LEASE AGREEMENT AND INSURANCE CERTIFICATES (2)
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LEASE AGREEMENT
lHIS LEASE AGREEMENT, made and entered into this Ld"y of ~ '
2001, by and between the CTIY OF CLEARWATER, FLORIDA a municipal corporation,
hereinafter referred to as "Lessor", and Daniel A. Beach, d/b/ a Harbor Barber and Beauty Styles,
25 Causeway Boulevard, Rooms 6 and 6A, Clearwater, Florida 33767, hereinafter referred to as
"Lessee" .
WITNESETH:
That in consideration of the covenants herein contained of the granting of this lease and the
sums paid and to be paid hereunder, the Lessor hereby leases to the Lessee and the Lessee hereby
leases from the Lessor according to the terms, conditions and covenants herein contained the
following described premises in the City of Clearwater, Pinellas County, Florida, to wit:
See attached Exhibit "A."
1HE P ARTlES HERETO HEREBY COVENANT AND AGREE AS FOLLOWS:
1. The term of this lease shall be for five (5) years beginning October 1, 2001, and ending
September 30, 2006. The Lessor retains the right to terminate this lease for any municipal need
consistent with the Lessor's charter, as well as failure to pay rent in atimely manner or change in use
of the property. In addition, Lessor may terminate this lease if the State of Florida or any of its
agencies or political subdivisions thereof acquire the demised property or any portion thereof for a
public purpose. This right of termination is in addition to the right of termination set out in
paragraph 14 of this Agreement.
2. The Lessee hereby covenants and agrees to pay rental thereof as follows:
a. To pay the total sum of $38,815.80 for the 60 month term of this lease,
that shall be paid in equal monthly payments of $646.93. Each monthly payment shall be due and
payable on the first day of the month, and shall be delinquent if not paid on or before the fifth day
of the month. Also, a Consumer Price Index (CPI) increase will be added to the montWy rent
payment on January 1st of each year of the lease.
b. Any amount due from Lessee to Lessor under this lease which is not paid
before the day the payment becomes delinquent shall bear interest at the rate determined by the City
Manager, plus a late charge ofTen Dollars ($10.00) to cover Lessor's expenses in collecting such
delinquency.
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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c. In addition to the fIrst month's rent of $646.93, which is due and payable on the
first day of the lease, the Lessee shall pay $87.22 in advance as a deposit to secure the faithful
performance of the Lessee's obligations hereunder. The Lessor may deduct from the deposit any
amount that might become due from the Lessee to the Lessor for damage to the premises or for any
reason or cause whatsoever except rent. At the end of the term of this lease, the deposit amount or
the balance thereof, if any, shall be credited to Lessee's last monthly rental payment.
3. The demised premises shall be used only for the purpose of conducting therein the
business of a barber and beauty shop.
4. The Lessee hereby covenants and agrees to make no unlawful, improper, or offensive use
of the leased premises. Lessee further covenants and agrees not to assign, mortgage, pledge,
hypothecate or sublet this lease or any of its right herein in whole or in part without the prior
written consent of Lessor. The consent of Lessor to any assignment, mortgaging, pledging,
hypothecating or subletting shall not constitute a waiver of the necessity for such consent to any
subsequent assignment, mortgage, pledging, hypothecating or subletting. If this lease is assigned, or
if the premises or any part thereof are sublet or occupied by anybody other than Lessee, Lessor may
collect rent from the assignee, sub-tenant or occupant, and apply the net amount collected to the
rent herein required, but no such occupancy or collection shall be deemed a waiver of this covenant,
or the acceptance of the assignee, sub-tenant or occupant as tenant, or a release of Lessee from the
further performance by Lessee of covenants on the part of Lessee herein contained. If at any time
during the term of this lease, any part or all of the corporate shares of Lessee shall be transferred by
sale, assignment, bequest, inheritance, operation of law or other disposition so as to result in a
change in the present effective voting control of Lessee by the person, persons or entity which
presently is the ultimate owner of a majority of such corporate shares on the date of this leases,
Lessee shall promptly notify Lessor in writing of such change. If the new owner is a private or
public corporation, Lessor shall promptly advise Lessee if it has any objections thereto andthe
reasons therefor. Lessor may terminate this lease anytime after such change in control by giving
Lessee ninety (90) days prior written notice of such termination, such notice to be provided within
thirty (30) days following the time period provided to Lessee. Lessee shall not permit any business
to be operated in or from the premises by any concessionaire or Licensee.
