CERTIFICATE OF INSURANCE FOR ENTRANCE MONUMENTS IN RIGHT-OF-WAY 1996
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CER.tIFICAt~dF INs.UaANQ6
Carlisle Fields & Company,
P.O. Box 7910
Clearwater FL 34618-7910
John R. Fields
!tU::....79 7..:J~:Hl.______
INSURED
Inc
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.MQAAI".1. 09/11/95
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
'1<
PRODUCER
COMPANY
A
Auto Owners Insurance Company
Morningside Meadows Homeowners
Civic Assn.
civic Assn. , Pauline Pollio
POBox 5182
Clearwater FL 34618-5182
COMPANY
B
COMPANY
C
COMPANY
D
COVERAGES
THIS IS TO CERTIFY THAT THE 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 CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
"'~--'-"---~--'_._----~--_._.-. . .--...-----....----------..---.----.-.-----
co
LTR
TYPE OF INSURANCE
POUCY NUMBER
POUCY EffECTIVE POUCY EXPIRATION
DATE IMMIDDIYYI DATE IMM/DD/YY)
UMITS
A
GENERAL UAB'UTY
X COMMERCIAL GENERAL L1AIIILlTY
.---. -=:J CLAIMS MADE W OCCUR
OWNER'S & CONTRACTOR'S PROT
2051781695
05/15/95
05/15/96
GENERAL AGGREGATE
PRODUCTS. COMP/OP AGG
PERSONAL & ADV INJURY
EACH OCCURRENCE
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON.OWNED AUTOS
FIRE DAMAGE IAny one flrel
MED EXP IAny ono poreonl
. 500,000
"'-..-..--.-- -. .. ... -
~~gQLg()()
t500,000
'--'---.-,--- ---,----
~...~-QQ,-QQQ
___5Q!QQ ()
5,000
AUTOMOBILE UABIUTY
ANY AUTO
~n/~~
COMBINED SINOLE LIMIT
OODIL Y INJURY
IPer person)
OODILY INJURY
IPcr accident I
GARAGE UABIUTY
ANY AUTO
E
PROPERTY DAMAGE
EXCESS UAB'UTY
,j
AUTO ONLY. fA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT .
AGGREGATE
EACH OCCURRENCE
UMBRELLA FORM
OTHER TitAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' UABIUTY
AGGREGATE
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
STATUTORY LIMITS
EACH ACCIDENT
DISEASE. POLICY LIMIT
EXCL
DISEASE. EACH EMPLOYEE
A Comm Application
2051781695
05/15/95
05/15/96
DESCRIPTION OF OPERATIONS/LOCATIONSIVEH'CLESISPECIALITEMS
City of Clearwater is added as additional insured
CERTIFICATE HOLDER
CANCELLATION
CITYC-l
SHOULD ANY OF TIlE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEllEOF, THE ISSUINO COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDeR NAMEO TO TIlE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATION OR UABIUTY
City of Clearwater
Risk Management
P.O. Box 4748,
Clearwater FL 34618-4748
ACORD 26'S (3/93/
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