CERTIFICATE OF INSURANCE (069)
Nussear Insurance Agency
2380 Drew St., Suite #5
Clearwater, FL 33575
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
American Sweeping, Inc.
2290 Ranchette Drive
Pa~ Harbor, FL 33563
COMPANY A
LETTER Auto-Owners
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
INSURED
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.
TlONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
OATE (MM/DDIYY)
POLICY EXPIRATION
OATE (MM/OOIYY)
LIABILITY LIMITS IN THOUSANDS
EACH
OCCURRENCE
GENERAL LIABILITY
COMPREHENSIVE FORM
X PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
X PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
X INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
BODILY
INJURY
$
$
20185384
7-l-85
7-l-86
PROPERTY
DAMAGE
$
$
81 & PO
COM81NED
$ 500
$ 500
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS)
X ALL OWNED AUTOS (~~7JRpl~~N)
HIRED AUTOS
NON,OWNED AUTOS
GARAGE LIABILITY
20264593
7-l-85
7-1-86
PERSONAL INJURY $
BODILY
INJURY $ 500
(PER PERSON)
BODILY
INJURY $ 500
(PER ACCIDENT)
PROPERTY
DAMAGE $ 500
81 & PO
COMBINED $
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
~~t~~ED $
STATUTORY
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
$
$
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
City of Clearwater
lO South Missouri Ave.
Clearwater, FL 33518