5. Lessee agrees that it will promptly pay all ad valorem real property taxes and personal
property taxes that may be assessed and filed against the demised property or the leasehold created
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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by this agreement, or both, during the term of this lease. Lessee further agrees that it will pay any
state sales tax due on the rental payment made by the Lessee to the Lessor and that it will pay all
other taxes and fees, including, but not limited to, occupational license, beverage license, and
permits relating the operation of the business conducted on the demised premises, which are
required by law. Nothing herein shall obligate Lessee to payor to reimburse Lessor for the payment
of assessments for permanent improvements, including but not limited to sidewalks, sewers, and
streets, that would benefit the demised premises.
6. The Lessee hereby covenants and agrees to pay all bills for electrical service to the
premises when due, to Florida Power Corporation. At no expense to the Lessee, the Lessor agrees
to furnish a refuse disposal location and a refuse disposal container located outside the demised
premises for the use of the Lessee.
7. The Lessee further covenants and agrees to operate the business authorized to be
conducted on the premises during the term of this lease, except for any period of time involved in
natural disasters, including governmental orders or requirements such as evacuation for humcane
preparations, and any time necessary to repair or replace any damage caused to the demised premises
by as natural disaster.
8. The Lessee assumes full responsibility for and covenants and agrees to save harmless and
indemnify the Lessor from any and all liability for damage to property and injury to persons resulting
from or in connection with the Lessee's use and occupancy of the demised premises under this lease.
In addition, during the term of the lease, Lessee shall at Lessee's expense obtain and maintain
insurance coverage conforming to the requirements in Exhibit "B" attached hereto.
9. If at any time during the term of this lease, the building or premises or any part, system or
component hereof (hereinafter, the "demised premises") shall be damaged or destroyed to the extent
that the Lessee cannot operate the business authorized to be conducted thereon, and the Lessor
determines that said demised premises can be restored by making appropriate repairs, the monthly
rent as provided for in paragraph 2a above shall abate until the demised premises have been restored
or until commencement of business by the Lessee, whichever is sooner.
If the demised premises shall be totally destroyed or so damaged as to render it practically useless
during the term of this lease, then and in that event, the Lessee or Lessor may terminate this lease as
of the date of such damage or upon thirty (30) days written notice to the other party to this lease.
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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(1) Terminate Lessee's right to possession under this lease and re-enter and
take possession of the premises, and re-Iet or attempt to re-Iet the premises on behalf of Lessee;
however, such re-Ietting or attempt to re-Iet shall only involve a prospective tenant capable of
providing comparable or better type service, at such rent and under such terms and conditions as
Lessor may deem best under the circumstances for the purpose of reducing Lessee's liability, and
Lessor shall not be deemed to have thereby accepted a surrender of the premises, and Lessee shall
remain liable for all rents and additional rents due under this lease and for all damages suffered by
Lessor because of Lessee's breach of any of the covenants of this lease. Said damages shall include,
but not be limited to, charges for removal and storage of Lessee's property, remodeling and repairs,
leasing, commissions and legal fees. In addition to its remedies hereunder, Lessor may accelerate all
fIxed rentals due under this lease, in which event the Lessee shall be liable for all past due rent,
accelerated rent and damages as described above; however, with respect to the accelerated rent,
Lessor shall receive only the present value of such accelerated rent. At any time during repossession
and re-Ietting pursuant to this subsection, Lessor may by delivering written notice to Lessee, elect to
exercise its option under the following subparagraph to accept a surrender of the premises,
terminate and cancel this lease, and retake possession and occupancy of the premise on behalf of
Lessor.
(2) Declare this lease to be terminated, whereupon the term hereby granted
and all rights, title and interest of Lessee in the premises shall end and Lessor may re-enter upon and
take possession of the premises. Such termination shall be without prejudice to Lessor's right to
collect from Lessee any rental or additional rental which has accrued prior to such termination
together with all damages, including, but not limited to, the damages specifIed in subparagraph (1) of
this paragraph which are suffered by Lessor because of Lessee's breach of any covenant under this
lease.
(3) Exercise any and all rights and privileges that Lessor may have under the
laws of the State of Florida and the United States of America.
11. The Lessee hereby covenants and agrees to keep and maintain the premises and fIXtures
located herein in good condition and repair during the term of this lease and any extension hereof,
and to return the premises to the Lessor upon the expiration of the term hereof in as good condition
as they now are, ordinary wear and tear and damage by the elements only excepted. No alteration or
improvements may be made to the premises without the written consent of the Lessor. Anyand all
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fixtures attached to the premises shall revert absolutely and become the property of the Lessor upon
the expiration of the term hereof; provided, however, that the Lessor at its option may require the
Lessee to remove all fixtures, partitions, racks, shelves or other improvements from the premises
upon the expiration of the term of the lease at the cost of the Lessee. Any damage to the premises
occasioned by said removal shall be repaired at the Lessee's expense.
