CERTIFICATE OF LIABILITY INSURANCE (6)
From Sarah Dietz To: Faxli4626957
Date: 7/21104 Time: 11 :29:02 AIv1
Page 1 01 1
!J~"<~~:.'.;:~i~:.::.........
MODUCER
K ....DA1i'~. "ii,
;~:! 0 7 21 04 j~~
A R OF INFORMATION
ONLY AND CONFI!RI NO RiGHTs UPON 1111 CElmFICAT!
tIOLDER. THIS CERTlFlCA1E DOES NOT AMl!ND, EXTEND 0Fl
AL TD 11IE COVERAGE AFFORDED BY THe POLICIES BELOW.
COMPANIES AFFORDING COVERAGI!
STAHL & ASSOCIATES
INSURANCE INC.
8200 SEMINOLE BLVD
SEMINOLE FL 33772
COMPANY
A
FIREMANS FUND INSURANCE CO
......
CRABBY BILL'S
C/O OFFICE OF
1901 ULMERTON
CLEARWATER
CLEARWATER BCH
LISA SMITHSON
ROAD STE 750
FL 33'762
COMPANY
B
COMPANY
C
OONPANY
D
ntl8 IS TO CEFmFY THAT THE PouaES OF N8UAANCE LISTED BELOW HAVE BEEN ISSUED TO tHE INSURED NAMED ABOVE FOR THE POUCY PERIOD
I~TED. N01WlTHSTANDING AN'I REQUIREMENT. TERM Ofl CONDl'l1ON OF ANY CON1'AACT OR OTHEA DOCUMENT WITH RESPECT TO WHICH 'THIS
CERnFlCATE MAY BE ISSUED OR MAY PERTAIN, ntE INSURANCE AFFORDED BY TIE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS.
EXCLUSIONS AND OONCITIONS OF SUCH Pa.IClE8. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS,
co
L1I1
TYPe OF ~
fICJUCY ........
1'OLIl:\' ........ ~ DNtAIIOII
DAft ~ DATI! tIIMIlDI\'Y)
......
lRM!IW.UAaII'Y MZX80830898
X ClOMMI!IICW. GENERAL UA8lUTY
CLAIMS MAIlE 00 OCCUI
OWNEII'S II CONTllACTOR'S PFIOT
GeNI!RAL AGGRI!GATE .2
PRODUCTS. COMPIOP AGG .2
PEASOrw. .. ADV INJURY .1
E!ACH OCCURFIIENOE .1
ME DAMAGE CMr .... 1I~) .
ME!) EXP (Any _ ~ .
000,000
000 000
000 000
000 000
100 000
5 000
AlII'OII..... UAaITY
NlV AUTO
AU. OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
N(lN.OWNED AUTOS
COMBINED SINGLe LIMIT .
BOCILY INJURY
(Pw~
.
BODILY INJURY
(Ptr IICClIdInt)
.
PROPI;RTY DAMME .
GARAGE IM8U1T
ANY AUTO
AUTO ONLY. EA ACCIDINT
OlHEFllHM AUTO ONLY:
EACH ACClCENT
AeGReaATI!!
EACH OCCURRENCE
AGGIAl!QAl'E
E~ LIAUJTY
UMBRELLA FOfW
01HEJllHAN UMM8.LA FO~
WGlKERS co.EIIIA'IION ..
IIIIII&.OYD.. UA8IUTY
1H! PROPRIETOR!
PARTNEA8IEXECUl1Ve
OFFlCllflS ARe:
011II!R
INCa.
EXCL
EL I!ACH ACCIDeNT
a Dl8EASe.POLICY LIMIT
EL 0l81!A8e-e.t. I!lliIPLOYEE
DaCIUI'nON 01" 0PIIIA1IONM.OCA~ ~
CERTIFICATE HOLDER IS LISTED AS AN ADDITIONAL INSURED LANDLORD
COVERED PREMISES: 37 CAUSEWAY BLVD, CLEARWATER FL 33767
FAX ATTN CATHERINE @ 462-6957
CITY OF CLEARWATER
MARINE DEPARTMENT
25 CAUSEWAY BLVD
CLEARWATER FL 33767
8HOUI.D iliff 01' 1..: MIOVI: DlI8CRIIUI ~ lIE CAt'""", -8 IIU'CIIlE 'lie
IXPIIAlION DATE ~. .,.. __ COIIPMY Wa&. ......VOA TO 11M.
~ DAve WRInU IIOIIaIl TO.... ~ ....... _ TO 'lIE......
IIUT PM.UfI& TO MAL 8Uc:tt tIIO'IICII .... ~ NO OIILDA",* OIl LIAIIUIT
OF AMY .... UfIOIII ..... OOIIJI: OR
~ ............A1IVE
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