MEMO REGARDING EXPIRATION OF LEASE & INSURANCE CERTIFICATES
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CERTIFICATE OF INSURANCE
GENERAL ACCIDENT GROUP
'JU
HOME OFFICE: 414 WAlNUT STREET, PHIlADELPHIA, PA. 19105
[B GENERAL ACCIDENT
X FIRE & LIFE ASSURANCE
CORPORATION. LIMITED
DTHE CAMDEN FIRE
, INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
DPENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certify to:
CIft aF CLlABWADR
P.O.BOX 47~ AftJf: em- CLDJ(
CLEARWAftR .33~
Address
that the company indicated above by the letter X has issued the following described policies:
Name of Insured
Cca.I IWlDA DS!AIJlWI'.r, DIC.
71-75 eADSIW~BLVD.
CLlAiWADR BiACJI. J'LOR-A 33516
Address
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
u 783385
* Workmen's Compensation
and Employers' Liabi lity
* Public Liability
Bodi Iy Injury
S
Property Damage
* Automobile Liabi ity
Bodily Injury
Property Damage
$ 100 ,000. $ lOQOOO.
$ , 000. $ 50 000 .
Each Person Each Occurrence
$ , 000. $ , 000.
xxxx $ ,000.
S!.Aftr.rORI
Each 'Occu rrence
Aggregate
GJ.A 4589989
DCL. P.LA!rE
*
Form
Amount
Burg I ary
$
*
Plate Glass
EFFECTIVE
DATE**
12/28/
xxxx xxxx
12/28/
EXPIRATION
DATE **
12/28/79
12/28/79
xxxx xxxx
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
Description of Operations Covered:
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded yo th
described herein, and is issued subject to the exclusions, conditions and other terms of the insura ce afforded der
hereinbefore mentioned.
CLEARWAftR,FLORIDA
11/16/78
Issued at
Date
~
FORM G-4142 REV. 1-73
Authori zed Agent
/'
,/
CERTIFICATE OF INSURANCE
'1 ~
I GENERAL ACCIDENT GROUP -
~
HOME OFFICE: 414 WALNUT STREET, PHILADELPHIA, PA. 19105
ru GENERAL ACCIDENT
X FIRE Ilt LIFE ASSURANCE
CORPORATION, LIMITED
Thi s is to certi fy to:
Address
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
City of Clearwater
P.O. Box 4~48, Attn: City
Clearwater, Florida 11518
Clerk
RECEIVEO
that the company indicated above by the letter X has issued the following described policies:
MAR 27 1978
Name of Insured
Address
POLICY
NUMBER
U76ll09
GLA 4534132
PG 227 7
Colony Marina Restaurant, Inc.
71-75 Causeway Blvd.
Clearwater Beach, Florida 33516
CITY CLERK
KIND OF INSURANCE
EFFECTIVE
DA T E **
EXPIRATION
DATE **
LIMITS
* Workmen's Compensation
and Employers' Liabi lity
* Public Liability
Bodi Iy Injury
Property Damage
* Automobile Liability
Bodi Iy Injury
Property Damage
2/28/77
12/28/78
Statutory
Each Occurrence Aggregate
$ 100 ,000. $ 100 ,000.
$ 50 ,000. $ 50 ,000.
Each Person Each Occurrence
xxxx xxxx
12/28/78
2/28/77
xxxx xxxx
*
$ ,000. $
xxxx $
Form Amount
$
,000.
,000.
Burglary
*
P late Glass
11/9/75
11/9/78
Comprehensive
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standord time at the address of the named insured as stated herein.
Description of Operations Covered:
This Certificate ,of Insurance neither affirmatively nor negatively amends, extends or alters the coverage offorded by the policy orpolicies
described herein, and is issued subject to the exclusions, conditions and other terms of the insurance afforde under the policy or policies
hereinbefore mentioned.
INC.