12. The Lessee, at its own cost, may place only window, wall or canopy signs on the
demised premises, provided said signs are approved as to color, style and letter size by the
Harbormaster of the Lessor, and additionally conform to the sign ordinance of Lessor presently in
force or as may be amended from time to time during the term of the lease. No other signs shall be
placed or maintained by the Lessee on the premises. Any nonconforming sign now on the premises
shall be removed by the Lessee within 30 days of approval of the lease. The Lessee shall, upon
expiration or termination of the lease, completely remove any and all signs that have been placed on
the leased premises by the Lessee.
13. If at any time during the term of the lease the Lessee is authorized to make
improvements to the demised premises, Lessee agrees in such event to indemnify and save harmless
the Lessor as follows:
a. For any mechanic's lien which may be asserted as a claim against the leased
property; and
b. For faithful performance of the covenants contained in paragraph 11 above; and
c. To obtain from the contractor a good and sufficient performance and payment
bond signed by a reputable insurance company doing business in Florida, which bond shall be in an
amount equal to one hundred (100%) percent of the cost of construction of the contemplated
improvements to the demised premises, guaranteeing that the improvements will be completed and
that subcontractors, laborers and materialmen will be paid in accordance with the contract for the
nnprovements.
14. In the event of the acquisition of this property or any portion thereof by exercise of
proper authority, by any governmental agency other than Lessor, whether by eminent domain or
otherwise, it is understood and agreed that notification of the institution of such action shall be
promptly given Lessee, so the Lessee may intervene in such action as a party. Lessee agrees to
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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comply with the results of any such actions, and agrees to release and hold the lessor harmless from
any damages resulting thereof.
15. Lessor covenants and agrees that upon payment by Lessee of the rents herein provided,
and upon observance and performance by Lessee of all the covenants, terms and conditions
required of the Lessee by the lease, Lessee shall peaceably and quietly hold and enjoy the leased
premises for the term of the lease without hindrance or interruption by Lessor.
16. Notices hereunder shall be given only by registered or certified mail, and shall be
deemed given when the letter is deposited in the mail, postage and other charges. prepaid, addressed
to the party for whom intended at such party's address first herein specified or to such other address
as may be substituted therefor by proper notice hereunder. Lessor's notices shall be directed in care
of its Law Department at the above-cited address.
17. As required by Section 404.056(8), Florida Statutes, the Lessee shall take notice of the
following:
RADON GAS: Radon is a naturally occurring radioactive gas that, when it has accumulated
in a building in sufficient quantities, may present health risks to persons who are exposed to it over
time. Levels of radon that exceed federal and state guidelines have been found in buildings in
Florida. Additional information regarding radon and radon testing may be obtained from your
county public health unit.
18. The undersigned shall personally guarantee to Lessor the timely performance of all
covenants and provisions of this Lease Agreement, including, but not limited to the timely payment
of all rent due hereunder.
19. This lease agreement constitutes the entire contract between Lessor and Lessee
concerning the leasing of the premises and consideration thereof.
20. In the event either party seeks to enforce this agreement or interpret any provision
thereof by law, or through attorneys at law, each party agrees to pay for its own attorneys fees and
costs, and that jurisdiction shall be in a court of competent jurisdiction in Pinellas County, Florida.
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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IN WTINESS WHEREOF, the parties hereto have set their hands and seals this ~~ay
of~, 2001.
Brian!g"J-/M
CITY OF CLEARWATER, FLORIDA
By~~":IJ:
William B. Home, II
Interim City Manager
Countersigned:
Mayor-Commissioner
Approved as to form:
Attest:
~~
Assistant City Attorney
~~..~~.
Cyrr . E. Goudeau- '-
City Clerk
BY:_~O (). (kJ
Daniel A. Beach
d/b/ a Harbor Barber and Beauty Styles
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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Exhibit "A"
LEGAL DESCRIPTION
Rooms 6 and 6a, Clearwater Marina Building, located on Lots 11 and 12 of City Park Subdivision,
according to the map or plat thereof as recorded in Plat Book 23, page 37 of the public records of
Pinellas County, Florida.
