CERTIFICATE OF INSURANCE (7)
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DATE (MMIDD/YY)
PRODUCER
Poe & Brown, Inc.
P.O. Box 1229
Tampa, FL 33601-1229
226-1300
TfiS CERTIFlCA TE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFlCA TE HOLDER. TfiS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
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03/31/99
INSURED
COMPANY
A St. Paul Fire & Marine Ins Co
COMPANY
COMPANIES AFFORDING COVERAGE
Clearwater Golf Park, Inc.
1875 Airport Drive
Clearwater FL 33515
B
COMPANY
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COMPANY
D
TfiS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICA TED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WfiCH TfiS
CERTIFICATE MA Y BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MA Y HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFF, POLICY EXP.
LTR LIMITS
DATE IMMIDDIYY) DATE IMMIDDIYY)
GENERAL LIABILITY GENERAL AGGREGATE
A COMM. GENERAL LIABILITY CK00903267 4/01/99 4/01/00 PROD-COMP/OP AGG.
CLAIMS MADE flL]OCCUR PERS. & ADV. INJURY
OWNER'S & CONTRACT'S PROT EACH OCCURRENCE o 000
FlRE DAMAGE(One Fire)
MED EXP(Any one person) 5000
AUTOMOBILE LIABILITY COMBINED SINGLE
ANY AUTO LIMIT
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (Per person)
fiRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
UMBRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND STATUTORY LIMITS
EMPLOYERS' LIABILITY
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THE PROPRIETORI INCL
PARTNERSIEXECUTIVE DISEASE-POLICY LIMIT
OFFICERS ARE: EXCL DISEASE-EACH EMPL.
OTHER
A CK00903267 4/01/99 4/01/00
BUILDING SPECIAL PERILS
ACORO:tS;S/:'!.tl\
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DESCRIPTION OF OPERA TlONSILOCA TIONSIVEfiCLES/SPECIAL ITEMS
Certificate Holder is Additional Interest (42105) as respects
Lease Agreement for 1875 Airport Road, Clearwater, FL 34625
/ >i' U 1 '
J,-.; -;.
CITY OF CLEARWATER
ATTN: LEO SCHRADER, RISK MGR.
P. O. BOX 4748
CLEARWATER, FL 34618-4748
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFf, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPRESENTATIVE
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