CERTIFICATE OF INSURANCE (2)
PRODUCER
MARSH USA INC.
3475 PIEDMONT ROAD, NE, SUITE 1200
TELEPHONE: 404-995-3000
I FAX: 404.995.3333
A TLANT A, GA 30305
i, Attn: ATLANTA.CERTREQUEST@MARSH.COM FAX:
04477-CCE-MAST.-06-07
INSUltED
CERTIFICATE NUMBER
A TL-001158673-03
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.
COMPANIES AFFORDING COVERAGE
COMPANY
A ACE AMERICAN INSURANCE COMPANY
Coca-Cola Enterprises Inc.
DBA St. Petersburg Coca-Cola Bottling Company
Attn: Steve McBride
2950 Gandy Bridge Boulevard
St. Petersburg, FL 33702
COMPANY
B INDEMNITY INS CO OF N. AMERICA
COMPANY
C N/A
COMPANY
D N/A
l1HIS 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
RTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE
MITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE I POLICY EXPIRATION LIMITS
LTR DATE (MMIDDNY) ! DATE (MM/DDNY)
A HDOG2173309A 11/01/06 11/01/07 GENERAL AGGREGATE $ 4,000,000
- .
COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 4,000,000
CLAIMS MADE II] 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 (An one erson $ 5,000
A ISAH08226581 11/01/06 11/01/07 COMBINED SINGLE LIMIT $ 5,000,000
i
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
B WLR C4445886A 11/01/06 11/01/07 X
A SCF C44458871 (WI) 11/01/06 11/01/07
X INCL EL DISEASE-POLICY LIMIT
EXCL EL DISEASE-EACH EMPLOYEE $
DEse IPTlON OF OPERATIONS/LOCATIONSNEHICLESlSPECIAL ITEMS
REI: ontract - City of Clearwater
City f Clearwater, its agents, officers, employees and volunteers are included as Additional Insureds (if required by contract) on the above General liability
~nd utomobile Liability policies
City of Clearwater
Attn: Mark Goheen
P.O. Box 4748
Clearwater, FL 33756
SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCEllED BEFORE THE EXPIRATION DATE THEREOF,
THE INSURER AFFORDING COVERAGE Vlnll ENDEAVOR TO MAil ---3.Il 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: Walter Gilstrap
V~ .()~
MARSH USA INC.
3475 PIEDMONT ROAD, NE, SUITE 1200
TELEPHONE: 404-995-3000
FAX: 404.995.3333
ATLANTA, GA 30305
ATTN: ATLANTA.CERTREQUEST@MARSH.COM FAX
CITY OF CLEARWATER
ATTN: MARK GOHEEN
PO BOX 4748
CLEARWATER FL 33758-4748
1..11...11.1...1.1.1.1..1..1..11.111.1..11..1..1..11..1.1.1..1
001 090
M-001090
303
001090