Exhibit "B"
INSURANCE REQUIREMENTS
1. Liability Insurance. Lessee shall maintain:
a. Comprehensive General Liability insurance to include premises/operator liability and
electrical liability in an amount not less than $500,000 combined single limit Bodily Injruy
Liability and Property Damage Liability.
b. Comprehensive Plate Glass Insurance on a replacement cost basis covering loss or
damage by any means, except by fire, or war, whether declared or not, to the plate glass
windows in the demised premises.
c. Worker's Compensation Insurance applicable to its employees for statutory coverage
limits in compliance with Florida laws.
2. Additional Insurance. The City is to be specifically included as an additional insured on all
liability coverage described above.
3. Notice of Cancellation or Restriction - All policies of insurance must be endorsed to provide the
City with thirty- (30) day's notice of cancellation or restriction.
4. Certified Copies of Policies/Certificate of Insurance. Upon specific written request of the City,
the Lessee shall provide the Lessor with certified copies of all policies of insurance as required
above. In the absence of a specific written request, the Lessee shall provide the Lessor with
Certificates of Insurance showing the Lessee has, at all times, the insurance coverage required by the
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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Lease. Unless notice is given to Lessee otherwise, such Certificates of Insurance shall be provided
to the Harbormaster. The fIrst CertifIcate of Insurance required by the lease shall be provided to the
Harbormaster before occupancy of the demised premises by the Lessee.
Exhibit "C"
GUARANTY OF PAYMENT OF RENT UNDER LEASE AGREEMENT
Guaranty is made this L day of ~, 2001, by Daniel A. Beach of
Harbor Barber and Beauty Styles, City of CI~aqer, County of Pinellas, State of Florida, herein
referred to as "Personal Guarantors: being the owner respectively, of Harbor Barber and Beauty
Styles, herein referred to as "Obligor: to CITY OF CLEARWATER, CIO City Attorney, P.O. Box
4748, Clearwater, Florida 33758, herein referred to as "Obligee".
RECITALS
1. Obligee has leased premises at 25 Causeway Blvd. to Obligor, whose business address is 25
Causeway Blvd., City of Clearwater, County of Pinellas, State of Florida, for use by Obligor in
conducting its business of barber and beauty shop.
2. The lease is conditioned upon guarantors giving security for payment of rent thereunder in the
form of a personal guaranty.
SECTION ONE
STATEMENT OF GUARANTY
Guarantors guarantee payment of rent under the attached lease agreement pursuant to the
terms thereof. If obligor defaults in the payment of any installment of rent, guarantors shall pay the
amount of such installment within 30 days after receipt of notice of default and demand for
payment. Guarantor's liability hereunder shall not be affected by reason of any extension of time for
payment of any installment granted by obligee to obligor.
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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SECTION 1WO
DURATION
This guaranty shall not be revoked during the five year term of the lease. Thereafter, if the
lease is renewed on the same terms, this guaranty shall remain in force until receipt by obligee of
written notice of revocation from guarantors, or until terminated pursuant to section Three hereof.
Renewal of the lease on different terms shall, at the option of the guarantors, operate to terminate
this guaranty as of the end of the five year period.
SECTION TIIREE
LIMITATION OF LIABllJTY
The maximum amount recoverable by obligee from guarantors pursuant to this guarantee is
$38,815.80, which amount is equal to the total rent due during the initial five year term of the lease.
If the aggregate of payments made by guarantors hereunder reaches the above-mentioned amount,
this guaranty shall terminate immediately.
SECTION FOUR
WAIVER OF NOTICE OF ACCEPTANCE
Notice of acceptance of this guaranty is expressly waived.
IN WITNESS WHEREOF, guarantors have executed this guaranty at
the day and year first above written.
t1MJ Lt. ~
Witness
Guarantor - Daniel A. Beach
Harbor Barber and Beauty Styles Rooms 6 and 6a Lease
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ACORD...
CEfffffl
E OF LIABILITY IN~'~IlANCE ~;i~~i~~
FAX -(727) 536-9985 THIS CERTIFICATE rliSSuED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
i PRODUCER (727)530-0684
Jack Rice Insurance,
13080 S. Belcher Rd.
Largo, FL 33773
Inc.
INSURED Har r Bar er Ir Beauty Styes
25 Causeway Blvd.
Clearwater Beach, FL 34630
INSURER A:.
INSURER B:
INSURER C:
INSURER D:
INSURER E:
INSURERS AFFORDING COVERAGE
Valley Forge Insurance Co.
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.
