CERTIFICATE OF INSURANCE (7)
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, 7/30/2002 12:43
Aviation Insurance Agency, IDe
Mary D'alauro-'Catherine Yellin
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CERTIFICATE OF INSURANCE
CERTIFICATE DATE: 07/30/2002 CERTIFICATE NUMBER: 02-0l(PR)
CERTIFICA TE HOLDER: POLICYHOLDER:
Clearwater Allpark, Inc. and David King
1000N. Hercules Avenue
Clearwater, FL 33765
City of Clearwater
Attn: Catherine Yellin
25 Causeway Boulevard
Clearwater, FL 33767
This is to certify 1hat the following policy(s), subject to the tenns, conditions, limitations and endorsements contained therein, and during their effective period, have been
issued by the company(s) indicated below. In the evert of material change or cancellation of said policy(s), the company will endeavor to notify the certificate holder, but
failure to do so shall impose no liability or obligation of any kind upon the undersigned or the company(s) involved.
Policy T}-pe:
Insurance Company:
Policy ~umber:
Policy Period:
PROPERTY
The Travelers
KTJ 63023 7T860-7 -0 1
August 3, 2002 to August 3, 2003
Location:
Clearwater Air Park, Clearwater, FL
Property Covered: Terminal Building, Insured Value $100,000
Maintenance Hangar, Insured Value $200,000
Shade Hangars, Insured Value $200,000
T-Hangars, Insured Value $270,000
Deductibles:
$1,000,00 Each and Every Loss with the following exceptions: A deductible of 3% of the total insured value is
applicable to losses caused by Wind, Wind Driven Rain, Hail, Tornado or Hmricane
THE FOREGOING EVIDENCE OF COJlERAGE IS NaI' VERBATIM OF POLICY CONDIDONS, LIMITATIONS OR LANGUAGE; THE POLICY(S) REPRESENTED
BY THIS CER1TFICATlI ARE NaI' AMENDED IN ANY WAI UNLESS SO STATED ON THIS CER1TFICATE.
ADDITIONAL AGREEMENTS:
Loss Payable
Payments for loss covered under the Aircraft Physical Damage coverage will be made payable to
Clearwater Airpark, Inc.; David King and City of Clearwater in an amount not to exceed the
Insured Value.
NOTICE OF CANCELLATION: IN TIlE EVENT OF :MATERIAL CHANGE OR CANCELlATION OF SAID POUCY(S), TIlE COMPMY(S) SHAIL ENDEAVOR
TO GIVE 30 DAYS WRITTEN NOTICE TO TIlE CERTIFICATE HOWER wrrn TIlE EXCEPTION OF A 10 DA YNOTICE FOR NON-PAYMENT OF PREMIUM.
Aviation Insurance Agency, Inc.
901 S.W, Martin Downs Boulevard
P.O, Box 2260, Pahn City, FL 34991
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www.avnms.com
Telephone (772) 286-0626 - Facsimile (772) 286-1108
Authorized Signature
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(5612?61 HI~
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AvIation Insu'ance Agency, IDe 1ry
King
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-------CERTIFJCA r'_QFLN 11RA
~~i:::g1f~ ~~{tFiff]ilOOL-~t;;~fM~io :;E~~E
)'Jstm WIlber .' I I Slll,lC.'oa;;t F1Ylllg SVlces, Inc. SUllGOag
67~? 3rd Ave.nue N~~h I C~eaJ'~:uter All-par lne, and David Kill
St. .petersburg, FL 3.1/10 I I OOU N, Hercules I venue
J Clearwater. FL ,Bft>5
ThiSiSt~-certiiY~i~mh~t:;;ii~):;-ng p~;;;Y(;,-~~bJecl~lel'ms~r~, Ii i;;;'ri~ndorse~-;;ms c~ Ri;;dih-c~~in. ~;:;-d-l~~;;lg h ir effective p~ril1d, hm been
