CERTIFICATE OF LIABILITY INSURANCE (6)
M..'ARSH
CERTIFICATE OF INSURANCE
CERTIFICATE NUMBER
CHI-001470699-01
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
PRODUCER
Marsh USA Inc.
701 Market Street, Suite 1100
St. Louis, MO 63101
Alln: Certificate Specialist
(t-;I
.
(314)342-7021
COMPANIES AFFORDING COVERAGE
OOOOO-ALL -ALL -05-06
COMPANY
A ST. PAUL FIRE & MARINE INSURANCE COMPANY
INSURED
Fi':lC~rl-jghtl LLC
'~,' .' :',S,i!W!)'fRC18tf
"lSU~ 'tW.
AlPharefta, GA 30005
COMPANY
B
COMPANY
C
COMPANY
D
supersedes ahd"replacessrjypreviquslyissqedcertificate forthepCllicy
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 'M-IICH 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
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DDIYY) DATE (MM/DDIYY)
LIMITS
A
AUTOMOBILE LIABILITY
GENERAL AGGREGATE "--$
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
$
COMBINED SINGLE LIMIT $
2,000;000
2,000,000
1,000,000
1,000,000
1,000,000
10,000
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE ~ OCCUR
OWNER'S & CONTRACTOR'S PROT
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
BODILY INJURY
(Per person)
$
BODILY INJURY
(Per accident)
$
PROPERTY DAMAGE $
EXCESS LIABILITY
AGGREGATE
EACH OCCURRENCE
EACH ACCIDENT $
$
$
$
$
GARAGE UABIUTY
ANY AUTO
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
UMBRELLA FORM
AGGREGATE
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
THER
INCL
EXCL
EL DISEASE-POLICY LIMIT
EL DISEASE-EACH EMPLOYEE
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Subject to all policy terms, conditions and exclusions, the City of Clearwater is incuded as additional insured on the above General Liability Policy ONLY as
required by written contract and as respects to building access license agreement.
CANCELLATION
.
!l29IAVN
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
City otj;f!e.fUII'l~ter, ,I
'~,' ,J,tt~,:W~,~,'~. ~iVision ofthe
'i'i'2'S.O$C6ola Avenue
Clearwater,Ft :Jg756
@~
!ft\~~@
~~
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE,ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Alfred A Peterfeso
~"",C?:,""'~"o~
VAUDASOF::04/28/06
CERTIFICATE NUMBER
CHI-001470699-03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE
POLICY. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE
AFFORDED BY THE POLICIES DESCRIBED HEREIN.
PRODUCER
Marsh USA Inc.
701 Market Street, Suite 1100
St. Louis, MO 63101
Attn: Certificate Specialist
,';:j,~
(314)342-7021
COMPANIES AFFORDING COVERAGE
COMPANY
A ST. PAUL FIRE & MARINE INSURANCE COMPANY
00000-ALL-ALL-06-07
INSURED
COMPANY
B
FiberLight, LLC
6230 Shiloh Road
Suite 210
Alpharetta, GA 30005
COMPANY
C
COMPANY
o
COVERAGES Ihj~cElrtifiCate super$ede~and replaces any previguslYTssuEld certificate forthepoliCy period
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 \NHICH 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.
,e6
LTR
. 'POLlCY'EFFECTIVE' 'POLICY EXPIRATlOfl'
DATE (MM/DDIYY) DATE (MM/DDIYY)
LIMITS
-~_._-----.~-,-,--- --- .--.--.-- ,--------,-,---
TYPE OF INSURANCE
POLICY NUMBER
A GENERAL LIABILITY TE01201819
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [K] OCCUR
OWNER'S & CONTRACTOR'S PROT
05/09/06
GENERAL AGGREGATE $
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY $
EACH OCCURRENCE $
FIRE DAMAGE (Anyone fire) $
$
COMBINED SINGLE LIMIT $
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
I TORY LIMITS
EL EACH ACCIDENT
EL DISEASE-POLICY LIMIT
EL DISEASE-EACH EMPLOYEE
05/09/07
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
.WORKERSCOMP!:NSATION AND
EMPLOYERS' LIABILITY
THE PROPRIETOR!
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
2,000,000
2,000,000
1,000,000
1,000,000
1,000,000
10,000
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
Re: Right of way - Franchise
Subject to all policy terms, conditions and exclusions, the City of Clearwater is incuded as additional insured on the above General Liability Policy ONLY as
required by written contract and as respects to building access license agreement.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF T11E POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
T11E INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL ----3D DAYS WRITTEN NOTICE TO THE
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
City of Clearwater
a political subdivision of the
State of Florida
112 S. Osceola Avenue
Clearwater, FL 33756
LIABILITY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Alfred A. Peterfeso
MM1(3/02)
~o..O~
VALID AS OF: 05/05/06