CERTIFICATE OF INSURANCE (098)
8-4-86
t'
JUSTUS INSURANCE, INC.
P.O. BOX 23356
TAMPA, FLORIDA 33623
'.. >~'-'.
HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
o RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
XTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
('l
C)
COMPANIES AFFORDING COVERAGE
L_~_~ _ '.
INSURED
ACTION STAFFING, INC.
P.O. BOX 823
BRANDON, FLORIDA 34299-0823
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COMPANY D
LEITER
E
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS
DATE (MMlDOIYY) DATE (MM/OOIYY) EACH
OCCURRENCE
BODILY $ $
INJURY
PROPERTY $ $
DAMAGE
BI & PD $ $
COMBINED
PERSONAL INJURY $
BODilY
INJURY $
(PER PERSON)
BODilY
INJURY $
(PER ACCIDENT)
PROPERTY $
DAMAGE
BI & PD $
COMBINED
BI & PD $
COMBINED
07-29-86 07-29-87 (EACH ACCIDENT)
(DISEASE.POLlCY LIMIT)
(DISEASE.EACH EMPLOYE
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV, PASS.)
ALL OWNED AUTOS .(OTHER THAN)
PRIV, PASS.
HIRED AUTOS
NON,OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
94C431859CAA
OTHER
DE FENCE
DESCRIPTION OF OPERA TlONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
Location:
220 W. BRANDON BLVD.
BRANDON, FL 33511
CITY OF CLEARWATER
10 MISSOURI AVE.
CLEARWATER, FL
SOUTH
33518
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
PIRATIOIt<PATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE JUSTUS INSURANCE, INC.