CERTIFICATE OF INSURANCE (126)
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.....
THIS CERTIFICATE IS ISSUED f~~~~!~~I~~:A~O~ !N~Y~~ ~O~F~~jIGHTS UPON THE CERTIFICATE HOLDER,
THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED B'Y THE POLICIES LISTED BELOW.
,JOSEPH U u
60:1. SWANN
Tf;t1Pr::i, FL.
COMPANIES AFFORDING COVERAGES
MOORE,
f.1VE
INC.
(B13)2~jl-<~699
NAME AND ADDRESS OF INSURED
COMPANY
LETTER
A
B
C
o
E
FCCI-f)]T
COMPANY
LETTER
COMPANY
LETTER
AETNA C ,\ S
33606
COMPANY
LETTER
lTNnv nnWEN CONSTRUCTION
CONPf-1NY
3645 45TH (i\-.IE
~~T PETERSBURG
COMPAN Y
LETTER
N
FL.
33714
CQMPAN Y
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time, Notwithstanding any requirement. term or con-
dition 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.
TYPE OF INSURANCE
POLICY
EXPIRATION DATE
limits 0
POLICY NUMBER
GENERAL LIABILITY
A
BODILY INJURY
s
CO 112083
04/01/88
COMPREHENSIVE FORM
PREMISES-OPERATIONS
EXPLOSION AND COLLAPSE
HAZARD
UNDERGROUND HAZARD
PRODUCTS/COMPLETED
OPERATIONS HAZARD
CONTRACTUAL INSURANCE
BROAD FORM PROPERTY
DAMAGE
'oj
,..., INDEPENDENT CONTRACTORS
s
s
PROPERTY DAMAGE
BODIL Y INJURY AND
PROPERTY DAMAGE S
COMBINED ~~i (; () .J J. ; (0)
PERSONAL INJURY S
BODI L Y INJURY
04/01/88 lEACH PERSON)
BODILY INJURY S
lEACH OCCURRENCE)
PROPERTY DAMAGE S
BODI L Y INJURY AND ~500 }
PROPERTY DAMAGE
COMBINED
04/01/88 BODI L Y INJURY AND S
PROPERTY DAMAGE
COMBINED
01/01/88
JOOl IEACHACCIDE TI
X PERSONAL INJURY
AUTOMOBILE LIABILITY
fi
X COMPREHENSIVE FORM
FJ669308
)( OWNED
X HIRED
X NON.QWNED
EXCESS LIABILity
fi
X UMBRELLA FORM
OTHER THAN UMBRELLA
FORM
XS51~S320
WORKER'S COMPENSATION
B
and
EMPLOYER'S ,LIABILITY
OTHER
7160
ESCRIPTION OF OPERATlONSILOCATIONS/VEHICLES
fiLL OF'Er;:tiTIONS
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 AND ADDRESS OF CERTIFICATE HOLDER
DATE ISSUED'
04/0'':; /8/
CITY OF CLEARWATER
ATTN: CITY ATTORNEY
P 0 BC))( 4'148
CUJ~RW{~TEF: FL