II~": TYPE OF INSURANCE POLICY NUMBER ~~N LIMITS
~NERAL UABlLITY ~64104586 03/2~/2000 03/20/2003 EACH OCCURRENCE $ 1,000,00(l
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 100,00
1 CLAIMS MADE m OCCUR MED EXP (Any one person) $ 10,00
A PERSONAl & ADV INJURY $ 1,000,00
-
GENERAL AGGREGATE $ 2 000.00
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP~PAGG $ 2.000.000
-=, .nPRO- n
POLICY JECT LOC
~TOMOBlLE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
AlL OWNED AUTOS BOOIL Y INJURY
- $
SCHEDULED AUTOS (Par person)
>--
~ HIRED AUTOS BODILY INJURY
(Par accidenl) $
>-- NON-OWNED AUTOS
PROPERTY DAMAGE $
(Pat accident)
RGE UABlUTY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS UABlLITY EACH OCCURRENCE $
::J. OCCUR 0 CLAIMS MADE AGGREGATE $
$
=1 DEDUCTIBLE $
RETENTION S $
WORKERS COMPENSAnoN AND I TORY LIMITS I 10m-
EMPLOYERS' UABlLITY E.L EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYEE $
E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERAnoNSlLOCAnoN~ICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPEClAl PROVISIONS
e: 25 Causeway Bl vd., C earwater, FL
ertificate holder is Additional Insured with respects to General Liability only. {Landlord}
!CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPlRAnoN DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
JL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Clearwater BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLlGAnoN OR LIABILITY
25 Causeway Blvd OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Clearwater, FL 33767 AUTHORIZED REPRESENTATIVE dl7tv~
Sandi Vernacchio/FLN
COVERAGES
ACORD 2505 (7/97)
@ACORD CORPORATION 1988
PRODUCER (72 7) 5 30- 0684
Jack Rice Insurance,
13080 S. Belcher Rd.
largo, Fl 33773
Inc.
/
TE OF LIABILITY INSUIlANCE oo;;~~aD;~
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ACORQ.. CERTIFIC
FAX (727)536-9985
..
INSURERS AFFORDING COVERAGE
INSlRED Harbor Barber & Beauty Styl es
25 Causeway Blvd.
Clearwater Beach, Fl 34630
I NSUli'ER A
I NSUli'ER B
I NSUli'ER C
I NSUli'ER D
INSURER E
Valley Forge Insurance Co.
COVERAGES
THE POLICIES OF INSUR6.NCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING
/4N'( REQUIREMENT TERM OR CONDITION OF /4N'( CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VlA-tICH 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 SHOVlIN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
W~ TYPE OF INSURANCE ~OLICV H.JMBER DATE',i.t.lltiOiYVi r DATe 'MMJi)i'ltWi' LIMITS
GENERAL LIASILrTY 1164104586 03/20/2000 03/20/2003 EACH O:CURRENCE $ 1,000,00
X COMMERCIAL GEf\ER"-L JA3IL TY FIRE DI'MAGE (MY one fire) $ 100,00
I CLAIMS MADE [IJ OCCLR r-ED EX? (Any om person) $ 10,00
A PERSONAL & I'D\' INJURY $ 1,000,00
G"NERAL AGGREGATE $ 2,000,00
-
GENt. AGG~EGATE LIMIT ,APPLIES PER PRODUCTS. COMP/OP AGG $ 2,000,00
I. nPRO.. nLOC
PCLlCY JECT
AlJTOMOBLE LIASILITY C:lM31r-ED Slt~GLE LIMIT
~ (Ea <ccljert) $
ANY AUTO
f---
AL OWNED AUTOS BODIL Y IN.URY
I-- (Per )erson) $
SCHE)ULED AUTCS
I--
HIRED AUTCS BOOlL Y IN.URY
I-- (Per 3codent) $
NCN-OWNED AUTOS
I--
f-- PROPEPTY DI'MAGE $
(Per KOdent)
RGE LIABILITY AUTO ONL> . EA ACCI DENT $
~Y AUTO OTHER ""N EA ACC $
AUTOONL> AGG $
EXCESS LIASLITY EACH O:CURRENCE $
=:J OCCLR D CLA MS MADE AGGREGATE $
$
~. DEDLCTlBLE $
RETENTI ON S $
WORKERS COM~ENSATlON AND 1 T~hIMITS I IVER
EMPLOYERS' LIASIUTY
E LEACH ,>.CClD"N" $
E L DISEASE. EA EMPLOYEE $
E L DISEASE. POLICY L1I1i1T $
OTHER .
