CERTIFICATE OF INSURANCE (5)
CERTIFIcATE OF INSURANCE
CERTIFICATE DATE: 08/01/2000 CERTIFICATE NUMBER: 00-01
CERTIFICATE HOLDER: POLICYHOLDER:
City of Clearwater
p, 0, Box 4748
Clearwater, FL 34618
Suncoast Flying Services, Inc.
(Loss Payees: Clearwater Airpark, Inc. and David King)
1000 N, Hercules Avenue
Clearwater, FL 34625
This is to certify that the following policy(s), subject to the terms, conditions, limitations and endorsements contained therein, and during their etTective period, have been
issued by the company(s) indicated below, In the event 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 Type:
Insurance Company:
Policy Number:
Policy Period:
PROPERTY INSURANCE
The Travelers
KTJ630237T860-7-00
August 3,2000 to August 3, 2001
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 of2% of the total insured value is
applicable to losses caused by Wind, Wind Driven Rain, Hail, Tornado or Hurricane
THE FOREGOING EVIDENCE OF COVERAGE IS NOT VERBATIM OF POLICY CONDITIONS, LIMIT A TJONS OR LANGUAGE; THE POL/CY(S) REPRESENTED
BY THIS CERTIFICATE ARE NOT AMENDED IN ANY WA Y UNLESS SO STATED ON THIS CERTIFICATE,
ADDITIONAL AGREEMENTS:
Loss Payable
Payments for loss covered under the Aircraft Physical Damage coverage will be made payable to
Suncoast Flying Services, Inc, and City of Clearwater in an amount not to exceed the Insured
Value,
RECEfVED RECE\VEO
~UG 031000
CITY CLERK DEPARTMEN1nSK MANAGEMENT
NOTICE OF CANCELLATION: IN THE EVENT Of MATERIAL CHANGE OR CANCELLATION OF SAID POLlCY(S). THE COMPANY(S) SHALL ENDEAVOR
TO GIVE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER WITH THE EXCEPTION OF A 10 DA Y NOTICE FOR NON.PA YMENT OF PREMIUM,
A viation Insurance Agency, Inc.
901 S,W, Martin Downs Boulevard
P,O, Box 2260
Palm City, FL 34991
Telephone (561) 286-0626 - Facsimile (561) 286-1108
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~Orized Signature
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