CERTIFICATE OF INSURANCE (052)
JOSEPH u.
601 SWANN
T At1P{.1} FL.
MOORE}
AVE
33606
NAME AND ADDRESS OF INSURED
LINDY BOWEN CONSTRUCTION
COMPANY
3645 45TH AVE
ST PETERSBURG
N
FL
INC.
EIVED
33714
COMPANY A
LETTER
COMPANY B
LETTER I:' 'T'
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
\,":ITY CLERK
APR 12 ~
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 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.
A
TYPE OF INSURANCE
GENERAL LIABILITY
0 COMPREHENSIVE FORM
0 PREMISES-OPERATIONS
0 EXPLOSION AND
COLLAPSE HAZARD
[!.] UNDERGROUND HAZARD
[I] PRODUCTS/COMPLETED
OPERATIONS HAZARD
0 CONTRACTUAL INSURANCE
0 BROAD FORM PROPERTY
DAMAGE
0 INDEP. CONTRACTORS
[] PERSONAL INJURY
AUTOMOBILE LIABILITY
~ COMPREHENSIVE FORM
[?j OWNED
[?j HIRED
[?j NON.OWNED
EXCESS LIABILITY
[1j UMBRELLA FORM
0 OTHER THAN UMBRELLA
FORM
LIMITS OF LIABILITY IN THOUSANDS (000)
EACH
OCCURRENCE
POLICY NUMBER
POLICY
EXPIRATION DATE
A
A
B
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITY
. ... .o:rma
BODILY INJURY
TBP302424327
04/01/ 6
ALL OPERATIONS
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
500
500
PERSONAL INJURY
BUA102424328
BODILY INJURY
(EACH PERSON)
04/01/ '6
BODILY INJURY
(EACH ACCIDENT)
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
100
UMB00242329
04/01/
COMBINED
718716
01/01/
Cancellation: Should any of the above described pOlicies be cancelled before the expiration date thereof, the issuing company Will
endeavor to mail 30 days written notice to the below named certificate holder, but failure to mail such notice shall im.
pose no obligation or liability of any kind upon the company.
NAME AND ADDRESS OF CERTIFICATE HOLDER
CITY OF CLEARWATER
ATTN: CITY ATTORNEY
F' 0 BOX 4748
CLEARWfiTER FL
DATE ISSUED
04/05/8~5
.I L. ~ IJ~v(.
't.~jQORE I NC
DSN
33518
AUTHORIZED REPRESENT A TIVE