INSURANCE BINDER
ME AND ADDRESS OF AGENCY
COMPANY
Insurance Corner
P.O. Box 40660
St. Petersburg, Florida 33743
Med-Bill Inc.
5800 49th Street North Suite #107
St. Petersburg, Florida 33709
Effective an 31
Expires IX] 12:01 am 0 Noon J an
!XJ This binder is issued to extend cov
company per expiring policy #
Description ot OperationlVehicles/Property
1984 Lincoln Town Car
1985 Lincoln Town Car
1980 Lincoln Cont. 4dr.
,19 86
31,19 87
NAME AND MAILING ADDRESS OF INSURED
MAR 6 1986
Type and Location ot Property
Coverage/Perils/ Forms
AGIQjll~suref
Coi $.
.
:jj
Type of Insurance
Coverage/ Forms
Limits of Liability
Each Occurrence
Bodily Injury $
Aggregatel
$
o Scheduled Form 0 Comprehensive Form
o Premises/Operations
o Products/Completed Operations
o Contractual
o Other (specify below)
o Med. Pay, $
o Personal Injury
Per
Person
$
Per
Accident
DAD B Dc
Property Damage $
Bodily Injury &
Property Damage $
Combined
Personal Injury
Limits ot Liability
Bodily Injury (Each Person) $
Bodily Injury (Each Accident) $
$
$
$
KJ liability n NOTlf:wnedp n Hired
~ SDgecl lea ertrs
~ ~. eductible $ 500
kJ Collision-Deductible $ 500
o Medical Payments $
kJ Uninsured Motorist $100/300,000
kJ No Fault (specify): 10,000
U Other (specify):
Bodily Injury & Property Damage
Combined $ 500,00
Property Damage $
D WORKERS' COMPENSATION - Statutory limits (specify states below)
o EMPLOYERS' LIABILITY - limit $
SPECIAL CONDITIONS/OTHER COVERAGES
"~
NAME AND ADDRESS OF 0 MORTGAGEE
o LOSS PAYEE
o ADD'L INSURED
LOAN NUMBER
15;:; I
Da~e