FLOOD POLICY DECLARATIONS ISSUED 06-07-2000 UNTIL 05-31-2001
G
FJOOD POLICY DECLARATIONS
06/07/2000 I
~TAWBA INSURANCE COMPANY
Columbia SC 29202
MORTGAGEE COpy
NO. 0130876900
58
RENEWAL
ISSUE DATE
6/07/2000
NAMED INSURED AND MAILING ADDRESS
CLEARWATER BEACH SEAFOOD &
RESTAURANT INC
37 CAUSEWAY BLVD
CLEARWATER FL 34630
FIRST MORTGAGEE NAME AND ADDRESS
CITY OF CLEARWATER
C/O RISK MANAGEMENT
PO BOX 4748
CLEARWATER FL 34618
POLICY TERM: 1 YEAR(S) INCEPTION: 5/31/2000 EXPIRATION: 5/31/2001
THESE DECLARATIONS ARE EFFECTIVE 5/31/2000 12:01 A.M. LOCAL TIME AT THE DESCRIBED LOCATION
COVERED BY TIllS POLICY LOCATED AT THE ABOVE MAILING ADDRESS, UNLESS OTHERWISE STATED BELOW.
RATING INFORMATION
CONSTRUCTION DATE: 01/01/1984
BUILDING DESCRIPTION: NON-RESIDENTIAL
NO. OF FLOORS: ~O
BASEMENT DESCRIPTION: NONE
CONTENTS LDCATION:N/A
COMMUNITY NAME:
COMMUNITY NO.:
PROGRAM STATUS:
CONDO TYPE:
CLEARWATER,
1250960000C
REGULAR
NOT A CONDO
CITY OF
COMMUNITY RATING:
RISK ZONE:
NO. OF UNITS:
ELEV ATEDBUll;DIN6:
08
A12
N/A
NO
LOWEST FLOOR ELEV ATON:
5.5
BASE FLOOD ELEVATION:
12.0 RATING ELEVATION:
-6
LIMITS OF
LIABILITY
BUILDING
CONTENTS
$220,000
NONE
DEDUCTIBLE
AMOUNTS
BUILDING
CONTENTS
$5,000
N/A
AMT. OF INS.
BASIC
RATE
OF INSURANCE IN FORCE FORBlJILDINg':~bcONTENTS
ADDITIONAL DEDUCTIBLE
PREMIUM AMT. OF INS. RATE PREMIUM BUYBACK/DISC.
TYPE OF
COVERAGE
TOTAL
PREMIUM
BUILDING
150,000 x 9.50 = $14,250
70,000 x 6.15 = $4,305 -$3,525.00 $15,030.00
CONTENTS
N/A
AGENT'S NAME AND ADDRESS
ALLEY REHBAUM & CAPES INC
2433 GULF TO BAY BLVD
PO BOX 4620
CLEARWATER FL 33758-4620
PREMIUM SUBTOTAL
COVERAGE D (ICC)
CRS DISCOUNT
EXPENSE CONSTANT
FEDERAL POLICY FEE
TOTAL PREMIUM
15,030.00
35.00
-1507.00
50.00
30.00
$13,638.00
ENDORSEMENTS:
END4:ICC
RECEIVED
JUN 1 L 2000
RISK MANAGEMENT
AGENCY NO,
S008287
PRODUCER NO,
AGENT PHONE NO,
(727) 797-5193
PAYOR
INSURED
COUNTERSIGNATURE