RENEWAL CERTFICATE FOR POLICY # 90-CF-3447-6
STAn "'.M
A
STATE FARM INSURANCE COMPANIES
. State Farm Fire and Casualty ctfnpany
P.O. Box 45061 .'
Jacksonville, FL 32232-5061
BUSINESS MISCELLANEOUS PROGRAM
AUG 02 1996 TO AUG 02 1997
~ . f.a~NEWAL CERTIFICATE
INSU.ANCI
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12 ..
11
10
9
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A-1214F55 F N
CITY OF CLEARWATER
ECONOMIC DEVELOPMENT
PO BOX 4748
CLEARWATER FL 34618-4748
Coverages and LImits
Section I
A Buildings
B Business Personal Property
C Loss of Income
Excluded
23 300
Actual Loss
8
7
6
5
4
3
2
1,
90-CF -344 7-6
TO BE PAID BY IfWURED
1..11..1..1.11.....111..1..1..11...1.11111..1..1..11..1...11.1
Deductlbles . Section I
Basic
Other deductibles may
apply - refer to policy
500
Insured: CARTER COMMUNICATIONS INC
Location: 25 CAUSEWAY BLVD RM 31,32
CLEARWATER BCH FL
Section II
L Business Liability
M Medical Payments
Gen Aggregate (Other than PCO)
Products-Completed Operations
(PCO Aggregate)
$300,000
5 000
600:000
600,000
Add Ins-II: CITY OF CLEARWATER
ECONOMIC DEVELOPMENT
Forms, Options, and Endorsements
Special Form 3
Amendatory Endorsement
Tree Debris Removal End
Policy Endorsement-Business
Advertising Injury Excl
Additional Insured
Personal Injury Exclusion
Glass Deductible Deletion End
Windstorm or Hail Exclusion
FP-6103
FE-6210.2
FE-6451
FE-6464
FE-6345
FE-6320
FE-6346
FE-6538.1C
FE-6331
Estimated Prem (See I)
FL EMPA Fund Surcharge
FL Trust Fund Surchg
Estimated Prem (See II)
Total Amount
$396.00
4.00
.45
$50.00
$450.45
Cov. A - Inflation Index: N/A
Cov. B - Consumer Price: 156.7
Audit period: Annual
Policy number 90-CF-3447-6 replaces 90-BP-7367-1.
"Tkvr~~~Iff4f~F'"
Agent BILL RUGGIE
Telephone (813) 443-0493
See reverse side for important information.
Please keep this part for your record.
Prepared AUG 07 1996
NOTICE TO POLlCYHOLDER:-., ...' ,> 1-'
For a comprehensive descri,pmJn-~f cov~rLes and forms, please refer to your policy. ' , ~ ,..~ - .-
Policy changes reque6ted before the "Date Prepared", which appear on this notice, are effective on the Renewal Date of this
policy unless otherwise indicated by a separate endorsement, binder, or amended declarations. Any coverage forms attached to
this notice are! also effective on the Renewal Date of this policy.
Policy changes requested after the "Date Prepared" will be sent to you as an amended declarations or as an endorsement to
your1'olicy. Billing for any additional premium for such changes will be maiied at a later date.
n, during the past year, you've acquired any valuable property items, made any improvements to insured property, or have any
questions about your insurance coverage, contact your State Farm agent.
Please keep this with your policy.
R,EICEIVED
NOV 14 1996
CITY CLERK DEPT.
: MOVED, PLEASE CONTACT YOUR AGENT.
A-1214F55 F
.,..
NOTE: DO NOTPA'
.. _. BEING PAID BY THE
CARTER COMMUNI'I~TIONS INC
: . 90-CF-3447-6 BUSINESS. Mise
THIS IS FOR INFC
Check here if ad
is indicated on b,
1000000
State Farm Insurance Companies
I FIRE REN C
0000
'LEASE CONTACT YOUR AGENT. IF THIS IS NOT
COMPLETE THE FOO!,-owIh1G.
8ured property, plea8e 8e,.Iour State Farm Agent.
t only 0 Location change I expect to be here
mge D Temporary change month8.
18
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ZIPIP08tal
Oounty
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Li8t below all other State Farro pollcie8 (II
on which prpmlum notlce8 8hould be 8en
(PLEASE Fl'lJNT)
Pol. No.
In8ured'8 Name
Pol. No.
In8ured'8 Name
Pol. No.
In8ured'8 Name
Pol. No.
In8ured'8 Name
New Re81dence Phone No. L_>
New BU81ne88 Phone No. (__ >