MEMO WITH ATTACHED CERTIFICATE OF INSURANCE # HFP-TBA 628536
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Aviation Insurance Agency
INCORPORATED
Palm Beach (407) IIV4-2826
4440 P.G.A. Boulevard
Palm Beach Gardens, Florida 33410-6575
Facsimile (407) 626.19n
July 16, 1991
City of Clearwater
P.O. Box 4748
Clearwater. Florida 34618
Re: SutlcoastFlying Service. Inc.
Clearwater Executive Airport
Gentlemen:
We. have enclosed a Certificate of Insurance evidencing the
existence of Airport Liability Insurance coverages for the
captioned.
Also enclosed isa copy of the endorsement which includes
the City of Clearwater as an Additional Insured.
We trust you will find this in order. Please feel free to
contact us if you have any questions.
Sincerely,
AVIATION INSURANCE AGENCY
(v( /~ ()J~
.~ .
Mary D'A1auro
Encs.
cc: Suncoast Flying Service. Inc.
RECEIVED
J U L 2 2 1991
r CITY CLERK
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C.IlITIPICA~ DP IN.UAANC.
~: June 18, 1991
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DIIaIpIIw Sched....
med Insured
Suncoast Flying Service, Inc.
1000 Hercules Ave.
Clearwater, FL 34618
The Home Insurance Company
HFP-TBA
6-15-91
6-15-92
Airport
ress of Insured :
Company
cy Numb.-
ffective Date
ration Date
raft Covered
COVERAGES
LIMITS OF LIABILITY
B-Passenger Bodily Injury liability
$
$
$
$
each person
each occurrence
A-Bodily Injury liability,
Excluding Passengers
each person.
C-Property Damage liability
each occurrence
D-Single limit Bodily Injury and
Property Damage liability _eluding Passengers
$
each occurrence
."Each Occurrence" limit is "Each Person" limit times number of "Passenser Seats (excluding pilot)".
F-AII Risks While Not In Motion
$
$
less $
deductible
G-AlI Risks While In Motion
less $
deductible
s, if any, under Coverages F and G is payable as interest may appear to the Named Insured and
(Absence of an .,try means "no exception")
Bodily Injury liability
$ Not Covered
$ Not Covered
each person
each occurrence
Property Damage liability
$ Not Covered
each occurrence
Single limit Bodily Injury and Property Damage liability
$ 1,000,000
each occurrence
CertIficate is issued to:
City of Clearwater
P. O. Box 4748
Clearwater, FL 34618
with whom we agree, if possible. to noti~ 10 days before date of Cancelation if policy should be canceled.
but the Company shall not be liable in any way for failure to live such notice.
ndorswnenb Attac:hed-
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N) DITIONAl INSURED
(PREMISES LEASED TO THE NAMED INSURED)
IT IS AGREED THAT THE "PERSONS INSURED" PROVISION IS AMENDED TO INCLUDE AS
AN INSURED THE PERSON OR ORG~NIlATION DESIGNATED BElO~, BUT ONLY WITH
RESPECT TO LIABILITY ARISING om OF THE OWNERSHIP, MAINTENANCE OR USE Of
THAT PART OF THE PRE~ISES DESIGNATED BELOW LEASEt TO THE NAMED INSURED, AND
SUBJECT TO T~E fOLLOWING ADDITIONAL EXCLUSIONS:
THIS INSURANCE DOES NOT APPLY:
1. TO ANY OCCURRENCE WHICH TAKES PLACE AFTER THE NAMED INSURED CEASES TO
EE A TEN ,i,NT IN SAI D PREM ISES ;
2. TO STRUCTURAL ALTERATIONS, ~EW CONSTRUCTION CR DEMOLITION OPERATIONS
PER FOR ME t BY OR ON f.EHALF OF THE PERSON OR ORGA N IZATI ON DES I GNATEO
BELOW.
SCHEDULE
DESIGNATION CF PREMISES (PART LEASED TO THE NAMED INSURED)
Clearwater Air Park
Clearwater, FL
NAME OF PERSCN OR ORGANIZATION (ADDITIONAL INSURED)
City of Clearwater
P.O. Box 474S
Clearwater, FL 34618
The following intentionally left blank if issued at Inception
This endorsement effective
nI,~' Ii~q]
Attached to and forming part of policy
HFP-h}RC;~t\
Issuedto Suncoast Flyina Service, Inc.
All other terms and conditions remain unchanged.
END, NO,
8
Authorized Representative
AV-'
Date DGOGTW TW 07
07/03/91