CERTIFICATE OF INSURANCE (120)
Seitlin & Company of Broward, Inc.
3330 N.W. 53 Street, Suite 307
Ft. Lauderdale, Florida 33309
INSURED
Mueller Contractors, Inc.
7450 N.W. 74 Avenue, 11373
Medley, Florida 33166-2492
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
COMPANY A American Insurance Company
LETTER
COMPANY B FCCI
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
THIS IS TO CERTIFY THAT 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 CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS.)
ALL OWNED AUTOS (OTHER THAN)
PRIV. PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
MXA80032776
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
Applied For
OTHER
DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLES/SPECIAL ITEMS
City of Clearwater
Engineering Dept.
P.O. Box 4748
Clearwater, Florida 33518-4748
POliC, E'FECTI'JE
DA~E IMM/DD/YVI
LIABILITY LIMITS IN THOUSANDS
OCC5~~~NCE AGGREGATE
POLICY EXPIRATION
OATE (MMfODIYY)
BODilY
INJURY
$
$
PROPERTY
DAMAGE
$
$
~~t~~ED $
$
PERSONAL INJURY
$
3C01_ v
\JJRV
?!:" 0\'%0'1 $
03/31/87
03/31/88
3001[ \
,~"UR\
:Pf" ACCIOE!,T $
PROPERTY
DAMAGE $
BI & PO
COMBINED
$1,000,
~~t~'~ED $
$
STATUTORY
03/31/87
$ 100, (EACH ACCIDENT)
$ 500, (DISEASE-POLICY LIMIT I
$ 100, (DISEASE-EACH EMPLOYEE)
12/31/8.7
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