~ESCRJ~TlDN OF OPERATlONsn.OCATlONSNEHlCLESlEXCLUSlONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
e: 25 Causeway Blvd., Clearwater, Fl
rertificate holder is Additional Insured with respects to General liability only. {landlord}
CERTIFICATE HOLDER 1 T AODmONAL INSURED INSURER LETTER: CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE "THE
EXPIRATION DATE lllEREOF, THE ISSUING COMPANY WIll. ENDEAVOR TO MAlL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of Clearwater BUT FAl.URE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION DR LlABllfTY
25 Causeway Blvd OF AN'( KII'<<l UPON 'THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
C1 earwater, Fl 33767 AUTHORIZED REPRESEHTATNE d>>j V&~u4~
Sandi Vernacchio/FlN
ACORD 25-8 (7/97)
@lACORD CORPORA liON 1988
c>
~
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IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract ber....een
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.
..
ACORD 25-5 (7/97)
ACORa.. CERTIFICATE OF LIABILITY INSURANCE
(7T536-9985
Inc.
DATe (MMIDOIYY)
03/21/2000
THIS CERTIFICATE ISIUED AS A MATTER OF INFORMATION
ONLY AND CONFERS . RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTI ATE DOES NOT AMEND, EXTEND OR
AL TFR THE COVERAGE AFFORDED BY THE POUClES BELOW.
I'ROOUCER (727)530-0684
Jack Rice Insurance,
13080 S. Belcher Rd.
Largo, FL 33773
~ Ha r & Beauty Styes
25 Causeway Blvd.
Clearwater Beach, FL 34630
I~RA.
I~RB:
1NSlR:R c:
I~RD:
I~E:
INSURERS AFFORDING COVERAGE
Valley Forge Insurance Co.
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.
't1G TYPE OF INSURANCE POLICY NUMBER DATe DATe~ LMT8
GENERAL LIABLlTY 164104586 03/20/2000 03/20/2001 EAOi OC~E $ I, 000 , ()()(]
X COMMERCI)IL GEr-.ERAL LIABILITY RRE OAAIAGE (Any one fire) $ 100,()()(]
I CLAJMS MADE [!] occ~ t.ED EXP (Any one person) $ 10,()()(]
A PERSONAL & KJV INJURY $ 100??oo
- 2 , 000, ()()(]
GEr-.ERAl At:?I:ifIf.GA TE $
- 2 , 000 , ()()(]
GEN'L AGGREGATE L1Io1T APPliES PER PROOUCTS - COMPIOP AGG $
n POLICY n '1& n LOC
Al1l'OMOBlLE UASILITY COIo6I1ED SINGlE LIMIT
~ (Ea acodelt) $
NlY AUTO
~
)ILL ()WIlED AUTOS BOOL Y 1N.UlY
r-- (Per person) $
SC~DU.EO AUTOS
~
HRED AUTOS BOOLYIN.J.RY
f-- (P... accidelt) $
NON-OWr-.ED AUTOS
r--
- PROPERTY DAMAGE $
(Per accidelt)
GARAGE UABIUTY AUTO CH. y. EAACCIDENT $
~ NlY AUTO OnER ll-Wl EA ACC $
AUTO CH. Y AGG $
EXCESS l.IABLITY EAOi OCCl.llRENCE $
=:J OCCLR D CLAIMS MADE At:?I:ifIf.GATE $
$
=1 DEOUCllI3lE $
RETENTION $ $
WOIU<ERS COMPENSATlON N.:J I TORY LIMITS I IVER
EMPLOVERS' UASlLITY EL EAOi ACODENT $
EL DISEASE - EA EIwf'lOYEE $
E.L DISEASE - POliCY LIMIT $
0'1l4ER
DESCRIPTION OF OPERATlONS/LOCAllONSlVEHlCLE8lEXCLU8lON8 ADDED BY ENXloRSBENTISPEClAL PROYllIlON8
Re: 25 Causeway Blvd., Clearwater, FL
Certificate holder is Additional Insured with respects to General Liability only. (landlord)
CERTIFICATE HOLDER I I ADDmONAl. INSURED; INSUEt LETTCR: CANCELLATION
8HOt.U) N<< OF nE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE nE
EXl'fiATIOH DATe llEREOF, nE ISSWtG COIIPN<<WI.L ENDEAVOR TO MAL
~ DAYS WRITTEN NOT1CE TO nE CERTFlCATe HOLDER NAMED TO nE LEFT,
City of Clearwater BUT FAL~ TO MAL SUCH NOT1CE SHALL IMPOSE NO OBUGAllON OR UA8LITY
25 Causeway Blvd OF N<< KKlll'ON nE COMPN<<, ITS AGENTS OR REPRESENTATIVES.
Clearwater, FL 33767 AUTHORIZED REPREsefTATIVE ~*'.~
Yakima M. I( ina/FLN
ACORD 25-S (7/91)
CMCORD CORPORATION 1988
MAR-21-2000 15:38
TEU
10 )QEARWATER 1"m1~
PAGE: 002 R=100"
'"
I
I
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 certificate
holder in lieu of such endorsement(s).
DISClAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
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.
ACORD 25-8(7/97)
MAR-21-20B0 15:39
TEL)
ID)Q..EARWATER I"mI~
PAGE: 12103 R=1l21l21"
"'rgo
FL 33773
MAR 2 6 1997
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERA E AFFORDED BY THE POUCIES BELOW.
COMPANIES AFFORDING COVERAGE
PRODUCER
.lack IIlce Insurance, Inc.
13080 S Be'cller lid.
INSURED
COMPANY
A
Valley Forge Ins Co
Harbor "rber & Beauty Sty'es
25 Causeway B'vd.
Clearwater Beacll FL 34630
COMPANY
B
COMPANY
C
COMPANY
D
::;.j,ii"iiik\\\:m\:::::':f::\\:::mf:::::::~:~:~:\~:~~::~~:::ffff:\\\\:::::::::::f::::::'~::::f:\~::::f::fffm\::~::::f:\:::::::::ffff:\':::m:~:::~:::~'~:~'::\\::::::~:::::::\:f:::::\\::::::::'~:::fff::::':::::\~::::::::\mf':f':ff:\:::::f::f::\\\':L.........:....::::::::::::::::::::::::::;:::::::.:
THIS IS TO CERTIFY THAT 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 CONTAACT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
co
LTR
TYPE OF INSURANCE
POLICY NUMBER
POUCY EFFECTIVE POLICY EXPIRATION
DATE (MMJDDIYY) DATE (MMJDDIYY) LIMITS
--...".--,~
03/20/97 03/20/00 GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMPIOP AGG $ 2,000,000
PERSONAl.. & ADV INJURY $ 1,000,000
EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE (An one fire) $ 100,000
MED EXP (Anyone rson) $ 10,000
03/20/97 03/20/98 COMBINED SINGLE LIMIT $ 1,000,000
BODILY INJURY $
(Per person)
BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH OCCURRENCE
AGGREGATE
WC STATU-
EL DISEASE - POLICY LIMIT
EL DISEASE - EA EMPLOYEE
03/20/97 03/20/00 Aggregate 2,000,000
Each Occurrence 1,000,000
GENERAL LIABILllY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE [!] OCCUR
OWNER'S & CONlRACTOR'S PROT
B164104586
A
A AUTOMOBILE L1ABILllY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
X HIRED AUTOS
X NON-OWNED AUTOS
B164104586
GARAGE L1ABILllY
ANY AUTO
EXCESS L1ABILllY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' !JABILllY
THE PROPRIETOR!
PARlNERSJ8<ECUTIVE
OFFICERS ARE:
OTHER
Barbers Malpratice Liab
INCL
EXCL
A
B164101586
DESCRIPTION OF OPERATlONSj\.OCATlONSNEHICLESlSPE91AL ITEMS
Certificate holder IS named as AdditIonal Insured with respects to General
Liability only (Landlord)
]~iifiiiiiii1;_F.if:\\\::::::::'::::f:':\::':':'::f:'::ffffffff:\\:::f::::::f:\:::::,ttt:f::::::::::::m:::f:t:fff::f:t\t:f:::iliiitiiii.ff:\:f::f::ff:\::::\:ffff:\':\::::::::::::::':\:::f:m:\:::ff:\\\t\\\\\\\\::\mfm\::::::,:\\\\::::::\:::::::
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FALURE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILllY
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
REPRESEN~
:::f:_i\.:r';=,,:::.:.:.:.:.'.If:\~ffffff::::::f:\::::\:::f::f::::::f::::::m:::::::::m::~::::::m\\::::~~\\\::\\\::\t:f:~~~:::::@:m:m:::~:::~::~:::~:~:::::::::r;/::i'::::~:::)::,::{::::::::::::~:t&':~:::::::::::::::~:::::::::::::::;:::::\(:,;:;;:,::':\:::t:'::':"('.:AiiiliJ!;iiB~r::::i:::':\k:':':':':'::::::~~:::::::m::::
City of C'earwater
C'earwater Marina
25 Causeway Blvd.
C'earwater Beacll
FL
34630
03/1:1/:17
JACK RICH INS.