..---/
Issued at Clearwater. Florida
Date March 24, 1978
FORM G-4142 REV. 1.73
Authori zed Agent
.1
f
t{ECE1VED
LAW OFFICES
MAcKENZIE, CASTAGNA, BENNISON fO GARDNER
NOV 9 1977
227 SOUTH GARDEN AVENUE
p, 0, DRAWER 2137
CLEARWATER,FLORIDA 33517
CITY CLERK
WILLIAM M, MACKENZIE
WILLIAM J. CASTAGNA
RICHARD T. BENNISON
JOHN C GARDNER
November 8, 1977
TELEPHONE: 442,5181
AREA CODE: 813
PLEASE REPLY TO'
Richard T. Bennison
Mr. Robert whitehead
Clerk, city of clearwater
city Hall
clearwater, Florida 33516
Re: Browning (seller) - Allison (Buyer)
Colony Ma,rina, RestCi:uran't
Marina Bui1dinq
Dear Bob:
This is to confirm our previous conversation concerning
the colony Marina Restaurant. As you mentioned, Mr. Browning had
shortly after the first of the year advised you of the change
of ownership but, as you mentioned, the city would like something
for their files to confirm this information.
My clients' names are Mr. Alexander s. Allison and Mrs.
Elizabeth Allison, his wife, who purchased all of the authorized,
outstanding and issued stock of clearwater Marina Restaurant, Inc.,
a Florida corporation which runs the restaurant at the marina. By
purchasing the stock, they, of course, purchased all of the assets
of the corporation, one of which was the Lease dated May 10, 1974,
between the city of clearwater and the corporation covering the
lunchroom on the ground floor in the clearwater Marina Building
located on Lots 11 and 12 of city Park Subdivision, etc.
This is to further confirm that Mr. and Mrs. Allison merely
continued the same insurance coverage that Mr. Browning had or
in other words, they took over his policy at the time of closing.
The agent is the same as Mr. Browning's, Rhodes Insurance Company,
1411 Cleveland street, Clearwater, Florida.
If there is any further information the city requires, please
advise.
It was good to have talked with you again since this town
has gotten so big, I never seem to get over to city Hall as when
I used to be over there everyday seeking your advice on how to do
this or that. Bill MacKenzie also wished me to extend his kindest
regards to you and with my own kindest re ards, I remain,
RTB/je1
cc: Mr and Mrs. Allison RI
r CERTIFICATE OF INSURANCE I
GENERAL ACCIDENT GROUP
,
HOME OFFICE: 414 WALNUT STREET, PHILADELPHIA, PA, 19105
[lJ GENERAL ACCIDENT
X FIRE ,8: LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
DPEN,NS, YLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
Address
City of Clearwater
P. O. Box 4748
CleRrweter, Florida 33518
RECEIVED
that the company indicated above by the letter X has issued the following described policies:
1976
Name of Insured
Address
POLICY
NUMBER
U 711100
GLA 44 425 06
PG 522757
Colony Marina Restaurant, Inc.
71-75 Causeway Blvd.
Clearwater, Florida ~~516
NOV
....
3
CU'Y 0.F1\....r.;::
KIND OF INSURANCE
LIMITS
EFFECTIVE
DATEH
EXPIRATION
DATE H
* Workmen's Compensation
and Employers' liabi lity
* Public liability
Bodi Iy Injury
Property Damage
* Automobile Liability
Bodi Iy Injury
Property Damage
11/9/76
11/9/77
Statutory
Each Occurrence Aggregate
$ 100 ,000. $ 100 ,000.
$ 50,000. $ 50 ,000.
Each Person Each Occurrence
xxxx xxxx
11/9/77
xxxx xxxx
11/9/76
, 000. $
xxxx $
,000.
,000.
$
*
Form
Amount
Burglary
$
*
11/9/78
Plate Glass
Comprehensive
11/9/75
* Absence of an entry in these spaces means that ,insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M.. standard time at the address of the named insured as stated herein.
Description of Operations Covered:
I"
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy orpolicies
described herein, and is issued subject to the exclusions, conditions and other terms of the insurance afforded under the policy or policies
hereinbefore mentioned. ~ ~.
