MEMO REGARDING CERTIFICATE OF INSURANCE AND CERTIFICATE OF INSURANCE
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
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
COMPANIES AFFORDING COVERAGE
Ohio Casualty
INSURED
Betty Perrino
DBA: Harbor View Beauty Styles
25 Causeway Blvd.
Clearwater, Florida 34630
. .
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 (MMlOOIYY)
POLICY EXPIRATION
OA TE (MMIDOIYY)
LIABILITY LIMITS IN THOUSANDS
OCCQ~~~NCE AGGREGATE
GENERAL LIABILITY
COMPREHENSIVE FORM
X PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PERSONAL INJURY
XBW (89) 50151632
03-21-88
03-21-89
BODILY
INJURY
$
$
PROPERl1'
DAMAGE
$
$
BI & PO
COMBINED
$1,000 $
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS (PRIV. PPSS)
ALL OWNED AUTOS (OTHER THAN)
PRIV. PASS.
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
PERSONAL INJURY $
BODILY
INJURY $
(PER PERSON)
BODILY
INJURY $
(PER ACCIDEN1)
PROPERl1'
DAMAGE $
BI & PO
COMBINED $
EXCESli LIAE\ILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
~6t~~ED $
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY
$
$
$
(EACH ACCIDENT)
(OISEASE.POLlCY LIMIT)
(OISEASE.EACH EMPLOYEE)
OTHER
Glass
DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESISPECIAL ITEMS
City of Clearwater
P.O. Box 4748
Clearwater, Florida 34618
10:
FROM:
COPIES:
SUBJECT:
DATE:
I
CITY OF CLEARWATER
Interdep(rtment Correspondence Sheet
William C. Held, Jr., Harbormaster
Elizabeth S. Haeseker, Assistant City
Cyndie Goudeau, City Clerk
Insurance Policy - Harbor Barber and Beauty Styles
March 31, 1987
I have received and reviewed the ins~rance policy for the Clearwater
Harbor Barber and Beauty Sales. This policy meets the requirements of
their lease agreement with the city. Expiration date is March 20, 1988.
WCH:mm
..
APR 2 198(
CITX C1EH.K