11,26
Q Page 2 of 2
nATF (lAM!fJl"lIWi
03/11117
T~IS CERnFICATE IS ISSUED AS A MAnER OF INFORMAll0N
ONL.Y AND CONFERS NO RIGHTS UPON THE CERnRCATE
~OLDER. '110111 CER11F1CATE DOES NOT AMEND, EXTEND DR
ALTER TllE COVERAGE AFFORDED BY THE POLlaES BELOW.
COMPANIES AFFORDING COVERAll!!!
F'ROlJUCER
J..1r "'.e '_ran.., Ine.
13080 S ..,.It., lid.
La".
1l. 33772
-I '";:-
INSURED
COMPANY
V.lle" Foree 'n. Co
THIS IS TO CERTIFY Ti-AT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE II\SUREO I\AMED ABOVE FOR THE POLICY PERIOD
INDICATED, NO"NITHSTA~IDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CO~TRACT 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 TERlvIS.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BE~ REDUCED BY PAID CLAIMS.
i I !
CO I TVIlE OF INSURA/olCE POLlCY NUMIER IPOlJCY EFFECTIVE IPOLICY EXPIRATO.I
L TR IDATE (W.OOJIIVI : DATE (I.lMI()DIYV)
SHOULD ANY OF 1ltE /I<BC'IE DfSCAIBED POLICIES BE CANCELLED BefORE 1ltE
EliI'lRATlON DATE 1MB'EOF. THE ISSUING COMPANY '/VLL 8'lDEAVOR TO "'AIL
~ DA\'S v.f1rnEN tlO11CE TO THE CEFlT1FICA11": HOLDER NAMED TO THE LEFT,
BUT FALUR; TO MAL ~ NOTICE SHALL IMPOSE NO OBlIGATCN OR U.6BllITY
OF lINY K~D ~ TliE CONPANY. ITS AGENTS OR _OENTATlIlES.
AUTHORIZED REPRESENTATIVE
V.Ir'IlI. ... Kine
H.rllor ..rll.r & B..uty Sty'..
25 Cau..",., .'INf.
B
Cle.rwate, "aoft F L 34830
COMPANY
C
COMPANY
D
A GEtoIEFlAL LI.'BLlTY
X COMMERCIAL GENERAL lIASllI"I
I a A~ MAIlF Iil oca IR
., I4f 0418.
02120187
02/J0/GO
02120187
02120188
A AUTO/O'lILE L1AS1L1TV 81.4f0418.
lINY AUTO
ALL O'MIIED AUTOS
SCHEDULED ~lJTOS
X H IR;D AUTOS
X I NON.(]WNFn AllTC~
GARAGE 1IA13111TV
A/oly AUTO
EllCESSLIABLITY
UMBREU.A FORM
OTHFR TliAN IIMRRRI A FORM
WORKI3'IS COMPENSATION AND
EMF'LOYERS' LIABILITY
lHE PROPRIErORI I
p~RrnERSiEXECUT1'IE INo.
OFFICEFlS ARE: ! EXCl
I OlHER
A , B.rb._ ".Ipr.tlc. 11.11 .,l4fOI...
I
03120187
03120100
IlESCllJPTION OF OP6'lt<T10t}SolOCA11ON!l!'IEHIClESS"Egu.L lTOMS
COrtlfica. "old.r I. named .. AddiIi...., Insared ."" ....pllOCs 10 a_aI
U.""'ty an'" (J.end'ardJ
C'1y 0' CI.a,.,ate,
C'ea,.,a"r IIerina
21 Cau..wa" B'vd.
C'_""."r ..1I01t
11
34.20
L1MIiS
, GEtoIEFlAL AGGREGA 11": $ 2,000,000
r---
: f'l;CtuCTS . COVIP<lP AGO $ 2,000,000
r
I ~ONAI ~ Anv INJ IRV '$ f ,000,000
, f ,000,000
I ElICH OCCURflENCE $
, mE DAMAGE (AnI 0"" Are) 1$ f 00,000
UEO i;XP (Ion,' cn~ pcl'OOn) 1$ fO,OOO
! COMBINED Sf.lGJ; LIMIT '$ f ,000,000
L I
: BODL v tUJRv I
; (Per penDf1) $
, BODILY NlJRY
I (p!:r ooc'dcrt,
i f'l;Cl'ERTV DAMAGE
~
I AUTC ONL V EA ACCIDENT
,
I ~ER THAN AL'TO ONLY:
$
1$
I $
'I a EACH ACCIDENT I $
a DISEASE POLICY L1M IT I $
a DISEJoSE . EA Ef,lPLOYEE $
....,r...,.
..olt Ocou.....no.
Z,OOO,OOO
f ,000,000