. RHODES INSUR"P.w~/AG CY, INC. ,-
Issued at Cl ea:rwater. Flor~da I /./ ,/.-c:' / ./"/'./"
Date November 2 , 1976 "', P// . / . ~ --.--------
.
Authorized Agent
FORM G-4142 REV. 1-73
CERTIFICATE O.F INSURANCE
GENERAL ACCIDENT GROUP
HOME OFFICE: 414 WALNUT STREET, PHIlADELPHIA, PA, 19105
[i] GENERAL ACCIDENT
X FIRE 8: LIFE ASSURANCE
CORPORATION. LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
Address
CITY OF CLEARWATER
P. O. Box 4748
Clearwater, Florida 33518
RECEIVED
that the company indicated above by the letter X has issued the following described policies:
4 1975
Name of Insured
Address
POLICY
NUMBER
u 668494
GLA 4377480
PG 522757
Colony Marina Restaurant, Inc.
71-75 Causeway Blvd.
Clearwater, Florida 33516
NOV
C(TY CLEkl(
KIND OF INSURANCE
EFFECTIVE
DATE**
EXPIRATION
DATE **
LIMITS
* Workmen's Compensation
and Employers' Liability STATUTORY
* Public Liability Each Occurrence Aggregate
Bodi Iy Injury
Property Damage
* Automobi e Li abi ity
Bodily Injury
Property Damage
11/9/75
11/9/76
*
$ 100 ,000. $ 100 ,000. x x x x x x x x
$ ,000. $ ,000. x x x x x x x x 11/9/75 11/9/76
Each Person Each Occurrence
$ ,000. $ ,000.
x x x x $ ,000.
Form Amount
$
COMPREHENSIVE 11/9/75 11/9/76
Burglary
*
Plate Glass
* Absence of on entry in these spaces means that insurance is not afforded with respect to the coverages apposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
Description of Operations Covered:
This Certificate of Insurance neither affirmatively nOr negatively amends, extends or alters the covera affor ed by the policy orpolicies
described herein, and is issued subject to the exclusions, conditions ond other terms 0 the insuranc affor
here inbefore mentioned.
Issued ot Clearwater. Florida
Date November ~, 1975
FORM G-4142 REV. 1-73
CERTIFICATE OF INSURANCE ~
I '~~ .
GENERAL ACCIDENT GROUP
HOME OFFICE: 414 WALNUT STREET, PHIlADELPHIA, PA, 19105
O GENERAL ACCIDENT
FIRE ,Be LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
RECEIVfD
Nov
City of Clearwater
c/o Robert WhiteheAn-~ity ~le~k
Address P.O. Rox 47aA
th ., Clearwater, 'Fla.. ~~51R f II' , I' .
at the company indicated aliove by tile retter .,Cnas ,s's;;ea"ihe 0 oWing descrrbed po ,c,es:
Address
Colony Marina Restaurant'. Inc.
71-7'5 Causeway Blvd.
Clearwater Beach, Florida 33515
Name of Insured
POLICY
NUMBER
KIND ,OF INSURANCE
LIMITS
EFFECTIVE
DATE**
EXPIRATION
DATE **
* Workmen's Compensation
U6284,gO and Employers' Liability
* Public Liability
GLA42 980 74 Bodi Iy Injury
Property Damage
* Automobile Liability
Bodily Injury
Property Damage
statuto'l'V
Each Occurrence Aggregate
$ 100 ,000. $ 100 ,000.
$ , 000. $ , 000 .
Each Person Each Occurrence
11/9/74
xxxx xxxx
11/9/74
11/9/75
11/9/75
xxxx xxxx
$
, 000. $
xxxx $
,000.
,000.
*
Form
Amount
Burg I ary
$
*
Plate Glass
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
Description of Operations Covered:
Restaurant
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy orpolicies
described herein, and is issued subject to the exclusions, conditions and other terms of the insuraTc fford~J~;der the policy or policies
hereinbefore mentioned. ,/ / /; 'iL ~
Issued at Clearwater, Fla. -ij~ . L-v7..r
Date Nov. 6, 1974 f.) )1P William . Rhodes.
