CERTIFICATE OF INSURANCE (087)
04/~:::8/B6
PRODUCER
HARVEY, PERCY & JONES INS.
324 NORTH DALE MABRY
P.O. BOX 24958
TAMPA,FL 33523-4958
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,
COMPANY A
LETTER
COMPANY B
INSURED LETTER
MILLER BROTHERS OF COMPANY
FLORI DA, INC. LETTER C
P 0 BOX 1095 COMPANY
RIVERVIEW, FL LETTER D
33569 COMPANY
LETTER E
. ,
COMPANIES AFFORDING COVERAGE
FIDELITY ~C
APR 80
, 11:tC
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POt,ICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS C_ERTIFICAlE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BViAE POliCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES,
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
DATE (MMIDDIYY) DATE (MM/DDIYY) EACH
OCCURRENCE
BODILY
INJURY $ $
PROPERTY
DAMAGE $ $
BI & PD $ $
COMBINED
PERSONAL INJURY $
BODilY
INJURY $
(PER PERSONI
BODilY
INJURY $
(PER ACCIDENT)
PROPERTY
DAMAGE $
BI & PD
COMBINED $
BI & PD $ $
COMBINED
STATUTORY
03/31/86 03/31/87 1 UO(EACH ACCIDENT)
,7) . - (DISEASE-POLICY LIMIT)
- . (DISEASE-EACH EMPLOYEE)
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
.'
EXCESS LIABILITY
------------- - ------
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
BINDER #1083
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
CITY OF CLEARWATER
POBOX 4748
CLEARWATER, FL