i-----------i
, (] , ::: PROPERTY DAMAGE !
:---:--------------------------------~----------------------------i--------------l--------------l---------------------------------i
: i EXCESS L I AB I L I TY :: : EACH oce: AGGREGATE :
--:-I-c[-J,l!MBRELbAFQRM > . n ,-->----------l----T- --I----:n:--____ .,.,...,~
: I (] OTHER THAN UMBRELLA FOR.M : ::: : :
:---i--------------------------------~----------------------------i--------------:--------------i---------------------------------i
! : : : ~ : STATUiORY 1
A: WORKERS' COMP :3906 1:2/06/90 12/06/91 : 1000 EACH ACC
AND 1000 DISEASE-POLICY LIMIT :
EMPLOYERS' L I AB 1000 DISEASE-EACH EMPLOYEE:
:---;--------------------------------;----------------------------:--------------;--------------;---------------------------------i
; OTHER :
, ,
j---------------------------------------------------------------------------------------------------------------------------------;
DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECIAL ITEMS
FLORIDA OPERATIONS ONLY
RE: Subaqueous Water Main, Clearwater Harbor, Clearwater, FL & Briley
Wild & Assoc. are included as additional insureds with respects to project
:> CERTIFICATE HOLDER <===============================> CANCElLATION <============================================================:
: = SHOUlD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX- ;
= PIRATION DATE THEREOF1 THE ISSUING COMPANY WILL ENDEAVOR TO MAIL3()
= DAYS WRITTEN NOTICE Tu THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT
= FAILURE TO MAIL SUCH NOTICE SHALL IMPO OBLIGATION OR LIABILITY Of
= ANY KIND UPON THE COMPANY, ITS A6EN PRESENTA IVES.
City of Clearwater
P.O. Box 4748
Clearwater FL
34618
,_ACORD 25-5 (3/88)
= AUTHORIZED REPRESENTATIVE
Bill Williams
.
=
Jr.