CERTIFICATE OF INSURANCE (6)
PRODUCER
DATE (MM/DDIYY)
07/31/96
THIS CERTlACATE IS ISSUED AS A MAnER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
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Northeast Underwriters, Inc.
POBox 7506
4790 1st Street North
St. Petersburg FL 33734-7506
INSURED
COMPANY
A
Commercial Union Ins Co
Clearwater Beach Seafoods &
Restaurant Inc
37-Causeway Boulevard
Clearwater FL 34630
COMPANY
B
COMPANY
C
co
LTR
TYPE OF INSURANCE
POUCY NUMBER
POUCY EFFECTIVE POUCY EXPIRATION UMITS
DATE (MM/DDIYY) DATE (MMJDDIYY)
05/31/96 05/31/97 GENERAL AGGREGATE 1,000,000
PRODUCTS - COMP/OP AGG 1,000,000
PERSONAL & ADV INJURY 1,000,000
EACH OCCURRENCE
FIRE DAMAGE (Anyone fire)
MED EXP (Anyone person)
COMBINED SINGLE LIMIT
BODILY INJURY $
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
AUTO ONLY - EA ACCIDENT
OTHER THAN AUTO ONLY: .-
EACH OCCURRENCE
AGGREGATE
$
$
$
05/31/96 05/31/97 BUILDING 2,256,000
PERSONAL PROPERTY 165,300
DEDUCTIBLE FOR EACH 1,000
A
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
X LIQUOR LIABILITY INCLUDED
AZR350878
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
\Rl IE @ \H
AU8 u 2
GARAGE LIABILITY
ANY AUTO
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
A PROPERTY COVERAGES
GLASS INCLUDED
INCL
EXCL
EXCESS LIABILITY
UMBRELLA FORM
--=~'---------_.
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
AZR350878
DESCRIPTION OF OPERATIONS/LOCATlONSlVEHICLES/SPECIAL ITEMS
FAX 462-6957 *54 7-31-96 ce
The City of Clearwater is named as an Additional Insured.
C~FlTlFIc.~;re~H()l:Q~j.;!;, ,::.
City Of Clearwater- Marine Department
Attention: Kathryn
25- Causeway Boulevard
Clearwater FL
ACORD~25:S~(1~S)f,.,."lil~iI!I~~j;;;:"i:"1:',. .
"h'-' ' " ..t"j:'_>H ,'t ",,;:- _, I' "---\n~1_~~..,,P:triK{;i;Jh~_. "1~"""
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EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
---...!!! DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON T PANY, ITS AGEN S 0 EPRE ATIVES.
AlTnIORl2ED REPR E
WM. Guy W
34630