CERTIFICATE OF INSURANCE # AP 3383682-04
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JUL 2 3 1999
AIG AVIATION
CERTIFICATE OF INSURANCE
THIS IS TO CERTIFY TO: CITY OF CLEARWATER
P.O. BOX 4748
CLEARWATER, FL 33618-4748
THAT THE FOLLOWING POLlCY/IES OF INSURANCE HAVE BEEN ISSUED TO:
CLEARWATER AIRCRAFT, INC.
1000 NORTH HERCULES AVENUE
CLEARWATER, FL 34625
AIRPORT LIABILITY POLICY NO. AP 3383682-04
POLICY PERIOD: From JUNE 7, 1999 to JUNE 7, 2000
INSURANCE COMPANY NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA
Commercial General Liabilitv Coveraae
Limits of Insurance
General Aggregate Limit (other than Products/Completed Operations)
Products/Completed Operations Aggregate Limit
Personal and Advertising Injury Aggregate Limit
Each Occurrence Limit
Fire Damage Limit (anyone fire)
Medical Expense Limit (anyone person)
Hangarl<eeper's Liability Coverage
Each Aircraft Limit
Each Loss Limit
Deductible (each aircraft) $
$
$
$
$
$
$
NOT APPLICABLE
1,000,000.
1,000,000.
1,000,000.
50,000.
1,000.
$
$
100,000.
500,000.
1,000.
OTHER COVERAGES/CONDITIONS/REMARKS
Coverage is subject to Aviation Millenium Endorsement Form No. 69718.
THE CERTIFICATE HOLDER AS AN ADDITIONAL INSURED WITH RESPECT TO LIABILITY
COVERAGES, BUT ONLY AS RESPECTS OPERATIONS OF THE NAMED INSURED.
THE COMPANY AGREES TO PROVIDE THE CERTIFICATE HOLDER WITH THIRTY (30) (TEN (10) DAYS
IF FOR NON.PAYMENT OF PREMIUM) NOTICE OF CANCELLATION.
THIS CERTIFICATE CANCELS AND SUPERCEDES THE CERTIFICATE DATED 06/04/1999.
The Aviation Managers have made provision to give the certificate holder prompt notice of cancellation of any policy
above. But, the Aviation Managers assume no responsibility for failure to provide such notice. This certificate does
not chan e in an wa the actual covera es rovided b the olic lies s ecified above.
Certificate No.
267581-01
Date of Issue
JUNE 30, 1999 (I<rm)
AV309B (1/99)
C C " 61'1 G I R ( SJL
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(D)
AVIATI(j~ INSURANCE AGENtV, INC;:ateNo.
CERTIFICATE OF INSURANCE
99-01
This Certificate does not amend, ex~nd. pr otherwise alter tbe terms and conditions of the policies referred to herein.
t.;lT" f"\l: f\11: I\'OwlI'T'!:R
NAMED IN URED
LDER
Clearwater Aircraft, Inc.
1000 N. Hercules Avenue
Clearwater I Florida 34625
HARBOKMA:i I tH\) ur-t-I City of Clearwater
P. O. Box 4748
Clearwater, Florida 33618-4748
Type of Coverage
Insurance Company, Policy Number
and Policy Period
Limits of
Liability
Airport Premises Liability
National Union Fire Insurance Company
of Pittsburgh, P.A. through
AIG Aviation, Inc.
Bodily Injury and
Property Damage
Combined
AP 3383682-04
06/07/99 to 06/07/00
limit
$1.000,000
each occurrence
LOCA liON COVERED
Clearwater Airpark
Clearwater, Florida
and including all locations necessary and incidental
to the operations of the Named Insured
The Certificate Holder is included as an Additional Insured but solely as respects operations of the Named Insured.
CANCELLATION: Should any of the described policies be cancelled before the expiration date thereof, the issuing company will endeavor to mail
thirty (301 days written notice to the above named Certificate Holder, but failure to mail such notice shall impose no obligation
or liability of any kind upon the company.
Aviation Insurance Agency. Ioc.
P. O. Box 2260
Palm City. Florida 34991
Telephone (561) 286-0626 Facsimile (561) 286-1108
June 4. 1999
Date Issued