COMPREHENSIVE GLASS POLICY # 50 41 68
NAMED INSURED
BL \lTI .
~_~.'__._~.__.C'.!____.__
-No. PG 51 85 62 'I COMPR~HENSIVE GLASS POLICY I
llR'E [lHll]; L:AsIIAl.ryrINSURANCE COMPANY':
Previous Policy
136 North Third Street
HAMILTUN, OHIO
--- ---. -. --, '''-,
RECEIVED
PG,_,.2~L,_~~:.!:___~?__~.
(A STOCK COMPANY)
MAR 7 1978
Item DECLARATIONS
~~-
I' j Address:
1 " I
I, 2. i Policy Period:
CITY CLERK
E. KNOUASE
Number & Street, Town, County,
State & lip Code
6~E~SO~~. T~lAiifsA~RoEDTK~EsTNEDT~~R~,DN From:
i i
.
---~-~t-;~Broker~ACK RANSOlI J\Gi!;NGY
Office Address P . O. BOX 331+)+
Town and State CLEARWATER, FLOR IDA
The glass is located at the above address,
unless otherwise stated herein:**
------"
Item Nu~rr le~~th W:~th
No. Plates Inches Inciles
lJescriptlon of Glass, lettering and Ornamentation; Position In Building. The glass
Is plain flat glass with ail edges set in frames, unless otherwise stated herein,
----sPECiFic--,..,1
LIMIT,
IF ANY
I
I
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j
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:.:1
pee" ,"M',> I
36.10., 'I
. I
6 . 4lt, i
i
REPRESENTATIVE:
1. 1+ 38 78 Fronts-Tempered
2. 26 76 Fronts- Tempered
26 76 fronts-Tempered
76 26 Door-Tempered
Tempered Glass less than _l..
'.
I" 4,1,'".',
0.19"'
1''U~'lki :j
) "'.'~ ~. "~
Territorial Multiplier
Balance of glass or lettering, if any
not insured hereunder
f4(:_~:,:':.:~'1-_i.
~~_'~~iF-i"~'.'/:t ::' 'jrl;\'\ j:~'hlUt
Endorsement numbers forming a part
of the policy on its effective date I SO 105 Annual Premium $
If this policy is written for a period of three years First Year $:+7 .
the net premium for three years shall be $ Payable Second Yeijr $ 1+7.
~. . The kind of business conduct;d~;h-e;; themgl;ss -I;-Ioc-;t-e-ci~; ------ ---------- ...--- _ -.-.-------- u . - - Third YeM - $.lj.7d- ----. :
__I (~"-_..lU.':':~":.":.~CC_U_"_~NCY LIST _""C". OCCUPANCY AFTER T"." ~O.".R"S~_"'_ ~"""~_'_~_ AC:!!'_1?~_~__;i~____ ___ _ _
}'ABSENCE OF AN ENTRY MEANS "NO FXCfPrION". ~~~ - -- -~- - - -.-----
CO~lIte:tJp.nCd_.J~€!PGh6, ~_-- J~;~-~y--J~-~~k'--n;l-~D(~~-;;l~ CJO~lr'm tOl:-'- -Fl~:~.
2-1...78/lh Agellt ,J.l
-:
FormG.73qob (Rev. of 8.1.58)
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/90/1- I /