CERTIFICATE OF INSURANCE (017)
Florida .Suncoast Insurance Agency, Inc COMPANIES AFFORDING COVERAGES
1345 South Missouri Avenu~
Clearwater, FL 33516
COMPANY A Travelers
LETTER
COMPANY B
lETTER
COMPANY C
lETTER
COMPANY 0
lETTER
COMPANY E
lETTER
NAME AND ADDRESS OF INSURED
Lambaton., Inc. dlbla
The Kew Tansey Co.
__uP 1___OLBox__807___
Tarpon Springs, FL 33589
RICHARD L. STEELE
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 POLICY NUMBER POLICY
EXPIRATION DATE
GENERAL LIABILITY
BODilY INJURY $ $
"
~PREHENSIVE FORM
MISES OPERA ~OP€R:rv-e
EXPLOSION AND COllAPSE
HAZARD
o UNDERGROUND HAZARD 650-934F063-5-TIA-84 03/01/8
Ii] PRODUCTS/COMPLETED
OPERATIONS HAZARD BODll Y INJURY AND
Ii] CONTRACTUAL INSURANCE PROPERTY DAMAGE $ 500 $ 500
Ii] BROAD FORM PROPERTY COMBINED
DAMAGE
iXJ INDEPENDENT CONTRACTORS
o PERSONAL INJURY PERSONAL INJURY $
AUTOMOBILE LIABILITY BODilY INJURY $
XJ COMPREHENSIVE FORM (EACH PERSON)
BODILY INJURY $
iJ OWNED 650-934F063-5-TIA-84 03/01/85 (EACH ACCIDENT)
iJ HIRED PROPERTY DAMAGE $
kJ NON-OWNED BODIL Y INJURY AND
PROPERTY DAMAGE $
COMBINED 500
EXCESS LIABILITY
BODll Y INJURY AND
o UMBRELLA FORM PROPERTY DAMAGE $
o OTHER THAN UMBRELLA COMBINED
FORM
WORKERS' COMPENSATION
and UB934F064-]-84 03/01/85
EMP.tOY.EB.s'LIMlILJD' -----~_._- __
OTHER
A
A
DESCRIPTION OF OPERATlONS/lOCATlONSNEHIClES
#3-131B6
Memorial Civic Center
40 W. Causeway Blvd.
Clearwater, Florida
NAY 2 1984
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mail -1-0- 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:
City of Clearwater
Finance Department
P. O. Box 4748
Clearwater, FL 33518
April 30,
SUNCOAST
. ~", "..'. '-,