CATV - CABLE TELEVISION (59)
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THIS BINDER IS A TEMPORARY INSURANCE CONTRACT. SUBJECT TO THE CONDITIONS SHOWN O~HE REVERSE SIDE OF THIS FORM.
PRODUCER Wg~~O.Ext): 516-741-6282 COMPANY BINDER # 222
John L. Gwydir Company, Inc.
1 Old Country Road
Carle Place NY 11514
Libert Mutual Insurance Co.
EFFECTIVE
DATE TIME
EXPIRATION
DATE
01/27/95
12:01
X AM
PM
01/27/96
THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY
PER EXPIRING POLICY #:
DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY (Including Location)
All locations of the Named Insured where
Vision Cable of Pinellas, Inc. is
pro forming work
TYPE OF INSURANCE
PROPERTY CAUSES OF LOSS
BASIC 0 BROAD 0 SPEC
COVERAGE/FORMS
AMOUNT
DEDUCTIBLE
COINS %
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCUR
X OWNER'S & CONTRACTOR'S PROT
X Personal Injury End. #
End. #CG2 805 RETRO DATE FOR CLAIMS MADE:
AUTOMOBILE LIABILITY
GENERAL AGGREGATE
PRODUCTS - COM PlOP AGG
PERSONAL & ADV INJURY $ 2,000,000.
EACH OCCURRENCE $ 2,000,000.
FIRE DAMAGE (Anyone fire) $
$4,000,000.
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
MED EXP (Anyone person)
COMBINED SINGLE LIMIT
BODILY INJURY (Per person)
BODILY INJURY (Per accident)
PROPERTY DAMAGE
MEDICAL PAYMENTS
PERSONAL INJURY PROT
UNINSURED MOTORIST
AUTO PHYSICAL DAMAGE
DEDUCTIBLE
ALL VEHICLES
SCHEDULED VEHICLES
ACTUAL CASH VALUE
STATED AMOUNT
OTHER
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE
EACH OCCURRENCE
AGGREGATE
SELF-INSURED RETENTION
STATUTORY LIMITS
EACH ACCIDENT
DISEASE - POLICY LIMIT
COLLISION:
OTHER THAN COL:
GARAGE LIABILITY
ANY AUTO
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
RETRO DATE FOR CLAIMS MADE:
WORKER'S COMPENSATION
AND
EMPLOYER'S LIABILITY
SPECIAL
CONDITIONSI
OTHER
COVERAGES
DISEASE - EACH EMPLOYEE
All Locations of the Named Insured where Vision Cable of Pine1las, Inc.
is performing work.
Bill to: Vision Cable of Pinellas, Inc c/o John L.
of Pinellas, Inc.
L. Gwydir Co., Inc.
Country Road,
Carle Place, NY 11514
. . . . . . . . . . . . . . . . . . . . . . . . . . . . ! . . . . . . . . . . . . . . . . . . . . . . . . . . .
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CONDITIONS
This Company binds the kind(s) of insurance stipulated on the reverse side. The Insurance is subject to the
terms, conditions and limitations of the policy(ies) in current use by the Company.
This binder may be cancelled by the Insured by surrender of this binder or by written notice to the Company
stating when cancellation will be effective. This binder may be cancelled by the Company by notice to the
Insured in accordance with the policy conditions. This binder is cancelled when replaced by a policy. If this
binder is not replaced by a policy, the Company is entitled to charge a premium for the binder according to the
Rules and Rates in use by the Company.
Applicable in Delaware
The mortgagee or Obligee of any mortgage or other instrument given for the purpose of creating a lien on real
property shall accept as evidence of insurance a written binder issued by an authorized insurer or its agent if
the binder includes or is accompanied by: the name and address of the borrower; the name and address of the
lender as loss payee; a description of the insured real property; a provision that the binder may not be canceled
within the term of the binder unless the lender and the insured borrower receive written notice of the cancel-
lation at least ten (10) days prior to the cancellation; except in the case of a renewal of a policy subsequent to
the closing of the loan, a paid receipt of the full amount of the applicable premium, and the amount of
insurance coverage.
Chapter 21 Title 25 Paragraph 211 9
Applicable in Nevada
Any person who refuses to accept a binder which provides coverage of less than $1,000,000.00 when proof is
required: (A) Shall be fined not more than $500.00, and (B) is liable to the party presenting the binder as proof
of insurance for actual damages sustained therefrom.
"
.
02/01/95
I
John L. Gwydir Company, Inc.
1 Old Country Road
Carle Place NY 11514
516-741-6282
ME 0
Ms. Camille Motley
City of Clearwater
P.O. Box 4748
Clearwater FL 34618
RECEIVED
FEa 0 6 1995
CITY CLERK DEPT.
Enclosed is the corrected binder with the 1/27/96 expiraiton date.
Kathy E. Urban