CERTIFICATE OF INSURANCE (9)
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CERTIFICATE OJF I~NS~lJRilNCE
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CERTIFICATE DATE: 08/01/2003 CERTIFICATE NUMBER: 03-01(PR)
CERTIFICA TE HOLDER: POLICYHOLDER:
City of Clearwater
25 Causeway Boulevard
Clearwater, FL 33767
CleErwater Airpark, Ine, a'1.d Lavil King
1000 N, Hen;ules A'Ien,le
Clecrwater, ;,L 33765
This is to certiJY that the following policy(s), subject to the tenns, conditions,limitationsmd endorscrru:nts contained thcreil, and during their effective period, have been
issued by the company(s) indicated below. In the eveJt of material change or cancellation of said policy(sl, the corrpanj will en,jea"'Jr to notify the cenificatc holder, but
failure to do so shall impose no liability or obligation of any kind upon the 'Jndersigned 0: the C(,mp2ny~s) involve,:;,
Policy T)lle:
Insurance Company:
Policy ~umber:
Policy Period:
PROPERTY
The Travelers
KTJ630237T860-7 -02
August 3, 2003 to August 3, 2004
Location:
Clearwater Air Park, Clearwater, FL
Property Covered: Terminal Building, Insured Value $110,000
Maintenance Hangar, Insured Value $220,000
Shade Hangars, Insured Value $220,000
T-Hangan, Insured Value $297,000
Deductibles:
$1,000,00 Each and EveryLosil with the following ~xcep,jons: 6. dedudiblc (,f~~{, of. 1e total insured value is
applicable to losses caused by Wind, Wild DriYen~ain, Hail, r ci'Trado or H:micane
THE FOREGOING EVIDENCE OF COJ:ERAGE IS NOT VERBAIlM OF POllCY CONDJIIOlv"S, lIMITATIONS OS LAftUUlGE; THE POllCY(S) REPRESENTED
BY TlllS CERTIFICATE ARE NOT AMENDED IN ANT WAY 'JNLE5JS ~O ST..4.TED OV THIS CERTIFICATE.
ADDITIONAL AGREEMENTS:
Loss Payable
Payments for loss covered vnd,:r the Aircraft Physical D'L'1I2.ge ,;m'~rage will be made payable to
Clearwater Airpark, !nc,; Dlvic. King and City ofClear'Nater i.n an mIount not to exceed the
Insured Value,
NOTICE OF CANCELLATION: IN TIlE EVENT OF :MATERIAL CH...N(;E OR CANCIUATION OF SAID POlICYS), THE COMPMY(S) SHALL ENDEAVOR
TO GIVE 30 DAYS WRITTEN NOTICE TO TIlE CERTIFICATE HOLDER WIlli THE E: {CEJ'110N l)FA H DAY NOT[CE Felt NON,], A1 nvlENT OF PRElVllUM,
Aviation Insurance Agency, Inc.
901 S.W. Martin Downs Boulevard
P,O. Box 2260, Palm City, FL 34991
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www.avnms.com
Telephone (772) 286-0626 - Facsimile (772) 286-1108
Authu.r:zed ::';igri:~'-~ure