issued by the compan)'ls) indicated below, In the event of material change or c ncellalion of said policy(;), the company will endeavor t , tify the certUr:ate holder.lJur
failure ro de) so shall impose no liability 01' obligation of any kind upon the und 'signed or lhe COrTl[)Rny(S) invo ed,
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Inc
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Policy Type:
IIlSU"Huce Company:
Polky ^ulllber~
Policy Period:
A IRCR4.FT
i)ld RepubJie Inslirance Com].JliUY
UnassIgned
Clcwber 1. 20(i' to October I, 2002
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A 1] RiBKs Ground and FlIght J
DllductIbJes: Fixed Gear A ircraft I $25(-,00 Not In Motion,
Retractable Gear !~il ~raft - $250,00 NolIn Ivr
$] ,000,000 Each OCClU'rllllce / $] r,OOO Each Person
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As Repur(ed 1vJonlLly
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tion / $2,500,00 In ,~tiOJ1
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AIRC'RAFT C()VERED
Hf..:LL COVERAGE:
LIABILITY COVERAGE:
THE FOREGOING EVIDENCE Of'COVERAGE fSNOT bERBATl."'fOF PO
BY THIS C'ERffnCATE 411.E .VOT AMENDED I
CYCONDITjO.^,S, LIMITATI< NSOR L.4NG.IC1GE: llli. h' POL/Cyr:,') PFPSEiij'NTED
ANY w,4Y UJvLE'g~ SO STAT ON THIS CEJ/1U'IC4~Jj
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ADDITIONAL AGREID1.EJ\'TS:
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NOTI!;~=-Qf' CANC~LI,A.TION: IN TIlE EVI,l\T UF MATERIAL CHANG]] UR LA.\lCELLATIUN UF SA! }uUCYIS,', THE COM'tNY(S) S lli~;;;w :~~
[I} GIVE 30 DAYS WRITTEN NOTICE TO THE l'ERTIFH'ATE HULDER WITH 'tHE E',LEPTI,)N UF A I') DA Y NOTWE FOR NUN.PAYj' ,"T OF PRE\1!lIM,
AVlatlOll InSUlance A?,ency, Ille ; ~ rl I
,9<J~ S W. \..'Ia,tilIl D. l.'WIlS H,mlevdrd . ". ;: lJ, I'..,. I,
P,I), Bc>x 2261) 1 / I
Palm City. FL 34991 I '---' ~,.
T <1,pho;, I 561 ) 28 6."6'6 - ,.",imil, ,561 } 286.1 ](" ~_ -l-~ -_ n_.~~..~_ ...... ___ _ ~ _ _~~__ _:,',. 1________ J
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(56128611 U~
Aviation Insuranc~ Agency" Inc
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Mart I)'Alauro-+Uavi
King
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CERTIFICAIE_
F~ INS
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RAN
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CERTIFICATE DATE: II/omonl r' CERTIFICAT NUMBER: 0\-15,__,__
CERTIFICATE HOLDER~-'-"'-------- POLICYHOLD R:-----u----'m-: r---'---- '
h.liltin Wl!bt\l.. " . . S,uncoast Flymg S~rv' es, Inc,~ SUllcoast Ji~ht Seh()(\l. be:
6742 3rd Avenu~ NOlth llearwater AIrpark. 1 c, and David Kmg ~ I
Sl. Petersburg, FL 33710 1000 N, Hilrcules A v , ue I
i CI~arwater. FI. 3376 f
This-isto-t~;tlfY[hnt the foU'o;[ng poiicy<s), subject w;~t;ms. c-;;;dTti.:;;;;:-iimitaion, and e~~I;;~~me~;~.. c-~ll;;jn' d therein. arlCJ:'oiUrl;;,gtl;) , itf~~ij;,;e-r~~0d-:-ha~;;;;~;I'-'
l~sued by the companytslllIdlcated below, Ialhe ,event.ot matenal change or canCtflal10n Jfsmd P01ICY.<,L the co pany will endeavor to no !i the Cel'tltlcat,~ .1OltIer', but
tmiure [0 do so shallltllpose no Ita.blltt)' 0,1' Obllg. allOr.l ct ar,lY kmd lip or.' the l1nderSlg.~. ed <'r the company,s) Irlvetvt- n-.'
