CERTIFICATE OF INSURANCE (13)
OFFICIAL INSURANCE NOTIFICATIONS
Mortgagee/ Additional Insured Copy only
Please do not Disregard
DO NOT SEND or make checks Davable to ELIOS Inc
Page 1 of2
To Whom It May Concern:,
On behalf of ourdients, we hereby notify you otthe,JaJlowing
changes mentioned in the "Reason section" below in the
policies listing you as Loss Payee.
printmail@elios.us
14405- 285017 -1187
If you are a financial institution and wish to receive
these notifications electronically, please email us at
support@elios.us.
If you have rec:elvedtbis in error please contact ELIOS
at 925 973 0881x115
For all other policy questions: Please call the
insurance company listed below.
******************* 3-DIGIT 337
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758-4748
1..11...11.1...1.1.1.1..1..1..11...1.1..11..1..1..11..1.1.1..1
Sincerely,
Management at ELIOS, Inc.
May 16, 2005
Total Notifications With this Document:
PoliCy: 41-01114231'2005 Reason :FlootttnsUTalTClr'Remtmter~ExpiratioITBiII ,-
'M~7~gt~K~~~~~1'Fturea:" ,,, "'"""" """"""""" "'In~u~~~~'~~~~~'
PO BOX 4748 CLEARWATER BEACH RESTAURANT
CLEARWATER FL 33758 USA : PO BOX 99
: INDIAN ROCKS BEACH
m"':Tarrief' "
. AUTO CLUB SOUTH
Some pages might have been left intentionally blank. Please match
the No. of transactions printed an this page.
-- Potic;rEff: From':0513T/2004' PolicyEff: 10 '05/3'1/2005'
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'lnsiirance'Cclrrlpany-"'" ,
Flood Processing Center
PO BOX 2057
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Notes:
FL __3,~785
USA
: CLEARWATER BEACH
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, F1,., 337,67 , ,lJSA,
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--. STAHL & ASSOCIATES INS INC
8200 SEMINOLE BLVD
SEMINOLE
_-l~ -Ena~No~----
, Eria::Sf
Legal Desc:
Flood Zone.
FL
33772
USA
A12
Code:
Phone No .
8008914222
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Contents 0
Increased Building Coverage 242,000
Increased Content Coverage 0
DeductIble Clause1 5000 Deductible Clause2 0
Pavable To: AUTO CLUB SOUTH PO BOX 2057 Kalispell MT 59903
Due Ot:
05/31/2005
Policy Type: Flood Insurance
Premium Amount 19067.00
Increased Premium Amount: 20171.00
j':i2celVED
NAY 1 9 2005
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