CERTIFICATE OF LIABILITY INSURANCE (9)
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RPR-10-2008 11:03 FROM:DRYMRRKMRRINE
273602333
TO: 4626957
P.l
CERTIFICATE OF LIABILITY INSURANCE I UA.::,t~~
RCOUCERAND 1H1! NMlI!D INSUReD THIS CERllFICATE IS ISSUED AS It. MAT1'ER OF INFORMATION ONLY
lE.B.S. AND CONFERS NO RIGHTS UPON THE CER11FlCATE HOLDER. THIS
CERllFICATE DOES NOT AMEND, EXTEND, OR ALTER THE COVERAGE
8722 South Harrison Street AFFORDED BY THE POLICIES BELaN.
Sandy, U1ah 84010 INSURERS AFFORDING COVERAGE
NSURI!D INSURER A: TIle Prime 1.._ Syadla'" ...
IH&UIER B:
WDVejlU1l11lln, IlK>. N;URER C:
lNSI.ftERo,
25 Causeway Bd INSURER I!'
Cleanwler Bench. FL 33767 INSlA:R Fe
COVERAGES
THE POUCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLlCY INDICATED. NOTWITHSTANDING AN'(
REQUIREMENT, TERM OR CONDITION OF ANV CONTRACT OR' OTHER OOCUMEHI' WITH RESPECT TO WHICH THIS CERTFlCATE MAY Be ISSUED OR MAY
PERTAIN, THE INSURANCE AFFORCED BY THE POLICIES OISCRIBED HEREfIIIS S\&lECT TO ALL THE TERMS. EXCLUSIONS AND CC>>IDITIONS OF SUCH
POLICIES. AGGREGATE uurrs SHOWN MAY HAVE BEEN REDUCED BY PAl) ClAIMS.
~~ POUCY EFFEC1l\IE ~~~~
1YI'I! OF lNIURANCE POUCl'f NUMIIER DA,. UMITS
~lNIU'IY IW:H 0CCURANCl! 5500,000.00
- COMMERCIAL GENERAL lIAllLl1Y I'IRE DAMAGE 1Anv_ tiel N/A
C1.AIMS MAD!! 0 ~ SP08lM:n. OWI12.008 04.'0112.009 III!D I!XP tAnv_--.I N/A
~ Commereial L18bDlty IlI'RSOlW. _INJURY N/A
Manuleript Policy GENERAL AGGIlEG\'lt! SI.ooo.ooo.00
61=n~"""n: . COIolP.()P /lG sO.oo
"LIMITS SHOWN ARE -- SI00.ooo.00
~ I.NIU'IY THOSE IN EFFECf AS OF ~AOGREGA'lt!
- AN'fAuro POLICY INCEPTION" ~Y tIJURV
- ALL ONNEDAlITC6 !Per PenGftI
- SOIEDULED AUTOS ~YrwR't
- HIRED AlJI'OS lPer ACcIdInII
- N(lN.(lWNEO AUTOS """"'" I DAMAGE
l-~
_ ~I.RYMMUSCRlPTFORM ~ PERSC>>I
SCHEDlILE AUTO
- PER .-coceNl'
- G.K.L.L
- OlRPD IICCREGA'lI!
- O.oc
CARGO ............., lII\MAGl!
-
- ON HOOK
- CONTRACTUAL UABIUTY
L-- OIHER
EXCESS UAlllU1Y I:;..cH ClCCURANC&
EI ocaJR 0 Cl.Al1olS MADE I.r~TE
RE'lt!NTlCN S
UIITA1lON OF COIIERAGE FCR MIDl1IONAL INIURI!D
Liability Covcroge is only pnwided to !be AddltionallllSllRd with respecllO AccidcntsolberwiSe ClMfCd IIIIder me PoIiey/CovcrDgc eo_ wlw::rc !be Jnsunod is found dirccdy
liablc 1100 not wIu:nl the Additional Insured is found independendy negligent of the Insured.
llESCllIP'l1ClN DF OPERAllCNlLOCA'JIClNllNEHICLE AIIDED BYEIlIlClr IIr-mSPEOAL PRO\/IIION
CovCllIllC is limited 10 only inmred 8Illivilies or operaOOllS identified in the Policy. RcolaI. Pc:rsonaJ Waten:nlft &; Jel-8tis.. RcnraI- PmonaI Waren:raft 4 Jet-SkilL. Rcn18I-
BlUIIlrmboal BoalS., Rental- Kayaks.
