REGULAR RENEWAL
Auto Club South Insurance Company
P.O. Box 33011
St. Petersburg, FL 33733-8011
1-800-884-4982
BFL 99.001 0201
0303055
5/18/02
FWOD DECLARATIONS PAGE
535 08701 FLD RGLR Renewal
General Property Form
Date of Issue
5/18/02
Insured
CRABBY BILLS
CLEARWATER BEACH RESTAURANT
1901 ULMER TON RD STE 750
CLEARWATER FL 33762-2326
Loan Number
CITY OF CLEARWATER
C/O RISH MANAGEMENT
PO BOX 4748
CLEARWATER FL 33758-4748
RECEIVED
MAY 2 2 i002
RISK MANAGEMENT
Insured Location (if other than above)
37 CAUSEWAY BLVD, CLEARWATER FL 33767
BuildingDescription Non-Res identia1
# of Floors Two Floors
Basement/Enclosure None
Community Name CLEARWATER,
Community # 125096
Community Rating 07 / 15%
Program Status Regular
Risk Zone A12
CITY OF
Condo Type N/ A
# of Units 0
Adjacent Grade 0
Elevation Difference 6-
Contents Location
BUILDING
CONTENTS
$220,000
$0
$5000
$0
$23,515.00
$.00
DEAR MORTGAGEE
The Reform Act of 1994 requires you to notify
the WYO company for this policy within SO days
of any changes in the servicer of this loan,
The above message applies only when there is
a mortgagee on the insured location,
ANNUAL SUBTOTAL:
DEDUCTIBLE CREDIT:
ICC PREMIUM:
COMMUNITY DISCOUNT:
EXPENSE CONSTANT:
$23,515.00
$4,468.00
$35.00
$2,862.00
$50.00
TOTAL WRITTEN PREMIUM:
FEDERAL POLICY SERVICE FEE:
$16,270.00
$30.00
TOTAL PREMIUM:
Premium paid by:
$16,300.00
Insured
Submit For Rate
This policy covers only one building, If you have more than one building on your property, please make sure they are all covered. See
III, Property Covered within your Flood policy for the NFIP definition of "building" or contact your agent. broker, or insurance company.
V(2l6fNAc 1. Cl~. CL~f(' .
This policy is issued by
AAA C.(!. ~ rrvJ\12.-' rJ (5
Copy Sent To: As indicated on back or additional pages, if anY'f<\.$Il-
00020000941011142310213800008
Lender