MEMO REGARDING LEASE AGREEMENT AND CERTIFICATES OF INSURANCE
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C I T Y
OF
}:_ IE
ARWATER
POST OFFICE BOX 4748
C LEA R W ATE R, F LOR I D A 3 4 6 1 8 - 4 7 4 8
February 22, 1989
BUR;E~E~7A~_~NS.!URANC!, I~J:;
ffl' ) I I (...) I r'. 1111 flr;.J t.. fl..)
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! ,Jl,?. 7~E~ 1989 ili
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Harbor View Beauty Styles
25 Causeway Blvd.
Clearwater, Fl. 34615
RE: Lease Agreement - Clearwater Marina
Dear Sir:
The above referenced lease agreement requires the lessee to maintain property
and casualty insurance with coverages as specified in the agreement, and to
provide the lessor with evidence of that insurance. The insurance certificate
on file with the Risk Management office of the City of Clearwater for this
lease has an expiration date of 3/21/89.
Please provide this office with an updated and valid insurance certificate of
insurance by March 31, 1989 or your lease agreement may be terminated.
If you have any questions concerning this matter, please feel free to contact
me.
Very truly yours,
~x~
Carole L. Greiner
Acting Risk Manager
cc: Bill Held, Harbcrmcster
~Burke-Lehman Insurance, Inc.
~ 2173 Coachman Road NE
Clearwater, Fl. 34625
MAR 6
198~
~.
3-:2-~7
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REC"!lVED
,._...:;.''''''\"T
(_~-i.;. .i
~='~"I-j::~R-K
"Equal Employment and Affirmative Action Employer"
/901/- ~6:
c. E' R it F I CAT E 0 FIN 5 U RAN C E ISSUE DATE (MMlDD/YYYY): 3/02/1'389
IPRODOCER--------------------------------l--j-----THIS-CERTlflCATE-iS-ISSUED-AS-A-MATTEliF-INFORMAT10N-ONLY-AND-CONFERS-NO..----i
IBurke-Lehman Ins. IYlc. - i RIGHTS UPON THE CERTIFICATE HOLDER. I TIS CERTIFICATE DOES NOT AMEND. I
12173 NE Coachman Rd. 1 EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . ,
1 Clearwater, Florida 34625 1-----------------------------------------------------------------------.------------;
1 I COMPANIES AFFORDING COVERAGE I
1--------------------------------------------1---------------------~-------------------------------------------------------------j
1 INSURED i COMPANY LETIE~ 'A: THE OHIO CASUALTY GROUP
IHarbor View Beauty Styles i COMPANY LETTER B:
125 Causeway Blvd. I COMPANY LETTER C:
I Clearwater' FL 34630 I COMPANY LETTER D:
! 1 COMPANY LETTER E:
i i I
1= COVERAGES ====================================================================================================================i
I THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY
I PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT
j TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAI~~ THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
I SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDITIONS Ut SUCH POLICIES. j
j--------------------------------------------------------------------------------------------------------------------------------1
ICO 1 TYPE OF INSURANCE POLICY NUMBER I POLICY ,POLICY EXPIR-j AL~ LIMITS IN THOUSANDS I
ILTRI iEFFECT. DATE; ATION DATE j I
I i I I MM/DD/YYYY j MM/DD/YYYY I I
1---1----------------------------------1---------------------------1------------1-------------1-----------------------------------1
1 [A] I GENERAL LIABILITY ! XBW50151632 1 3/20/1989 I 3/20/1990 i GENERAL AGGREGATE 1 $ 1. 000 i
IrX]COMMERCIAL GENERAL LIABILITY I I IPRODUCTS-COMP/OPS I ' I
L- j - "-CC~-__C ------.----1 - --_________ ---_1 L }lBGH~G!ITf--- i-1J/JOL-i
I I[X] [ ]claims made [X]occurrence I iPERS. & ADVERTISING I
! 1 I INJURY i $
I[ JOWNERS & CONTRACTORS PROTECTIVE I I i
1 I lEACH OCCURRENCE I $ 1,000
I[ ] I IFIRE DAMAGE (ANY ONE 1
I I I FIRE) I $ 50
I [ ] I : IMEDICAL EXPENSE (ANY
I I Iii j ONE PERSON) . $ I
;---j----------------------------------I---------------------------1------------1-------------1----------------------:-----------1
i[ ] I AUTOMOBILE LIABILITY I I I I CSL ' $ I
i ![] ANY AUTO I I i IBODILY INJURY I 1
1 I [ } ALL OWNED AUTOS 1 I i I (PER PERSON) ; $ i
1 1 [ ] SCHEDULED AUTOS I 1 I BODIL Y INJURY j ]
I I [ ] HIRED AUTOS 1 I I (PER ACCIDENT) i $
1 I [ ] NON-OWNED AUTOS I I,
I I[] GARAGE LIABILITY I IPROPERTY DAMAGE j $
I 1 [ ] I I I 1 I
i---i----------------------------------I---------------------------1------------1-------------1----------------------------------;
i[ j iEXCESS LIABILITY i I I EACH OCCURRENCE AGGREGATE i
I I [ ] i I:
I I [ ] OTHER THAN UMBRELLA FORM j I I $ $ I
1---1----------------------------------1---------------------------1------------1-------------1----------------------------------1
I [ ] I WORKERS' COMPENSATION Iii I STATUTORY i
