CERTIFICATES OF INSURANCE
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PRODUCER
: COMPANY E
~ LETTER
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICHTHI$_ .
.uCE;RIIfICA.I.t: MAY J3EJSSUED..OFt.MAYPERTAIN,THEINSURANCE. AFFOACEOBYTHE-PQUCIES OESCRISED .HEREIN .IS-SUBJEcrTO -.a.u THE TEAMS,
EXCLUSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
.. ............................................
TYPE OF INSURANCE
.....,....,..............,:.....................................................................................................:.................................:................
POLICY NUMRR
i POUCY DRCtMl iPOUCY DPlRAnON!
. DATI! (MM,OO/YY) i DAn! (MMtOOIYV) ,
UNITS
GENERAL UABIlITY 21CSEJ 41910E
COMMERCiAl GENERAL UABIUTY
CLAIMS MADEJ<:.i OCCUR.
OWNER'S & CONTRACTOR'S PROTo
AUTOMOBILE UABIUTY
NlY AUTO
ALl OWNED AUTOS
SCHEDUlED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE UABIUTY
21CSEJ41911E
9/01/92 9/01/93 :.~.~~~.~~~.R.~<3~~.... .'??().,(?(?O..
:p.~~~~.~.~~~p./C).p.~GG. .. .*??.<J.,.(?(?()..
.p..~~.~~~V. INJURY ..~??(?L().()(?
:.~.~.~~~~~... ..~??q,()q(?
.~~~.~~.o.~.(~e>roe.flre) . .*~q()h,qq().
~ t.ED. EXPENSE (Any one peBOn) '5 0 0 0
9/ 01/ 9 3 , COMBINED SINGLE
:UMIT
'250 000
......... ...............,.............
9/01/92
'BODILY INJURY
: (Pet person)
,
: BODILY INJURY
: (Per lICCkIent)
$
: PROPERTY DAMAGE ,
BE3087374
9/01/92 9/01/93
: OTHER TliAN UMBRELLA FORM
WORKER'S COMPENSAnON
AND
EMPLOYERS'UABIJTY
21WLJ41909E
9/01/92 9/01/93 STATUTORY UMITS
EACH ACCIOENT
DISEASE-POLICY UMIT
DISEASE-EACH EMPLOYEE
OTHER
DESCRlPnON OF OPERAnONSILOCATIONSIVEHlCLE8i8PECIAL R1!M8
p~fI!JmPAt~HP~Q~fI
iri~@fii!?;!ri!:ii!i!i!i!ri!;!W!iii!i!iii!i}??}!(
. . . . . . . . . . . . . . . . . .
......-...........
............ ....
it!!,i:iPMP.f:!~:AnqJ~.:ii?l{ .... ......... .:'//:.:.................
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCElleD BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAil ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BlJT FA! RE TO MAil SUCH NOTICE SHALL IMPOSE NO OBUGATlON OR
UABIUTY NY KIND UPON THE COM NY :S-OR REPRESENTATIVES.
Z
..:.:(::CACORDCORPORAflON<1990
CITY OF CLEARWATER:.:.:.:
900 CHESTNUT STREET :;:;:;:;
P.O. BOX 4788 _
CLEARWATER FL 34618 :,:",:
A(;Q~!>'~JYiliO ::::,:y:."::E;;y8;;;gn::;:;y.E:':.M0ttMl1i@lHJIS:~@%lTy.
LYKES INSURANCE INC
POBOX 2879
TAMPA FL 33601
CER,..IF"I..~~m-E....QF".......I.N,S'l.J.aAN.t'E..... f
_ ...../< ... . .' ISSUE DA; (;~D~
THIS CERTIFICATE IS ISSUED AS A MATrER 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
PRODUCER
fm~:rY A
NUTMEG INSURANCE CO
.-.
. ......... ....................... .......................................................................
IHSURED
fm~:rY B
................. ..,.-.;.'t'.,-;:......;'..
'(
HARrF'9gp ...f.Ig:E; ....~N.~...q9;a.~~~.r~.: (~..~0::-\.......
l~ It', \'
AEGIS INS SERV INC (.~) I:, ,.,,1
.... ..... ................. ...................................S {..~ . ( .,..:.....~...
..,. '"
LYKES ENERGY INC
PEOPLES GAS SYS
PO BOX 2562
TAMPA FL 33601
fm~:rY C
COMPANY D
~R TWIN CITY FIRE INS CO
........ n. ........... ............ ...... ..... ............... ................................ ...................
f~:rY E
..():\..~~......... .... .... ....
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHiCH Tri;S
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
TYPE OF IHSURANCE
POUCY NUMBER
POUCY EFFEcnYEl'OUCY EXPIRAnON
DATE (MMlDDIYY) DATE (MMlDDIYY)
LIMns
GENERAL UA8/UTY 2 1 CLRJ 41907 E
COMMERCIAl. GENERAl. UASIUTY
CLAIMS MADE X . OCCUR.
OWNER'S & CONTRACTOR'S PROT.
AUTOMOBILE UA8/UTY
X ANY AUTO
. ALL OWNED AUTOS
SCHEDU'~ AUTOS
. HIRED AUTOS
· NON-QWNED AUTOS
. GARAGE UABIUTY
21CLRJ41908E
9/01/91 9/ 01/ 92~E.N~~.~~~~~~h..hh....??()hd>.9.()....
" p.~c:lo.~~P'fl)" .~G.~:... h.'.?'? (),..<>.<>..C>...
h,.E~~~~ .~. AJ:l~:. ~u.~:v. h" ~.?? <>. f...C> <>. ()
~~U.~~~E:~.??<>.f..().()<>.h.
.. f'I~~. ~~~~~. (~. Clfle.....).. .....:1:. () (),.. <>'9..C>..
. aED. EXPENSE (Any _ 1*8Oft) . .5 0 0 0
9/01/91 9/01/92 COMBINEDSINGLE
.UMIT
$250 000
.. .... .f... ...
. BOOIL Y INJURY
(Per pefIOn)
$
21CLRJ41908E
9/01/91 9/01/92
. .. ... ...._-... ...
............................-..
..............................
.........h........................................................... .......
EXCESS UABIUTY
. UMBRB.1A FORM
. OTHER THAN UMBRB.1A FORM
X0082A1A91
9/01/91 9/01/92
WORKER'S COMPENSAnON
AND
EMPLOYERS' UABftJTY
21WLJ41906E
9/01/91 9/01/92
OTHER
EACH ACCIDENThhhh~:I.()<>.L()()()h
qDIS.~~~UCY UMIT hhhh.~.~<>'<>'L()()<>'
DISEASE-EACH EMPLOYEE '10 0 0 0 0
~ ~ :........ "'G T ""("l -:-: ~,
.i>", ~ ;......... .Lo .:
DESCRIPTION Oil OPERAnONSA.OCAnONSIVEHlCLESiSPECIAL ITEMS
(~ ~,--)
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E~!,~ ~':.. ~'.'J
CITY OF CLEARWATER
900 CHESTNUT STREET
P.O. BOX 4788
CLEARWATER FL 34618
CERTIFICATE HOLDER
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION 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 OBUGATlON OR
UABIUTY OF ANY KIND UPON TH COMPANY, ITS AGENTS OR REPRESENTATIVES,
ACORD2S~S(7/90r
F
... '..iC"ACOFibCOF/POFiA liON 1990
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