CERTIFICATE OF INSURANCE (11)
Auto Club South Insurance Company
P.O. Box 33011
St. Petersburg, FL 33733-8011
1-800-884-4982
BFL 99.001 0201
0303055
4/23/03
FLOOD DECLARATIONS PAGE
535 08701 FLD RGLR Renewal
General Property Form
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Date of Issue
4/23/03
Insured
CRABBY BILLS
CLEARWATER BEACH RESTAURANT
1901 ULMER TON RD STE 750
CLEARWATER FL 33762-2326
Loan Number
CITY OF CLEARWATER
C/O RISH MANAGEMENT
PO BOX 4748
CLEARWATER FL 33758-4748
Insured Location (if other than above)
37 CAUSEWAY BLVD, CLEARWATER FL 33767-2003
Building Description Non-Residential
#of Floors Two Floors
Basement/Enclosure None
Community Name CLEARWATER,
Community # 125096
Community R~ting 07 / 15%
Program Status Regular
Risk Zone A12
CITY OF
Condo Type N / A
# of Units 0
Adjacent Grade 0
Elevation Difference 6-
Contents Location
BUILDING
CONTENTS
$220,000
$0
$5000
$0
$23,819.00
$.00
----
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ANNUAL SUBTOTAL:
DEDUCTIBLE CREDIT:
ICC PREMIUM:
COMMUNITY DISCOUNT:
$23,819.00
$3,573.00
$35.00
$3,042.00
DEAR MORTGAGEE
The Reform Act of 1994 requires you to notify
the WYO company for this policy within 60 days
of any changes in the servicer of this loan.
The above message applies only when there is
a mortgagee on the insured location.
TOTAL WRITTEN PREMIUM:
FEDERAL POLICY SERVICE FEE:
$17,239.00
$30.00
TOTAL PREMIUM:
Premium paid by:
$17,269.00
Insured
Submit For Rate
This policy covers only one building. If you have more than one building on your property, please make sure they are all covered. See
III. Property Covered withinyour Flood policy for the NFIP definition of "building" or contact your agent, broker, or insurance company.
BFLG99.100 0503 0503
BFLD99.308 0601 0691
BFLD99.312 0503 0503
This policy is issued by
AAA
Copy Sent To: As indicated on back or additional pages, if any.
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00020000941011142310311300005
Lender
BFL 99.001 0201
0303055
4/23/03
09 4101114231 02
Agent (727)391-9791
STAHL AND ASSOCIATES INS INC
8200 SEMINOLE BLVD
SEMINOLE FL 33772
1st Mortgagee
CITY OF CLEARWATER
C/O RISH MANAGEMENT
PO BOX 4748
CLEARWATER FL 33758-4748
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APR 2 H 2003
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00020000941011142310311300005
Lender