CERTIFICATE OF INSURANCE (144)
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PRODUCER ' I' THIS CERTIFICATE IS ISSUFn ,\!:.' !\,ATT~R OF INFORMATION ONLY AND CONFERS
JOSEPH U MOORE INC (03) I NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND I
I EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
I
\ COMPANIES AFFORDING COVERAGE
I COMPANY LETTER A AMERISURE
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I COMPANY LETTER B MICHIGAN MUTUAL
~~aH~tDcONSTRUCTION & I COMPANY LETTER C FCCI
ENGINEERING CORP I
POBOX 23422 I
TAMPA FL I
ZIP CODE 33000-135A I
I
POBOX 18245
TAMPA FL
ZIP CODE 33679
COMPANY LETTER D
COMPANY LETTER E
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COVERAGES
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
PERIOD INDICATED.l. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CON[lITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
WHICH THIS CERTI~ICATE MAY BE ISSUED OR MAY PERTAIN/ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJEC
TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS OF SUCH POLICIES.
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CO POLICY POLICY
LTR TYPE OF INSURANCE POLICY NUMBER EFF. DATE EXP. DATE ALL LIMITS IN THOUSANDS
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IGENERAL LIABILITY I I
A) (X) COMMERCIAL GENERAL LIABILITY i CPP0275558 07/01/87 07/01/88 I GENERAL AGGREGATE $1000
i ( ) CLAIMS MADE (X) OCCURRENCE I I PRODUCT-COMP/OPS AGGREGATE $1000
I ( ) OWNERS ~ CONTRACTORS PROTECTIVE I i PERSONAL & ADVERTISING INJURY $ 500
( ) I I EACH OCCURRENCE $ 500
I ( ) I I FIRE DAMAGE (ANY ONE FIRE) $ 50
1 I I MEDICAL EXPENSE (ANY ONE PERSON) $ 5
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IAUTOMOBILE LIABILITY I I
Bi (X) ANY AUTO I HG434835822 07/01/87 07/01/88 CSL $
I ( ) ALL OWNED AUTOS I I BODILY INJURY
I ( ) SCHEDULED AUTOS I (PER PERSON) $250
(X) HIRED AUTOS I I BODILY INJURY
I (X) NON-OWNED AUTOS I i (PER ACCIDENT! $500
( ) GARAGE LIABILITY I PROPERTY
I ( ) I I DAMAGE $100
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I I I EACH
IEXCESS LIABILITY I I OCCURRENCE AGGREGAT
BI (X) UMBRELLA FORM I CU0270549 07/01/87 07/01/88 I
( ) OTHER THAN UMBRELLA FORM I $2000 $2000
I I I
__~_':"'"~. -~~~.::.~~=_~,"':"'.,"""_.........~~_~.~_~..~_~_~._.:'~_...._-_.....~.~,~_='='.~~.~_"':'""~~.~.-:'_~ ~~_o:-,~=.:!':"_~_=~--=~_:_--- - -__....,._,- - __...._...."" ..._.___ __ __....____ - - -- --__ -______________~____~
J I I STATUTORY
C;WORKERS' COMPENSATION I 7645 01/01/88 01/01/89 I $100 (EACH ACCIDENT)
I AND I I $500 (DISEASE-POLICY LIMIT)
EMPLOYERS' LIABILITY I I $100 (DISEASE-EACH EMPLOYEE)
I I I
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I I I
I OTHER I I
I I I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
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CERTIFICATE HOLDER I CANCELLATION
I
CITY OF CLEARWATER I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
I PIRATION DATE THEREOF I THE ISSUING COMPANY WILL ENDEAVQRTO MAIL 30 DAYS
P.O. BOX 4748 I WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE
CLEARWATERA FL I TO MAIL SUCH NOTICE SHALL IMP NO OBLIGATION OR LIABILITY OF ANY KIND
ZIP CuDE 33518 UPON THE COMPANY, ITS AGE OR REPRESENTATIVES.
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I AUTHORIZED REPRESENTATIVE
I JOSEPH U. MOORE/ INC.