CABLE - CERTIFICATE OF INSURANCE (2)
PRODUCER
Marsh USA, Inc.
1166 Avenue of Americas
New York, NY 10036
CERTIFICATE NUMBER
NYC-001112057-10
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POUCY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POUCIES DESCRIBED HEREIN.
COMPANIES AFFORDING COVERAGE
1042 -ALL-GAWU-04-05
AMERI
TX
FL
COMPANY
A AMERICAN HOME ASSURANCE CO.
INSURED
VERIZON AMERICAST
ATTN: WANDA KOTERBA, MC: HQK02B75
6665 N MAC ARTHUR BLVD.
IRVING, TX 75039
COMPANY
B ILLINOIS NATIONAL INSURANCE CO.
COMPANY
C NATIONAL UNION FIRE INSURANCE COMPANY
WANDA K
COMPANY
D
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTIVE POUCY EXPIRATION UMITS
LTR DATE (MM/DDIYY) DATE (MMlDDIYY)
A GENERAL UABIUTY RMGL 480 6331 06/30/04 06/30/05 GENERAL AGGREGATE $ 10,000,000
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ INCLUDED
CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (Anyone fire) $ 50,000
$ 10,000
A AUTOMOBILE LIABIUTY RMCA 518 9069 AlO/S 06/30/04 06/30/05 $ 1,000,000
COMBINED SINGLE LIMIT
A X ANY AUTO RMCA 518 9067 TX 06/30/04 06/30/05
A ALL OWNED AUTOS RMCA 518 9068 VA 06/30/04 06/30/05 BODILY INJURY $
A SCHEDULED AUTOS RMCA 518 9081 MA 06/30/04 06/30/05 (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE UABlUTY AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS UABlUTY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
A WORKERS COMPENSATION AND RMWC 5212679 AlO/S 06/30/04 06/30/05
EMPLOYERS'UABlUTY
B--- - --- --...----.--,-- '" RMWC 52'12676-It;Mt;N'f;WI" 06130/04 ". 13OIe5--
A THE PROPRIETOR! X INCL RMWC 5212675 CA 06/30/04 06/30/05 EL DISEASE-POLICY LIMIT
C PARTNERSIEXECUTIVE EXCL RMWC 5212678 NV, OR 06/30/04 06/30/05 EL DISEASE-EACH EMPLOYEE $
OFFICERS ARE:
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLESlSPECIAL ITEMS
CERTIFICATE HOLDER IS ADDITIONAL INSURED (EXCEPT ON WORK COMP) AS RESPECTS OPERATIONS OF THE NAMED INSURED TO THE
EXTENT AND LIMITS REQUIRED BY CONTRACT.
CITY OF CLEARWATER, FLORIDA
ATTN: PAM AKIN, CITY ATTORNEY
112 S. OSCEOLA AVENUE
CLEARWATER, FL 34618-4748
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL ---30 DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Steven Becker
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