CERTIFICATE OF INSURANCE (157)
UNCOAST INS ASSOC IHe
. O. BOX 22668
AMPA FL 33622-2668
ILLER BROTHERS OF
LORIDA INC.
. O. BOX 1098
IVERVIEW, FL 33569
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 ATLANTIC UND. NO AM. INC
LETTER
COMPANY B GULF INSURANCE GROUP
LETTER
f~~~NY C AM. CASUAL TV CO OF READING, PA.
COMPANY D
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 OPERA nONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
61520144M
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV, PPSS,)
AlL OWNED AUTOS (OTHER THAN)
PRIV, PASS.
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
BA5287351
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
6152017411
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
ARX5183404
OTHER
DESCRIPTION OF OPERA T10NS/LOCA TIONSNEHICLES/SPECIAL ITEMS
C1tv of Cl..~w.t.~
P. O. Box 4748
Clea~w.t.~, FL 33518
- -
POLICY EFFECTIVE
OA TE (MM/OOIYY)
POLICY EXPIRATION
OA TE (MMIOOIYY)
04/07/88
4/07/89
03/31/88 3/31/89
04/07/88 4/07/89
04/04/88 4/04/89
LIABILITY LIMITS IN THOUSANDS
OCCQ~R~NCE AGGREGATE
BODILY
INJURY
$
$
PROPERTY
DAMAGE
$
$
BI & PO
COMBINED
$ 1, 000 $
PERSONAL INJURY $
BODILY
INJURY $
(PfR PfRSONI
OOOILY
INJURY $
IPfR ACCIDENT)
PROPERTY
DAMAGE $
BI & PO
COMBINED $
g6t~I~ED $ 1, 000 $
(EACH ACCIOENT)
(OISEASE.POllCY LIMIT)
(OISEASE-EACH EMPLOYEE)