CERTIFICATE OF INSURANCE
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GU 6715
(Ed. 2-68)
CERTIFICATE OF INSURANCE
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This is to Certify, that policies in the name of
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NAMED
INSURED
and
ADDRESS
IPinellas County Board of County
Commissioners
315 Haven street ,
LCleaIWater, Florida 33516
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THIS CERTIFICATE DF INSURANCE NEITHER AffiRMATIVELY NDR
NEGATIVELY AMENDS, EXTENDS DR ALTERS THE COVERAGE
AFFORDED BY ANY POLICY DESCRIBED HEREIN,
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are in force. at .the daJe hereof, as follows:
KIND OF POLICY POLICY LIMITS OF LIABILITY
INSURANCE NUMBER PERIOD BODILY INJURY PROPERTY DAMAGE
WORKMEN'S Provided by. Workmen's
Eff, Compensation law-State of NIL
COMPENSATION Exp,
COMPREHENSIVE GENERAL . Eff, J2/30/76 I , 000 Each person I ,000 Each occurrence
LIABILITY GLA 10 48 20 Exp, J2/30/79 I , 000 Each occurrence I , 000 Aggregete
I 1, 000 , 000 Aggregate Sir gle Limit
MANUFACTURERS' AND Eff, I , 000 Each person I , 000 Each occurrence
CONTRACTORS' LIABILITY Exo. 000 Each occurrence I , 000 A,gre..te
OWNERS', LANDLORDS' . Eff, I , 000 Each person I , 000 Each occurrence
AND TENANTS' LIABILITY Exo. I , 000 Each occurrence I , 000 Aggregate
CONTRACTUAL Eff, I , 000 Each person I , 000 Each occurrence
LIABILITY Exo, I ,000 Each occurrence I ,000 Aggregate
AUTOMOBILE LIABILITY .
o Dwned Automobiles Eff, I , 000 Each person I , 000 Each accident
o Hired Automobiles Exp, $ ,000 Each accident
o Non.Owned A,tomobiles
COMPREHENSIVE AUTO- Eff, I , 000 Each person I , 000 Each occurrence
MOBILE LIABILITY Exp. I , 000 Each occurrence
OTHER: Eff,
Exp,
In the event of an~ material change in, or cancellation of, said policies, the undersigned company will endeavor to give written notice to the party to whom this
certificate is issued, but failure to give such notice shall im.pose no obligation nor liability upon the com.pany.
Artificial Reef Staging Area
Clearwater, Florida
SE Section 9-29-15
.854 Acres M.O_L.
Druggists Insurance Co.
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NAME
and
ADDRESS
CERTIFICATE ISSUED TO:
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, City of Cl ea rwa ter
112 S. Osceola Avenue
Cl earwater, Flori da 33516
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