CERTIFICATE OF LIABILITY INSURANCE (10)
ACDRDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
06/19/08
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Kansas, Inc. (Wichita) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
PO Box 2992 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Wichita, KS 67201
316267-9221 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Markel American Insurance Company
Clearwater Beach Seafood, Inc. INSURER B:
dba Crabby Bill's INSURER c.:
PO Box 99 INSURER D:
I Indian Rocks Beach, FL 33785 INSURER E:
Client#. 27616
CLEABEA
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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN, 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 REDUCED BY PAID CLAIMS.
NSR TYPE OF INSURANCE POLICY NUMBER Pgk!flr~';i~g~E p~~fJ/if&~~N LIMITS
LTR
A ~NERAL LIABILITY 8521 RS0043792 06/04/08 06/04/09 EACH OCCURRENCE $1 000 000
X- COM M ERCIAL GENERAL L1AB ILlTY FIRE DAMAGE (Anyone fire) $100000
- ~ CLAIMS MADE W OCCUR MED EXP (Anyone person) $
X- Liq Liability PERSONAL & ADV INJURY $1 000 000
_$1,000,000 GENERAL AGGREGATE $2 000 000
~'L AGGRErilE L1M IT APfilS PER: PRODUCTS -COMP/OP AGG $2 000 000
POLICY X ~~g;: X LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
- ALL OWNED AUTOS BODILY INJURY
(Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY
(Per accident) $
- NON-OWNED AUTOS
PROPERTY DAMAGE $
(Per accident)
RAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
OESS LIABILITY EACH OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
REef'" $
R DEDUCTIBLE ED $
RETENTION $ $
WORKERS COMPENSATION AND JUN 2 oj 2D DB IT~9.~T~W-" I IOJ~-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $
OFF CIAL RECORD E.L. DISEASE - EA EMPL OYEE $
.- S Al\ln EL DISEASE - POLICY LIMIT $
OTHER .. E SRVC. DEP1
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
Certificate Holder is Additional Insured (Landlord) as respects the referenced location:
Loc# 1 - 37 Causeway Blvd; Clearwater Beach, FL
CERTIFICATE HOLDER I I ADDmONAL INSURED' INSURER LETTER: CANCELLATION
SHOULD ANYOFTHEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEXPlRATlON
City of Clearwater Marine DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL30-DAYSWRlTTEN
Property NOTICE TOTHE CERTIFICATE HOLDER NAM EO TOTHE LEFT, BUT FAILURE TODOSOSHALL
25 Causeway Blvd IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITSAGENTS OR
Clearwater Beach, FL 33767 REPRESENTATIVES.
I A~~'}RE~RESENTATIVE
ACORD 25-5 (7/97)1 of 2
#S386245/M386242
EMT
@) ACORD CORPORATION 1988