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<br />ISSUE DATE (MMIDDIYY)
<br />9/11/91 al
<br />
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
<br />CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
<br />DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
<br />POLICIES BELOW.
<br />
<br />COMPANIES AFFORDING COVERAGE
<br />
<br />At~t.lllt&
<br />
<br />c
<br />
<br />CERTIFICATE OF INSURANCE
<br />
<br />PRODUCER
<br />
<br />CRUMP E & S OF FLORIDA, INC.
<br />1211 Semoran Blvd., Suite 227
<br />Casselberry, Fl 32707
<br />
<br />COMPANY A
<br />LETTER
<br />
<br />Mt. Hawle Insurance
<br />
<br />f~~~NV B
<br />
<br />INSURED
<br />
<br />ALAN CHEMICAL, INC.
<br />3008 Orange Avenue
<br />Ft. Pierce, Fl 33450
<br />
<br />COMPANY C
<br />LETTER
<br />
<br />f~T~~~NY D
<br />
<br />f~~~NY E
<br />
<br />COVERAGES ' , , " ", " .'," ',.. . '>' , , ' , "'" _'.' " ,
<br />
<br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br />INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
<br />et:RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.
<br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,
<br />
<br />CO
<br />LTR
<br />
<br />POLICY NUMBER
<br />
<br />POLICY EFFECTIVE POLICY EXPIRATION
<br />DATE (MMIDDIYY) DATE (MM!DDIYY)
<br />
<br />TYPE OF INSURANCE
<br />
<br />A
<br />
<br />GENERAL LIABILITY
<br />
<br />COMPREHENS~EFORM
<br />
<br />PREMISES/OPERA TIONS
<br />UNDERGROUND
<br />EXPLOSION & COLLAPSE HAZARD
<br />PRODl:CTS!Cor~PLETED OPER,
<br />
<br />I BODIL Y INJURY OCC,
<br />BODIL Y INJURY AGG,
<br />PROPERTY D,AMAGE OCC,
<br />PROPERTY DAMAGE AGG, $
<br />
<br />
<br />5/12/91
<br />
<br />5/12/92
<br />
<br />BI & PO COMBiNED OCC, S 500 000.00
<br />BI & PC> COMBINED AGG, S 500 000.00
<br />PERSONAL INJURY AGG, I s 500 000.00
<br />
<br />MOL008038
<br />
<br />CONTRACTUAL
<br />INDEPE'mENT CGIHRACTORS
<br />BROAD FORM PROPERTY DAMAGE
<br />
<br />PERsor...':'.l INJURY
<br />
<br />SURPLUS LINES AGENT Frances l. 8ro In
<br />Lie, Il 0118267237 1211 Semoran 81'J,
<br />SUite 227 I
<br />Casselberry FL 32707 . 'I;
<br />
<br />PROD AGT Sid Banack Insurance
<br />I
<br />CITY Vp,.n 'Reach. Fl I
<br />" ....... I
<br />,.. I
<br />F1o"da Su'p1"s Ltr1cs L,w, Persons tns~r,
<br />cd ty Surplus Llr;,~~ Ca'ners do not have
<br />the protection of nc" Florida Insurance I
<br />- . , '1 he e'l::pnt of any rt ht of
<br />recovery tor the cbllgation ot any InSOIVlnt
<br />uni;(ens~d Insurer
<br />FILE 1/ 1001-91 3rd
<br />
<br />~2 y l? f7 3~/f '/9 A
<br />
<br />D:SEt,SE-PO,-,CY LIf,'.!T
<br />, EASE-~AC~ ErJPLCYEE I s
<br />
<br />AUTOMOBILE L1ABILlTV
<br />ANY AUTO
<br />
<br />BODILY It,JURY
<br />(Per person)
<br />
<br />All OWNED AUTOS I Prlv Pass. )
<br />ALL owr'~=D AUTOS 1 Ot~er Tha:"l l
<br />Pr.:v. Pass.
<br />
<br />I BODILY INJU=iY
<br />(Per acctoentj
<br />
<br />HIRED ,"'JTOS
<br />
<br />NOf>,j.OV~'~ED I-UiOS
<br />
<br />i PR:)PE=iTY DAI.~AGE
<br />I
<br />l =-rt'\:: v 't1JUcv &.
<br />I P~,3PEF'T\- OAt\"!,GE
<br />I COMei~,;ED
<br />: E.,A:~ OCCURPEr"CE
<br />f-----
<br />\'::"'3GP.::Cl..7::
<br />
<br />GARAGE :"';;',8JLiTY
<br />
<br />EXCESS LIABILITY
<br />
<br />UMBRE,-Lt.. FORI~
<br />
<br />OTHER 1~,t..r-..: UMBi=:ElLA FORt..~
<br />
<br />
<br />WORKER'S COMPENSATION
<br />
<br />! S"T t..:LiTOFY Uto'll,S
<br />
<br />AND
<br />
<br />EMPLOYERS' LIABILITY
<br />
<br />OTHER
<br />
<br />DESCRIPTION OF OPERA TlONS'LOCATIONSIVEHICLESISPECIAL ITEMS
<br />
<br />LIMITS
<br />
<br />s
<br />
<br />Is
<br />
<br />I
<br />
<br />Is
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<br />IS
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<br />
<br />CERT'FICATEJtOLOERi~...~~~f~\,_ '~;J,:..~",:~~~1;'::\~"~~~'::~' .~.2-. '.;,.~~~~~:'" I ~~l~1:'~~~CEltAnoN .~ "'~:';, . '~~1~~i..:'?,~~~~~~'~~i~~-ib~~f<..1..~~~...~~r.~:'>~ ~~"l~'~" .....:~>:.)_ ~l'~:, .~~!~;(:._
<br />
<br />CITY OF ZEPHYRHILLS BUILDING
<br />DEPARTMENT
<br />5335 8th St
<br />Attn: Roy Burnside
<br />Zephyrhills, Fl 33540
<br />
<br />SHOULD "",NY OF THE A30\'E DESCRIBED ?OLlCI"S BE CAr.;CELLED BEFORE ThE
<br />EXPIRATIOI'-,! DATE TH~REOF, THE !SSU!~\G COtAPA"':Y \\'ILL E~JDE.:"VOR TO
<br />MAIL _-1.0 DAYS VVC:l"T7Er..; i~f.)lt2E TO THE CEq"'IFtC';:E HOLDEq rJAr.~EJ TO THE
<br />LEFT EUT FAILUr:.E TO r;",A.=L SUCH NCTIC'E SH4L~ 'r'.~;::OSE ~'JO C1BllG.:OTION G=1
<br />
<br />LI.A.Bll1TY OF ..~t~y K!~":~ U:)ON THE (,;)t ~~." ',~
<br />
<br />AUl HORIZED qf pr1(S~!\j7 t.. rIVE
<br />
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