CERTIFICATE OF INSURANCE (066)
PRODUCER
~futual Ins. Agency @ Clea~!ater, Inc.
P. O. Box 1779
10 N. Missouri
Cleanvater, FL 33517
INSURED
Albert ii.Ross dba Albert's P1urnbblg
1456 Plateau Rd.
Clearwater, FL 33515
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
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
Auto Ckn&E eEl V E
SEP191985
CIlt CLERK
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
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PROOUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
12 20157327
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV PASS)
ALL OWNED AUTOS (OTHER THAN)
PRIV PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE L1ABI L1TY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
LIABILITY LIMITS IN THOUSANDS
EACH
OCCURRENCE
BODILY 300 $ 300
INJURY $
PROPERTY 50 50
DAMAGE $ $
BI & PD $ $
COMBINED
POLG! EFFECTIVE
OA TE I MMIOOIYY)
POLICY EXPIRATION
OA TE (MMIDOIYY)
9-1-85
9-1-86
PERSONAL INJURY $
BODILY
INJURY $
(PER PERSON)
BODILY
INJURY $
(PER ACCIDENT)
PROPERTY
DAMAGE $
BI & PD
COMBINED $
~~t:::;'ED $
STATUTORY
$
_u $
$
Plumbers Licensing Requirements
Pine1las County City Clerks Office
P. o. Box 4748
Clearwater, FL 33518
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE