RENEWAL BINDER ATTACHED TO LETTER
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Poe &Associates, Inc.
P.O. Box 1348/Tampa, Florida 33601
(813) 228-7361
Telex 52-629
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April 26, 1985
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Mr. G. B. Weimer
Assistant City Manager
City of Clearwater
P. O. Box 4748
Clearwater, Florida 33518
Re: Clearwater Golf Park, Inc.
Business Insurance
Dear Mr. Weimer:
As of this date, we have not received the renewal policies for
the above captioned and are herewith attaching a ren~wal Insurance
Binder to act as your evidence of coverage until the policies are
received.
If you have any questions concerning this, please give us a call.
Bestre ards,
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R th M. Wiese (Mrs.)
Commercial Lines Assistant
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attachment
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o POE & ASSOCIATES, INC.
P. O. BOX 1118
TAMPA, FLORIDA 33601
Effective12: 01 A m 5-.11 ,1985
Expires 12:01 am U Noon ,19
o This binder is issued to extend coverage in the above named
company per expiring policy #
(except as noted below)
NAME AND MAILING ADDRESS OF INSURED
Description of Operation/Vehicles/Property
CLEARWATER GOLF PARK, INC.
1875 AIRPORT DRIVE
CLEARWATER, FLORIDA 33515
Type and Location of Property Coverage/Perils/ Forms Amt of Insurance Oed. Coins.
%
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ON CLUB HOUSE & PRO SHOP BUILDING ALL RISK $135,000.100. 80
LOCATED 1875 AIRPORT DRIVE,
CLEARtiATER, FLORIDA.
ON CONTENTS CONTAINED IN ABOVE BUI DING ALL RISK $ 15,000. 100 80
ON GOLF CART STORAGE BUILDING -
SAME LOCATION ALL RISK $ 39,000. 100. 80
ON METAL CLAD EQUIPMENT SHED -
SAME LOCATION ALL RISK $ 24,000. 100. 80
o Scheduled Form iii Comprehensive Form
~ Premises/Operations
Products/Completed Operations
Contractual
,[] Other (specify below) BFCGL
AD Med. Pay. $ P, $
o Personal Injury "e-sor
Per
Accident
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Limits of Liability
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Property Damage $ 1,000,0011 1,000,
combin::rsonallnjUry .~=h:_=~=
Limits of Liability
Bodily Injury (Each Person) $
Bodily Injury (Each Accident) $
Type of Insurance
Coverage/ Forms
D Liability [iJ Non-owned iii Hired
D Comprehensive,Deductible $
o Collision-Deductible $
D Medical Payments $
D Uninsured Motorist $
o No Fault (speCify):
[J Other (specify):
Property Damage $
Bodily Injury & Property Damage
Combined
liJ WORKERS' COMPENSATION - Statutory Limits (specify states below) 1iJ EMPLOYERS' LIABILITY - Limit
SPECIAL CONDITIONS/OTHER COVERAGES
$110,300 INLAND MAEcrNE FLOATER $1,000,000 - LIQUOR LIABILITY
$ 10,000 EMPLOYEE DISHONESTY COVERAGE
$ 1,000 LOSS OUTSIDE MONEY & SECURITIES
~ 1'888 1I8~yI~MRLM2N~uM~'~T~~fumNCY
LOSS PA YEE
[Xl ADD'L INSURED
LOAN NUMBER
CITY OF CLEARWATER
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CONDITIONS
This Company binds the klnd(s) of nsurance stipulated or t'1e 'everse side.. This insurance IS subJect-
to,ttie terms, conditions'andllmltatlons of the pollcY(les: in=,-,"ent use by the CompailY:
This binder may be cancelled by the Insured by surrewier 0t ,'IS b,ncJer or by written notice to the
Companystat!ng when cancellation will be effective T', :Wl'je' '-nay be cancelled by the Company
by notice to tre insured In accordance with the pollcj )~.j'tlon5 TI-115 binder IS cancelled when
replaced by a POliCy If thiS binder IS not replaced by a " "-,e =:0 pany IS entitled to charge a
premium for the binder according to the Rules and Rate' ';se 8j the Company.
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