.1ceRTtFI~.6TP HOLDER IIiiII ADDlll0NAL INSURED I I LOSS PAYEE
City of Clearwater . City MarIna S/olOUl.O JoNi 0;: THE AIlOIE CESCRIBED POlICIES BE CANCEU.l!D BEFORE THE EXPIRAllON
DATE lHEREOF'. 1HE lSllUNG INSURER WI.L ENDEA\IOOlO MAL ~AYS WflmEN
NO'JICE lOlHE CERTIFICATE HOlDER tWlEDlOlHE LEFT. BlJ\'FALURETO DOSO SHAlL
2S CaIlSCWllY Blvd IMPOSE NO 0IlLIGA'I\ON OR UAIlI.IIY 01' AH'i IQNO l.-clN 'lliE! INSURER. t'rs AGENTS OR
CJearwalI:r BeadI. FL 33767 REPRESENTAll\IES.
Catherine Yellin . ~:,,;-.C 6P..C. It..>
A&mIClRIEI
I
UDA-F-030 030CT2005
'"
RPR-10-2008 11:04 FROM:DRYMRRKMRRINE
273602333
TO: 46269S7
P.2
ADDITIONAL NAMED INSURED ENDORSEMENT
PAP.99-12
This Endorsement changes the tanns and conditions of the PoIiey Issued. Please read it carefully I
The following requirements govern coverage under the Policy and must be adhered to for coverage to be
provided to the Insured under the Policy. No activities conducted by the Insured are covered under the Policy
unless they are conducted in full compliance Y.4th all fA the requirements speclfied below and in the Policy. The
Insured must advise its employees, agents, contractors, and/or subcontractors of these requirements and
ensure that they also abide by them for coverage to be provided. The Insured agrees and understands that any
noncompliance vAth the follO\Mng specified requirements and/or the terms and conditions set forth In the Policy
will result in the denial of coverage under the Policy meaning the Insurer will not be obligated to indemnify or
defend you.
Policy Number: SP0804214
Insured: Wavejammerz, Inc.
Effective Date:
419/2008
Additional Named Insured: City of Clearwater - City Marina
Attention: Catherine Yellin
25 Causeway Blvd
Clearwater Beach, FL 33767
Generating an additional premium of: $0.00
The 'Who is a Insured" provision fA the Policy, for the limit purpose of liability arising from Your Work and
subject to all other terms and conditions of the PolIcy and this Endorsement, shall indude as an additional
Named Insured, the persons or organizations scheduled in this Endorsement.
The coverage provided by this Endorsement only extends to cover the Additional Named Insu~ for allegations
of liability based upon alleged, actionable COnduct of the Insured and only to the extent the Insured would have
been liable and coverage would have been afforded under the terms and conditions of this Policy had such
Claim been made against the Insured.
The Policy expressly provides that coverage is to be construed and enforced in accordance v.ftth the laws of the
State of Utah, and the Insured has consented to the jurisdiction of the courts of the State of Utah to hear and
decide diSputes constitution or relating to coverage issues.
Any Additional Named Insured is subject to all of the terms, provisions, conditions, exclusions, definitions.
limitations, representations, and Endorsements of the Policy issued to the Insured, the Policy. and all refated
documents providing coverage to the Insured.
A copy of the Insured Policy may be obtained from the Insured or by contacting the Insurer office in Sail lake
City, Utah. during nonnal business hours.
Endorsement No.: 2
~r!':~~
t
Jose E. Figueroa
DO02028
Surplus Unes Tax
Surplus Unes Fee
PAP-99-1217JUL2006
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