i:.~~c::~ih~ompany~-;~j~l~~~:~ :~~~~nce L~~I~P8~-1~--r---------'-, ------------- ;------
Policy ;-.( 1II11 bt'r: Unasslgn0cl I ~
Policy Per-loci: , October 1. 21)01 to October 1. 2002 I. .,1
PREMISES LIABILITY $l.OC{l,OCiO 1<t1ch OCCUlTellCe i I
PRODUCTS/CUlvIPLETED OPERATIONS $1,(100.000 ~ach Occurrence / Aggre te / $1 OU,OUU EaCh~IIson
HANGARKEE:?ERS LIABILITY $1 nn,liUU Eah Aircraft I $500,OO(J E, .h (.'ccunence J
J.)educllble -F).()('lI E,'ch ,md Every I I
THE FOREGOiNG EVIDENCE o.? CO. VER4.GE. IS ,1\,'OT VERBA, TIM OF POLl 'Y CONDITIONS. UkUTATIo. 's OR L.4NGU4GE. .. TH5.'..l'olIcrr.':> RE1RE,i~~'NTE[)
BY THIS CERlIFlCATE Al/.E SOT .4MENDED TN . J.J~4.Y [WIESS SO STATE ONTHlS CERTlFICATt-
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ADDITIONAL AGREE:VIEl\'TS: ~
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~9T.1c::.1!!()F_~C;!i;J.J.~n()fI!: IN TilE EVIiKT OF MATERIAL CBAN 'R OR CA)lCELLATION OF
TO GIVE 30 DAYS WRtTTEN NOTICE, TO THE CERTJFJCATE HOl.DER WIT THE EXCEPTION OF A [,) D,
A'Iiabon lnSl1l'i1IlCe,\geney, lnc,
901 S. W, vlal1ill Downs Boulevard
P Cl, Box 2260
Palm City, FL :14991
Telephone (561) 286-0626 -- Facsimile (561) 286-] 108
D PllLlCY(S). THE C<f.\lfANY(S) S!L:;:L E,N;::;:-:;)I:
Y NOTICE FOR NON-Pf'tJENT OF PRTfJUM,
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EFFECTNE DATE:
AIRPORT INS RANCE JINDER "
PHOENIX A VI nON MAN 'GERS r i
I October I, 200 I ill
j Suncoast Flying S rvices, Inc.; ~
Suncoast Flight S hool, Inc.;
I.' Clearwater Airpar , Inc. and Il:,.I'I',
David King J
1000 N. Hercules venue
Clearwater, FL 3 765
NAMED INSURED:
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AViation, I1,'surance Agency
INCOtPORATED
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And any location 'ecessary and inJi1ental
to the operations fthe Named Insj d.
f $1,000,000 Each ccurrence ~
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i $1,000 Each Pers n r:
I $5,000 Each Occ ence t
J $1,000,000 Each ccurrence / Ag1Jgate
j $ 100,000 Each :rson 11
I Estimated ReceiPf' : ij~
i Repairs & Servic , $300,q
I Parts Not Installe , $ 50,~".
! Sale of Fuel & Oi $192,Q ,0
' Sale of Used 1\irctaft If An~ J
j Sale of New Alrc~ft If Any; i
V ending ~ If An~,
1 $100,000 Each Aicraft I
f $500,000 Each Oqcurrence ~ i
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j Deductible:., ~ :
$1,000 Each and fvery Loss , )
Including any loc tion necessary a!J incidental
. to the operations f the Named InSf~' d.
i Excludes In-Flig t Coverage. In~ Ught means
I the time commen ing with the actlt I take-oJ]'
I run of the aircraft and continuing/hereaftel'
I until it has compkted its landing 1lQl.
