CERTIFICATE OF INSURANCE
~~~~~~!:!~:..II~IIIIIIII':I.I~llil.I.I...IIIII'SSUE DATE2(~:~D;;~
PR UC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
F' h B I CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE
I S e r - r own, n C . ~ .. DOES NOT AMEND, !'XTEND OR ALTER THE COVERAGE AFFORDED BY THE
p, O. Box 711 h,f ;:-CE~ "V.. POLICIES BELOW,
Pensacola, Fl 32593-0~1'1L.. i ED COMPANIES AFFORDING COVERAGE
adm/lb
904-432-7474 F ES 25 1995
Bi Itmore Construction Co,
1055 Ponce Deleon Blvd.
Be II ea i r
t..,K DEPT.
Inc,
COMPANY A
LETTER U S FIRE INSURANCE CO
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY 0
LETTER
COMPANY E
LETTER
INSURED
~
Fl
34616
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICA TE MAYBE ISSUED OR MA Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CD
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MMlDD/YY) DATE (MMlDO/YV)
LIMITS
GENERAL LIABLITV
COMMERCIAL GENERAL LIABILITY
CLAIMS MADE D OCCUR.
DWNER'S & CONTAACTOR'S PROTo
GENERAL AGGREGATE ;
PROOUCTS-COMP/OP AGG. $
PERSONAL & ADV. INJURY $
EACH OCCURRENCE ;
FIRE DAMAGE (Anyone lire) ;
MEO. EXPENSE (An '"' arson ;
COMBINED SINGLE ;
LIMIT
80DlLY INJURY ;
(Per person)
BODILY INJURY ;
(Per accident)
PROPERTY DAMAGE ;
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
STATUTORY LIMITS
-EACH-ACCIDENt__ _______
DISEASE-POLICY LIMIT
DISEASE-EACH EMPLOYEE
_L~___
$
;
EXCESS LIABILITY
WORKER'S COMPENSATION
AND--
EMPLOYERS' LIABILITY
OTHER
A Bu i I de r 's R i s k
3210705063
1/01/95
1/01/96
IIAII R i skU
DESCRIPTION OF OPERATIONSILQCATIONSNEHIa..ES/SPECIAL ITEMS
Project:
Work, Maas Brothers Property, Clearwater I FL
Exist ing Structure/S1 ,500,000 Renovat ion Work
1 000 All Other Per i Is
City of Clearwater
ATTN: Bill Baker
Asst. City Manager
POBox 4748
Cle ter Fl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 D SWRITTENNOTICETOTHECERTlFICATEHOlDERNAMEDTOTHE
LEFT, BUT FA U E TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
lIABIL YOF N KINDUPO THE PANY, SA ENTS OR REPRESENTATIVES.
064701000