I I AND I I $ (EACH ACCIDENT> i
I I EMPLOYERS' LIABILITY ; i $ !DISEASE-POLICY LIMm:
I I I 1 I j $ (DISEASE-EACH EMPLOY.) I
1---1-----------.-----------------------1---------------------------I------------I-------------j----------------------------------j
I [ J 1 OTHER 1 I I I
: 1 I 1 I
ill 1 1
1 I I I
j--------------------------------------------------------------------------------------------------------------------------------1
IDE5CRIPT10NS OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS I
1 i
I
I
1-
OLDER ============================ CANCELLATION =================================================================1
I SHOUlD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
City of Clearwater 1 EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
i P.O. &oK 4748 I 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
I Clearwater, Fl. 34618-4748 1 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIL-
I I ITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. :
I 1-------------------------------------------------------------------------------.- j
I : AUTHOR~EP~SENTATIVE 11 '--1L. --:t2 . L ~ :
-------------------------------------------------------- ~-------~~~------------------~
ACORD 25-5 (11/85) ACORD is a registered trademark of ACORD Corporation
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 COVERAGE AFFORDED BY THE POLICIES BELOW.
Burke-Lehman Insurance
2173 NE Coachman Rd.
Clearwater, Florida 3462
COMPANIES AFFORDING COVERAGE
Cleat"water
FL 34630
COMPANY A
LETTER THE OHIO CASUALTY GROUP
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
INSURED
Harbor View Beauty Styles
25 Causeway Blvd.
. .
THIS IS TO CERTIFY THAT 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 CONDI.
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
OA TE (MMlODIYY)
POLICY EXPIRA nON
DATE (MM/DDIYY)
LIABILITY LIMITS IN THOUSANDS
OCCD~~~NCE AGGREGATE
GENERAL LIABILITY
X COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
X PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
03/20/89
03/20/90
BODILY
INJURY
$
$
PROPERTY
DAMAGE
$
$
~6t~~ED $
1000 $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PP SS)
ALL OWNED AUTOS (OTHER THAN)
PRIV PASS.
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
PERSONAL INJURY $
BODILY
INJURY $
(PfR PfRSON)
BODILY
INJURY $
(PfR ACCIDENT)
PROPERTY
DAMAGE $
BI & PD
COMBINED $
EXCESS . LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
~6t~~ED $
WORKERS' COMPENSA nON
AND
EMPLOYERS' LIABILITY
STATUTORY
$
$
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE-EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS/LOCATlONSNEHICLES/SPECIAL ITEMS
11~1'
of Clearwatel'''
Box 4748
Clearwater, Fl.
34618-4748
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 COVERAGE AFFORDED BY THE POLICIES BELOW.
Burke-Lehman Insurance, Inc.
2173 NE Coachman Road
Clearwater, Florida 34625
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
Ohio Casualty
INSURED
Betty Perrino
DBAz Harbor View Beauty Styles
25 Causeway Blvd.
Clearwater, Florida 34630
r
.,
F
F
.
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r
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f
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
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 CONDI.
TIONS OF SUCH POLICIES.
TYPE OF INSURANCE
POLICY EFFECTM
OA IE (MMIOllIVY)
POLICY EXPIRA liON
OA IE (MMIOllIVY)
LIABILITY LIMITS IN THOUSANDS I:.
occQ~~~~~CE AGGREGATE t;
~~
POLICY NUMBER
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISES/OPERATIONS
UNDERGRDUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTs/COMPLETED OPERA nONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERlY DAMAGE
PERSONAL INJURY
XBW (89) 50151632
03-21-89
BODILY
INJURY
03-21-88
PROPERTY
DAMAGE
BI & PO
COMBINED
$
$
$
L
F'
$
$1,000 $ l,ooor~
lx
l]
k
,,:
t
"
~
[
~
r
['
('<
PERSONAL INJURY $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PISS.)
AlL DWNED AUTOS (OTHER THAN)
PRIV. PASS.
HIRED AUTOS .
NON-OWNED AUTOS
GARAGE lIABllIlY
mlY
INJURY $
(PER PERSON)
IllOtLY
I/WRY $
(PER ACCIOEtIl)
PROPERTY
DAMAGE $
BI & PO
COMBINED $
BI & PO $
COMBINED STATUTORY
$
$
$
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS~ COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
Glass
DESCRIPTION OF OPERA T10NSlLOCA T10NSNEHICLES/SPECIAL ITEMS
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City of Clearwater
P.O. Box 4748
Clearwater, Florida 34618
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$
(EACH ACCIDENT)
(DISEASE-PDlICY LIMIT)
(DISEASE-EACH EMPLOYEE) i-
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