CERTIFICATE OF INSURANCE (12)
,~___,,_.________, H
PA-lE(l.4M/PDlYY)
11/15/2004
THISCEAttF.CATEJS 'SSUEOAS A ERQFINFQRMATfON
ONLY AND CONFERS NO RIGtfTS ... '. N tHe CeRTIFICATE
HOLDER. THIS CERTIFICATE. DOES NOT AMEND, EXTEND OR
AL TERTHECOVERAGE AFFORDED ~y THEP04ICIES6ELOW.
COMPANIES AFFOROING!COVERAGE
COMPANY,
A ARCH SPECIALTY INSURANCE tQ.
C()V~fl~~J.;~+i'~i': Fl:;t~i,tm:!!;i'i:!re'!!;!'i l!~II'ff;li'!ff!t;l!!i!Et,l '; ~, "iD'l', ,.,' c" ':,l~i'i!;';;;!T>::"ul;!i:l{! l)sm:!!'!l!"'fl~lll!T;!!l,!c"'t'!%!!!'i'!,: . "j!!iii;'~:i
THIS. 1$ TO CERTIFYTHAT THEPOUCIESOFI EI.QWHAVE eEEN ISSUEO TO THE ;~URED NAMEOAfio~E FORTHE POLICY Pt:R100
IN01QATSD,NOTWITHSTANOINGtANY' F\EQUIFlSMl: NOITIONOF ANY CONTRACT OROTHEROOClJtvlENT WI1'kRESPEOT TOWHICHn-IlS
CERTIFICj\TE' '-4,WSEIS$UEDQR MAY PI;FlT!liN, AFFORDED. BY THE POLIC'ESDESG ',HEREIN IS SlISJECT TO ALL THE rEAMS.
Ej(CLUSIONSANDCONDITIONS OF SUCH POLicies, Ll OWN MAY HAVE BEEN REDUCED BY PAID MS,!
,
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A CORa..
PI'lOOUC€R
AVIATIONIN$URANCE AGENCY INc.
901$. W, M::IrtinDownsBIVd.
Palm City, PL 34990
INSUREO
Clearwater Airpark,. hid,
1000 N,Hurcules Avenue
Ch~::Irwater. FL33765
COMPANY
B
COMPANY
C
COMPANY
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CO
LTR
11/14/2004
I'OUCy a:fi€cnVE PoLIcY exPII\Ai'\\)N
DATE {MIIWDfYVI ClA'fE tMWPDffYI
UMITS
TYpE OFINSUflmCE
POLICY NUMBE!R
j
A
I GENERAL LIABILITY
COMME:RClALGENE,RALLIABIUTY
.CLAI/ilSMAOEDodCUA
OWNER'S a CONTf\ACfOl'l'S,PROT
X HKL
,
CAA000268PO
AQTQMQBILELIA81UTY
ANY !\UTO
ALL OWNED AUTOS
SCHSOIJLGClAUTOs
HIRE:O,AI./TOS
NON.QWNl;DAtlTOS
BODILY INJURV j
(Petpet$Qll) !
BOOILY,lNJUFlvl
(P6f~l I
PROPSFlTYClAMAsE
I
GARAGE UAIlIUTY
ANYAl.lrO
EXCESSUABIUTY
UMBRELLAFC/AM
OTHER THAN UMBRELLA FOAM
WORJ<.EA,s'.cOMI'ENSATIONANP
',-4f~t?,Lbye:.~s~:~tA~itrr-Y .
EACH OCCUAA CE
AGGREGATE
we STATU.\
ELEACHACCloEr.cr $
EL OISEASE , pOLICY LIMIT $
EL DIS.EASE- OYEE $
mEpAOPA.II:!TOfll INeL
PARTNERSlEXECUTIVE
OFFICERS ARE: EXCL
OTHE.R
HangatKeeper's Liability
A EachAlrcrafl
Each Loss
Deductible
,
I
CAA000268QOO
i
11/1412005
SlQO,OOO.
$500.000.
$2.500
11/14/2004
OESCRlPTIONOF OPl:MT10NSlLOCATlONSNEHICLESlSpeClAL IT!;,M$
~<< (~,;-
s
S
$
S
S
$
1.000.0PO.
1.000.000.
1.000,000.
500,000.
50,000.
1.000/S,OOO
EXCLUOED
s
s
EXCLUDED
s
EXCLVDED
S
EXCLUDED
EXCLUDED
EXCLUDED
EXCLUDED
C~RTi'FIC~'I~!H~~P~ij!~~;:;!*;ii::f"'"
City of Clearwater
25 Causeway Boulevard
Clearwater, FL33767-
8E . CANCELLED BEFORE THE
EXPIRATION .DATE THEREOF, THE ISSUING .0 ANY W1LLENOEAVORTO MAIL
_30_ DAYS WRmEN NOTtCETO THe CERlIFICAU HOLOER NAMEOTO THI: LeFT,
j
BUT FAILURE TO MAIL SUCH NOTI \lrl.IMI;'Ol'IE "iO OBUGATION O.R UABIUTY
OF ANY KINO UPON THE . SOltREPRESENTATlVes.
AUTHOR~eOREpRESENTATWe