CERTIFICATE OF INSURANCE (160)
1
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THIS IS TO CERTIFY THAT 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 CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EffECTIVE
DATE IMM/DDiYY)
POLICY EXPIRATION
DATE (MM/ODIYY!
ALL LIMITS IN THOUSANDS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCURRENCE
OWNER'S & CONTRACTORS PROTECTIVE
TO BE ASSIGNED
1217/l2l1/88 1217/1211/89 GENERAL AGGREGATE
PRODUCTS,COMPIDPS AGGREGATE
PERSONAL & ADVERTISING INJJRY
EACH OCCURRENCE
fiRE DAMAGE IANY ONE fiRE)
MEDICAL EXPENSE (ANY ONE PERSON)
$ 1
$ 1
$
$
$
$
AUTOMOBILE LIABILITY TO BE ASSIGNED 07/01/88 07/01/89
CSl
X ANY AUTO $
ALL OWNED AUTOS BOOll Y
INJURY
SCHEDULED AUTOS (PER PERSI]~" $
X HIRED AUTOS BODll Y
INJURY
X NON,OWNED AUTOS !PER $
ACCIDENTI
GARAGE LIABILITY PROPERTY
DAMAGE $
TO BE ASSIGNED 1217/1211/88 1217/l2l1/89 EACH
OCCURRENCE
$ 2, C)l2I0 $
OTHER THAN UMBRELLA FORM
...B--~WO'RKERS"COMP'ms-A rro-N
AND
EMPLOYERS' LIABILITY
-J217.64 r.:.j______~"_____m_ ....QO"..L-0-1
_1 ~ ~a 5T3\TUTORY
$
$
$
100 (EACH ACCIDENT)
500 iDISEASEPOLlCY LIMIT)
10121 (DISEASE EACH EMPLOYEE'
OTHER
DESCRIPTION OF OPERATIONS I LOCATlONSIVEHICLES/RESTRICTIONS/SPECIAL ITEMS
CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER, FL 33518