CERTIFICATE OF INSURANCE (6)
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CERTIFICATE OF INSURANCE
CERTIFICATE DATE: 08/02/2001 CERTIFICATE NUMBER: 01-0HPR)
CERTIFICATE HOLDER: POLICYHOLDER:
City of Clearwater Suncoast Flying Services, Inc.
Gordie Wills, Aviation Manager (Loss Payees: Clearwater Airpark, Inc. and David King)
Clearwater Municipal Marina ' 1000 N, Hercules A venue
25 Causeway Boulevard Clearwater, FL 34625
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This is to certify that the following policy(s), subject to the terms, conditions, limitations and endorsements contained therein, and during their effective 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.
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Policy Type:
Insurance Company:
Policy Number:
Policy Period:
PROPERTY
The Travelers
KTJ630237T860-7-01
August 3, 2001 to August 3,2002
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 2% 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 VERBA TIM OF POL/CY CONDITIONS, L/MITA TIONS OR LANGUAGE; THE POL/CY(S) REPRESENTED
BY THIS CERTIFICATE ARE NOT AMENDED IN ANY WAY 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.; Clearwater Airpark, Inc.; David King and City of Clearwater in an
amount not to exceed the Insured Value.
NOTICE OF CANCELLATION: IN THE EVENT OF MATERIAL CHANGE OR CANCELLATION OF SAID POLlCY(S), THE COMPANY(S) SHALL ENDEAVOR
TO GIVE 30 DAYS WRITIEN NOTICE TO THE CERTIFICATE HOLDER WITH THE EXCEPTION OF A 10 DAY NOTICE FOR NON.PA YMENT OF PREMIUM,
Aviation Insurance Agency, Inc,
901 S.W. Martin Downs Boulevard ~~ ' _ () ^ _
P,Q. Box 2260 LA... ~ UJ/.. ~
Palm City, FL 34991
Telephone (561) 286-0626- Facsimile (561) 286-1108
Authorized Signature