LETTER AND RENEWAL INSURANCE BINDER (2)
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~A,." ...~
POE & ASSOCIATES. INC.
P. O. BOX 20195
ORLANDO. FLORIDA 32814
April 30, 1981
Ms. Lucille Williams
City Clerk
City of Clearwater
P. O. Box 4748
Clearwater, Florida 33419
/ /7-; 0
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Re: Clearwater Golf Park, Inc.
Dear Ms. Williams:
As of this date we still have not received the renewal policies on the above captioned.
Therefore, we have attached a Renewal Insurance Binder to act as your evidence of coverage
until they are received.
~~
uth M. Wiese (Mrs.)
Commercial Lines Assistant
/rmw
attachment
Binder No.
POI , ASSOCIATES. DlC.
P. o. lOX 20195
OII.AlmO, rLOJIDA 32814
COMPANY
AETNA :mstJUBCI CCltPANY
~ Effective 12:0lA m 5/1 ,19 81
Expires IS 12:01 am 0 Noon 6/1 ,19 81
o This binder is issued to extend coverage in the above named
company per expiring policy #
( except as noted belowl
Description of Operation/Vehicles/Property
NAME AND MAILING ADDRESS OF INSURED
CL'IWIRATD GOLP PAB. DIC.
1875 Airport Drive
Claarvater. P10rida 33515
.
OaGolf Cart Storqa BailAliq,J,ocat"
1875 Airport Drive, Cl..na~..~.~
Coverage/ Perils/ Forms Amt of Insurance Oed.
ALL JUS $125,000 $100.
ALLU. . $ 10,000 $100. 80
> ALL USI. $ 12.600 $100. 80
Type and Location of Property
OIl Club Boue . Pro Sb.op 10catM 187S
Airport Dri.... ClearwateJ:. Plod"
OIl co._a coat.1..... iJa .... lluUd'.
o Scheduled Form
IJIPremises/ 0 perations
BlProducts/Completed Operations
o Contractual
o Other (specify below)
iJ Med, Pay. $ 1,nNI'er $1.0,000
V'.....~rson
iI Personal Injury
~omprehensive Form
Bodily Injury
Property
Damage
$
Type of Insurance
Coverage/Forms
limits of liabilit
Each Occurrence
$
$
Per
ACCident
e..
&lB
[XC
Bodily InjUry &
Property Damage
Combined
Personal InjUry
limits of liability
Bodily Injury (Each Person) $
Bodily Injury (Each Accident) $
ii1 Liability iJ Non-owned
o Comprehensive-Deductible
o Collision-Deductible
o Medical Payments
o Uninsured Motorist
o No Fault (specify):
o Other (specify):
iI Hired
$
$
$
$
Property Damage
$
Bodily Injury & Property Damage
Combined $
300,
ZI WORKERS' COMPENSATION - Statutory Limits (specify ';itates below) Xl EMPLOYERS' LIABILITY - Limit
$ 100,
SPECIAL CONDITIONS/OTHER COVERAGES
o.
$24.1OG.00 - .. fMIJ:I CBD .. ,. , " .
$38,610.00 - . GCU .... ~I. .. ~
t1I,800.00 - ..... DUJUI,:i~ ,CQUUQB. ..,.,' .," .
. 1,000.00 - 1.011 0IJ'fSD&. J4II.~,~ ~.. .1ICQlUD.-
NAME AND ADDRESS OF 0 MORTGAGEE
o LOSS PAYEE
illt-DD'L INSURED
LOAN NUMBER
CIft ,.. <=J....a.-.....
1'. o. .. 4741'
ew-""". ~'IU. DSl7
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Date
t ,\
ACORD 75 (11-77)