CERTIFICATE OF INSURANCE (223)
Fisher-Brown,
P.O. Box 711
Pensacola, FL
ADM: s c
904-432-7474
INSURED
i))..:iiii!I':iD1:"'ijpxm:._.:':::\\tt..f)))I..:'II:'..'::::::''':..::''.:':''':'I'::(\I':':':'::@jJIi.likE'':':}(:);;:)((
""'i:.::::::::e:ii:~:::i:,:,:IL'..:i,:,::,,:::::i:iiii:::i:8ei:::::i::::!!i::,::::::\:,:,:;:::::::::;L::'::,:L:i::;:i.~il!it:::::i:!:::::::::::::i:!:::: 12/28/95
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONL Y 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
'i:':! At~ttlll."
.....................
'PRoDucER
Inc.
(i.E:CE!VCC;
32593-0711
.JAN Of: 1998
COMPANY
A
USF&G CO (PF)
R ...,.. '!" r T!' ~
L"".l.. i . .;
Bi Itmore Construction Co,
1055 Ponee DeLeon Blvd,
Belleair, FL 34616
CITY I'v1ANAGER
Inc.
COMPANY
B
U S FIRE INSURANCE CO
COMPANY
C
Riscor
THIS IS TO CERTIFY THA T THE POLICIES OF INSURANCE LISTED BELOW HA VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD ,
INDICA TED,NOTWITHST ANDING ANY REQUIREMENT, TERMOR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECTTO WHICH THIS
CERTIFICA TE MA Y BE 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,
co TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE (MM/DD/YY) DATE (MM/DD/YV) LIMITS
GENERAL LIABILITY GENERAL AGGREGATE $ 200000
A COMMERCIAL GENERAL LIABILITY 1MP30096805202 1/01/96 1/01/97 PRODUCTS.COMP/OP AGG $ 200000
CLAIMS MADE UU OCCUR PERSONAL & ADV INJURY $ 100000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE $ 100000
FIRE DAMAGE (Anyone fire) $ 5000
MED EXP (Anyone person) $ 500
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
D X ANY AUTO 1AB30072127802 1/01/96 1/01/97
ALL OWNED AUTOS BODIL Y INJURY $
SCHEDULED AUTOS (Per person)
X HIRED AUTOS BODILY INJURY $
X NON.OWNED AUTOS (Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGA TE $
EXCESS LIABILITY EACH OCCURRENCE $ 10000000
B X UMBRELLA FORM 5530331988 1/01/96 1/01/97 AGGREGA TE $ 20000000
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND STATUTORY LIMITS
- EMPI.OYER6'1.IABILITY
C 60921 1/01/96 1/01/97 EACH
THE PROPRIETORI INCL DISEASE. POLICY LIMIT
P ARTNERS/EXECUTlVE
OFFICERS ARE: EXCL DISEASE. EACH EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONSILOCATIONS/VEHICLES/SPECIAL ITEMS
RE: PARTIAL USE OF CITY OF CLEARWATER OWNED PROPERTY FOR TEMPORARY PARKING
:(cgijMf:'!dAti#H.gijpgi[::i}::(!!}:::i:!CARtJtijijAttQi\1
........................................................................................................................ .
..............................................................
..............................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.................................................................................
.................................................................................
.................................................................................
064701000
CITY OF CLEARWATER
ATTN: CITY MANAGER
POBOX 4748
CLEARWATER FL 34616
"....""""'"""L",,
.AOP.hl:)i~lmf$i.$) ."",.", ........::':':...:
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELl.ED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILl.Je>>~V,dRXt6 MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
}B1iY~HJWfAU(~~~~~Sl.1Y
:l9XX; IJIIIQKXIXOJKXK&CX:1ij[pA1(ji\lOOO~1iMi~ii'NiHl~~.
AUTHO I EPRESENTATIVE 064701000
...............................................
..............................................
...............................................
..............................................
:......::':::::::::::::::'........::,:,.::::,:~ m:~Ac6ip.::c6iPORATiQNd9.ji: i
............................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.............................................
............................................
.............................................