CERTIFICATE OF INSURANCE
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QERTIFICATEOF1NSURANCE
ATL-001158673-02
PRODUCER
MARSH USA ING.
ATTN: TAHIRAH JOHNSON
3475 PIEDMONT ROAD, NE, SUITE 1200
FAX: 404-760-5663
A TLANT AOFFICE .CERTREQUEST@MARSH.COM
ATLANTA, GA 30305
04477 -CCE-MAST.-2006
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 DESCRIBEO HEREIN.
COMPANIES AFFORDING COVERAGE
COMPANY
A ACE FIRE UNDERWRITERS INSURANCE COMPANY
INSURED
Coca-Cola Enterprises Inc.
DBA SI. Petersburg Coca-Cola Bottling Company
Attn: Steve McBride
2950 Gandy Bridge Boulevard
SI. Petersburg, FL 33702
COMPANY
B ACE AMERICAN INSURANCE COMPANY
COMPANY
C N/A
COMPANY
D N/A
COVERAGES
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 POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MMIDD/YY) DATE (MMIDD/YY)
B GENERAL LIABILITY HDO G20587908 11/01/05 11/01/06 GENERAL AGGREGATE 1$_ 4,000,000
-------.-------....-- ._~--,--.,-_.-,---
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COM PlOP AGG 1$ 4,000,000
_~I CLAIMS MADE [K] OCCUR PERSONAL & ADV INJURY $ 1,000,000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 2,000,000
-~~_._--,-_._,---"--_.._--~-,_."----
FIRE DAMAGE (Anyone fire) $ 50,000
-----_._~
MED EXP (Anyone person) $ 5,000
B AUTOMOBILE LIABILITY ISA H07940270 11/01/05 11/01/06 $ 5,000,000
COMBINED SINGLE LIMIT
X ANY AUTO
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE 1$
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
[~ ANY AUTO OTHER THAN AUTO ONLY:
I-..J -------- EACH ACglDENT $
I I AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
R UMBRELLA FORM AGGREGATE $
, OTHER THAN UMBRELLA FORM $
A WORKERS COMPENSATION AND WLR C44335608 11/01/05 11/01/06 X I OJ~-
EMPLOYERS' LIABILITY ._-,--~
A SCF C4433561A (WI) 11/01/05 11/01/06 EL EACH ACCIDENT $ 1,000,000
THE PROPRIETOR! X INCL , EL DISEASE-POLICY LIMIT $ 1,000,000
r PARTNERSIEXECUllVE --.-- ._--~-- ----..,------ ----------------
OFFICERS ARE: EXCL EL DISEASE-EACH EMPLOYEE $ 1,000,000
OTHER
DESCRIPTION OF OPERATlONS/LOCATlONSNEHICUES/SPECIAL ITEMS
Re: Contract - City of Clearwater
City of Clearwater, its agents, officers, employees and volunteers are included as Additional Insureds (if required by contract) on the above General Liability
and Automobile Liability policies
CERTIFICATE HOLDER . CANCELLATION
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE Vv'ILL ENDEAVOR TO MAIL -3D DAYS WRITTEN NOTICE TO THE
City of Clearwater
Attn: Mark Goheen
P.O. Box 4748
Clearwater, FL 33756
CERTIFICATE HOLDER NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
L1ABIUTY OF ANY KIND UPON THE INSURER AFFORDING COVERAGE, ITS AGENTS OR REPRESENTATIVES, OR THE
ISSUER OF THIS CERTIFICATE.
MARSH USA INC.
BY: Walter Gilstrap
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