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(CL W) Clearwate Air Park
Clearwater, FL
LOCA nON COVERED:
PREMISES LIABILITY:
PREMISES MEDICAL PAYMENTS:
PRODUCTS/COMPLETED OPERATIONS:
GROUND HANGARKEEPERS LIABILITY:
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1$1,000,000 Each Oc urrence III ..:';
1$ 100,000 Each Pe son t
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j$l,OOO,OOO Each OCfurrence !
1$ 100,000 Each PerSon ' 1
Icoverage excludes iructural alterati~,.,~S' new
,tconstruction and de olition. If cov~~e is
required, underwriti g information ~t be
Jprovided to the Undfrwriters for thei"" *eview
and premium rating'j ~ !
$50,000 Each occwfence I i
. United States of A$l rica, its territortt
or possessions, Can da or the ISland~" I
of the Bahamas (ex uding Cuba) Ii'
!Worldwide with restect to damages :' I
jbecause of bodily injury or propertyi: ;
: damage arising out ~, f a product whi ;
I was sold for use or qonsumption wit'i
I the territory describl' d above provide,~ the
1 original suit for suc .' damages is bro, ht
I' within such territor ( i,:
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see ttached list of
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$ 1,485.00 Premis s Liability ill
$ 7,714.00 Produc Liability 1 i
$ 2,200.00 Hangar eepers LiabilityJ",.1
1$ 121.00 Fire Le al Liability t
; $11,520.00 TOTA t I
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THIS BINDER IS SUBJECT TO THE TEoJS, CONDITIOJS, LIMIT A ~*)NS AND
EXCLUSIONS OF THE POLICY FORM ;fcuRRENT US* BY THE f i
UNDERWRITERS. I I :j I
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Aviation Insprance Agency ~ !
IN COR ORATED ~ i
AIRPORT INSU NeE BJ~DER
PHOENIX A VIA ION MANA~ERS
HOST LIQUOR LIABILITY:
$1,000,000 Each Oc urrence
$ 100,000 Each Pe son
NEGLIGENT INSTRUCTION LIABILITY:
~EPENDENTCONTRACTORS
LIABILITY:
FIRE LEGAL LIABILITY:
TERRITORY COVERED:
ADDITIONAL INSURED:
Date Recognition Exclusion Endorsement.
War Hi-Jackin and Other Perils Exclusion will e added to the ren wal
these exclusions)
ANNUAL PREMIUM:
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Explanation of ffect on POli~Y II
Effective October 1, 2001 this policy will not cover c aims caused by: j j
a) War, invasion, acts offoreign enemies, hostilitiel (whether war be de ared or not), ci 'l,war, .
rebellion, revolution, insurrection, martial law, ~ilitary or usurped po er or attempts, ;usurpatton of
power. ~ L!
b) Any hostile detonation of any weapon of war e loying atomic or n clear fission andf,.:'t fusion or
other like reaction or radioactive force or matter, , ' j I
c) Strikes, riots, civil commotion or labor disturbanfes. I j
d) Any act of one or more persons, whether or not ~ents of a sovereign ower, for pOlitiqa,~",;., , or terrorist
purposes and whether the loss or damage resulti therefrom is accid / tal or intention,'
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e) Any malicious act or act of sabotage. ~ i II
f) Confiscation, nationalization, seizure, restraint, tention, appropriati n, requisition, f<f. itle or use
by or ~nder the order of any government (wheth civil military or de acto ) or public Qrl ocal
authonty. 'i f i
g) Hi-jacking or a, ny unlawful seizure or wron~ful c~ntrol of the Aircraft, or crew in flight~dncluding any
attempt at such seizure or control) made byany rson or persons 0 bard the Aircraft ~ ting wittout
the consent of the Insured. , ) f
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Furthermore this policy does not cover claims arisin~ while the Aircraft is outside the cont:fJ of the
Insured by reason of any of the above perils. 1 !. .
The Aircraft shall be deemed to have been restored ti the control of the ured on the safJr~turn of the
Aircraft to the Insured at an airfield not excluded by eographicallimits 0 this policy, and~ntirely
suitable for the operation of the Aircraft (such safe r urn shall require tha the Aircraft be V,,'jked with the
engines shut down and under no duress).' 1
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