CERTIFICATE OF LIABILITY INSURANCE (3)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
LTR DATE (MMIDO/YY) DATE (MM/DD/YY)
GEN ERAL LIABILITY BODILY INJURY OCC S
COMPREHENSIVE FORM n BODILY INJURY AGG $
EMISES/OPERATIONS
P
R U PROPERTY DAMAGE OCC $
L
?
NN
EXPLRSIION 8 COLLAPSE HAZARD PROPERTY DAMAGE AGG $
PRODUCTS/COMPLETED OPER N? I BI & PD COMBINED OCC $
CONTRACTUAL BI & PD COMBINED AGG $
INDEPENDENT CONTRACTORS PERSONAL INJURY AGG $
BROAD FORM PROPERTY DAMAGE I Tw_ VC D
PERSONAL INJURY
A AUT OMOBILE LIABILITY 9677117000 1 /08/10 BODILY INJURY
$
X ANY AUTO )
r
'¢ (Per person) 1,000,000
ALL OWNED AUTOS (Private Pass) r BODILY INJURY
$
ALL OWNED AUTS
i
h
th
P
t (Per accident) 1,000,000
X r
(Ot
an
va
e
er
HIRED AUTOS ry [ 1?
yU\t
PROPERTY DAMAGE
$
X
NON-OWNED AUTOS
rr 1,000,000
GARAGE LIABILITY CAF•
0F r.l P. ?? BODILY INJURY 8 PROPERTY
DAMAGE $
?p
?i??` i
. .V(- COM13I ED
EXCESS LIABILITY Cr .L EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND U
T LIMITS ER
EMPLOYERS' LIABILITY ,-
---
"E1cCF-ACCIDENT-.-._.- - - --
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THE PROPRIETOR/ INCL _
_ EL DISEASE-POLICY LIMIT $
PARTNERS/EXECUTIVE
OFFICERS ARE:
EXCL
_
EL DISEASE-EA EMPLOYEE
S
OTHER
DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLESISPECIAL ITEMS
THE CITY OF CLEARWATER IS AN ADDITIONAL INSURED AS PER THE COMMERCIAL AUTO
LIABILITY.
PROJECT: CITY OF CLEARWATER
CITY OF CLEARWATER
ENGINEERING DEPARTMENT
100 S MYRTLE AVE
CLEARWATER FL 33756
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
1-0_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILUR IL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND PON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REURESENTATIVE
Mitchetl Marsh, Ext 2214 LG A
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