CERTIFICATE OF INSURANCE (196)
PRODUCER
FRANK B. HALL & CO. OF FLORIDA
POST OFFICE BOX 23545
TAMPA, FL. 33623-3545
PHONE: (813) 884-8470
I
ISSUE DATE (MMIDD/YY)
5-25-89 1t
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
~~~~NY A
COMPANIES AFFORDING COVERAGE
TRAVELERS
CODE
SUB-CODE
INSURED
~~~NY B
MILLER BROTHERS OF FLORIDA, INC.
POST OFFICE BOX 1098
RIVERVIEW, FL. 33569
~~~~~NY C
: 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 REOUIREMENT, 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
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DDIYY)
ALL LIMITS IN THOUSANDS
4-7-89
1.000
1.000
1,000
1,000
50
5
GENERAL LIABILITY
UJ -66083SG6 711
ITL-89
4-7-90
GENERAL AGGREGATE
PRODUCTS-COMP/OPS AGGREGATE
PERSONAL & ADVERTISING INJURY
AUTOMOBILE LIABILITY
X
ANY AUTO
A XALL OWNED AUTOS
X
SCHEDULED AUTOS
X
HIRED AUTOS
XNQN-OWNED AUTOS
GARAGE LIABILITY
UJ -660835G6 711
ITL-89
4-7-89
MEDICAL EXPENSE (Anyone
, COMBINED 1 000
SINGLE $, ,
4-7-90 LIMIT
CESS LIABILITY
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION
STATUTORY
AND
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYE
EMPLOYERS' LIABILITY
DESCRIPTION OF OPERA T10NS/LOCA TIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
CERTIFICATE HOL.DER
iCMllCEL.L.A. TION
1~~i~i.S(3/&8'
,'~' '~f,""':'~:\'.~~~iik;.-:,+ -~cf--T;j';,H->'t
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRAT:RtJ DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL _ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
, LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
:,"'HO~;~~\NK~~ FL.
ii~~:F\I~;1'riii\mi\~~!!;jfiji\;!!i\'i0~iii"'i~ii\'i'1i!n'+/ i' ."T@ACl)'Rb''CORPCJRATlON 198
City of Clearwater
P.O. Box 4748
Clearwater, FL 33518