CERTIFICATE OF LIABILITY INSURANCE (4)
MAR/05/200B/WED 09: 13 AM
Well-Fargo Ins Svs
FAX No. 727 799 (:117
P. 001
ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYI
3105106
PRODUCER 727-796-6666 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Wells Fargo Insurance Services ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Southeast, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
P.O. Box 31666
Tampa, FL 33631-3666 INSURERS AFFORDING COVERAGE
INSURED Alexandra of Clearwater Beach, INSURER A: ESSEX INS. co
Inc. dba Pier 60 Concessions INGURiiR iii; NCltiQnel Surety Corooratlon
P 0 BoX 3337 INSURER c:
,Clearwater FL 33767 INSURER D:
INSUREfI E;
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONOITION OF ANY CONT~CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ceRTIFICATE MAY aE ISSUED OR
MAY PEI\TAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEeN fll!DUCStl BY PAID ClAIMS.
J~';: TYPE OF INSURANCE POLICY NUMBER ~1fr'1U~t(,~ P8k'f.t,~~m~m~ LIMITS
A ~RAL LIABILITY 3CY9003 2/15/08 2/15109 EACH OCCURRI$lIlCe $ 1000000
..x 3MMERCIAL G6NERAL LIABILITY fiRE DAMAGE IAIlY one file) $ 100000
- eLAJ~S MADe [i] OCCUR M~ EXP (JIny on; Pl'l'$Onl . 5000
PERSONAl & ADV INJURY . 1000000
GENERAL AGGREGATE $ :<lODooOO
~'L AC3GREr9 LIMIT Af'n PER: PRODUcrS. COMPIOP AGG . 2000000
. POLICY ~ LOC
A ~TOMOBILE LIABIIJTV 3CY9003 ~ liJ~a.. r '1f~09 COII/IBINED SlNGL~ LIMIT
ll:aacddentl . 1000000
- ANY AUTO ~ i,.
- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS MAR 06 2008 (Pgr Pl'1WI11
-
..x.. HIRED AUTOS BODILY INJURY
8
A- NON-OwNED AU'l'OS IPer _idontl
... - _"".... .....~.... __ 0..... ..._ ...._ ___ __n .... .--....-.-.-........... ..__.__.._-,~ .....::....+f>feC ROS"N\m--- ..- ........ .,.----...-- . ---- -.-.. . --...-.. --.......-. - '.
l ' . PROPERTY DAMAGE .
CS D 1 (Pet acclden1l
GARAGE LIABILITY AUTO ONt V A fA ACCIDENT $
=1 ANY AUTO OTHER THAN EA ACe $
AUTO ONL V~ AOO .
B ID<CeSS L1ABlUTY BIND698658 :ZJ1 !SIOS 211 !l/09 EACI-l OCCURRENCE $ 1000.00
::KJ 'OCCUR" 0 ClAIMS MADE AGGREGATE $ 1000000
$ ..
~ DEDUCTIBLE 0 $
RETENTION . $
WORKERS COMPENSATION AND WC STATU- T IDJr.
EMPLOYERS' LIABILITY .
E.L. EACH ACCIDENT
E.L. DISEASE. EA EMPLOVEE $
E.L. OlseASE . POUCY UMIT . .
OTHIOIl
DESCRlPTIOIII O~ Ol>et'lA'J'IONS/LOCATIONSNEHICLES/ID<CLUSIONS ADDED BY ENDORSEMENTISPECIAl. PROVJelOlll5
RE: 10 PIER 80 DRIVE, CLEARWATER BEACH. FL 33767
RENTAL OF BEACH UMBRELLAS, CHAIRS a.. FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURED
AS RESPECTS GENERAL LIABILITY COVERAGE. FAX 462-6967
FLA STATUTE MANDATE$10 DAYS NOTICE OF CANe. FOR NONPAY OF PREMIUM'
CERTIFICATE HOLDER I X I AOOITIONAL IIIIGURJOD: INSURER LE'lTER, CANCELLATION
CITY OF CLEARWATER SHOUI.P ANY OF 'I'll!! ABO\II; DEGCRlBED POLlCIEB lIE CAI\ICaL~D BliFORE THE E~TION
DATE THEREOf, THE ISSUING INSUReR Will ENDEAVOR TO MAIL ~ DAYS WIIITTEN
25 CAUSEWAY BLVD. NOTICE TO THE CERTIFICATE HOLDllR NAMED TO THE LEFT. BlIT FAILURE TO DO $0 $HAU-
CLEARWATER, FL 33767 IMf'CGE 110 O!lUBATlON 0" LlABIUTY Of ANY KIIIID I,/POIII THE IIIIGUI\Ql. ITS AlJEIITS OR
REPRES~TI7ES. ^ .J"'\
, AUTr:;t:::! ~
ACORD 25-S {7/97l
47.71
@ ACORD CORPORATION 1988
MAR/05/200B/WED 09: 14 AM We J 1 - Fargo Ins Svs
FAX No. 727 799 [:117
P. 002
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ias) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certWtcata
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute II contract betwElen
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
"-0' ... ______.____...____...__.... ~ _......_._.._..__..._.__.~._.._.___.... .,.____ ____._..___._.. ..___,_..._..._____.. ..._...._ ._.__._ _._ ___....__..__..__....._.. ..__........_ _ ~...___. .._........ ._...._..._ .___.__
ACORD 25-$ (7197)