CERTIFICATE OF INSURANCE (101)
COMPANIES AFFORDING COVERAGES
WALLACE WELCH WILLINGHAM
PO BOX 33020
ST PETERSBURG, FL 33733
COMPANY
LETTER
COMPANY A
LETTER
B
C
D
E
AMERISURE COMPANIES
NAME AND ADDRESS OF INSURED
PENINSULAR SIGN CO. INC.
P.O. BOX 220
PINELLAS PARK, FL 34290
COMPANY
LETTEP
COMPA',Y
LETTER
COMPANY
LE-:-TER
This is to certify that policies of insurance listed below havebeen issued to the insured named above and are in force al this lime, 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 conditions of such policies,
TYPEOF INSURANCE POLICY NUMBER
GENERAL LIABILITY 874-H92'32
-KJ COMPREHEN~VEFORM
KJ PREMISES-OPERATIONS
KJ EXPLOSION AND
COLLAPSE HAZARD
KJ UNDERGROUND HAZARD
KJ PRODUCTS/COM PLETED
OPERATIONS HAZARD
KJ CONTRACTUAL INSURANCE
KJ BROAD FORM PROPERTY
DAMAGE
KJ INDEP, CONTRACTORS
KJ PERSONAL INJURY
AUTOMOBILE LIABILITY 434-892'34
KJ COMPREHENSIVE FORM
KJ OWNED
KJ HIRED
KJ NON.OWNED
EXCESS LIABILITY
0 UMBRELLA FORM
0 OTHER THAN UMBRELLA
FORM
WORKERS' COMPENSATION 3BO-H92'31
and
EMPLOYERS' LIABILITY
OTHER
POLICY
EXPIRATION DATE
LIMITS OF LIABILITY IN THOUSANDS (000)
EACH
OCCURRENCE
10/01/87
BODIL I' iNJURY
500
PROPERTY DAMAGE
$
100
BODiLY IN,JURY AND
PROPERTY DAMAGE
COMBINED
PERSONAL INJURY
10/01/87
BODiLY INJURY
,EACH PERSON)
,lIJDIL Y INJURY
lEACH ACCIDENT!
PROPERTY DAMAGE
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
BODiLY INJURY AND
PROPERTY DAMAGE
COMBINED
10/01/87
Cancellation: Should any of the above described policies be cancelled before the expiration date thereof, the issuing company will
endeavor to mail 30 days written notice to the below named certificate t1010er, but failure to mail such notice shall 1m,
pose no obligation or liability of any kind upon the company,
NAME AND ADDRESS OF CERTIFICATE HOLDER
DATE ISSUED 09/02/86
CITY OF CLEARWATER
BUILDING DEPARTMENT
CLEARWATER, FL .