I/'J Authori zed Agent
FORM G.4142 REV. 1-73
CERTIFICATE OF INSURANCE
:.
,
GENERAL ACCIDENT GROUP
HOME OFFIGE: 414 WALN.Ul STREET, PHILADELPHIA, PA. 19105
O GENERAL ACCIDENT
, FIRE & LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
DPENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
City of Clearwater
c/o Robert Whitehead - City Clerk
Address p'.a. Box 4748
Clearwater, Florida 33~18
that the company indicated above by the letter X has issued the following described policies:
ReCEIVED
NOV
1 1973
Address
~~i;n~ M:~1na Restaurant.
8U way Boll1~vard
ci;;rwat~r BARch, Florida
Inc.
CITy ClE,RK
Name of Insured
33515
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
EFFECTIVE
DATE**
EXPIRATION
DATE **
LA42-056-03
* Workmen's Compensation
and Employers' liabi lity
* Public liability
Bodi Iy Injury
Property Damage
* Automobile Liability
Bodily Injury
Property Damage
Each Occurrence Aggregate
$ 25 ,000. $ 25 ,000.
$ , 000. $ , 000 .
Each Person Each Occurrence
XXXX xxxx
11/9/73
11/9/74
XXXX xxxx
$
, 000. $
xxxx $
,000.
,000.
Form
Amount
Burglary
$
*
Plate Glass Scheduled Comprehensive - ACV
11/9/72
11/9/75
PG-51S80S
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M.. standard time at the address of the named insured as stated herein.
Description of Operations Covered:
Restaurant
This Certificate of Insurance neither affirmotively nor negatively amends, extends or alters the coverage afforded by the policy or policies
described herein, and is issued subject to the exclusions, conditions and other terms o1,e insurance for d under the policy or policies
hereinbefore mentioned,
Issued atClftarwat~'l', Flo'l'1da
Date October 'i1. lQ7'i
Author; zed Agent
"j
FORM G-4142 REV. 1-73
..
.:\ ~
"
CERTIFICATE OF~ INSURANCE
GENERAL ACCIDENT GROUP
HOME OFFICE: 414 WALNUT STREET. PHilADELPHIA. PA. 19105
~ GENERAL ACCIDENT
FIRE B: LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
Address
City of Clearwater
c/o Robert Whitehead - City Clerk
P.O. Box 4748, Cl~arwatp-~, Flor1da
33518
that the company indicated above by the letter X has issued the follawing described policies:
Address
Colony Marina Restaurant. Inc.
7175 Causeway Boulevard
Clearwater Beach, Florida 33515
Name of Insured
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
EFFECTIVE
DATE**
EXPIRATION
DATE **
* Workmen's Compensation
and Employers' Liabi Iity
* Public Liability
Bodi Iy Injury
GLA40-740-81 Property Damage
* Automobile Liability
Bodily Injury
Property Damage
Burg I ary
Each Person Each Occurrence
$ 10 ,000. $ 20 ,000.
x x x x $ ,000.
$ ,000. $ ,000.
x x x x $ 000.
Form Amount
$
Aggregate
$ 20
$
,000.
,000.
11
x x x x
x x x x
*
Plate Glass
Actural Cash Value
11/9/72
11/9/75
*
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
Description of Operations Covered:
Restaurant
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afford
described herein, and is issued subject to the exclusions, conditions and other terms of th nsurance af rde
hereinbefore mentioned.
Issued at Clearwater, F10ltida
Date December 15~ 1972
y the policy orpolicies
derthe policy or policies
Agency
Authorized Agent
FORM G-4142 REV. 3/69
CERTIFICAT.E OF ~NSURANCE I
e~ dccuient rgJ<O<<jv
GENERAL BUILDINGS. PHILADELPHIA, PA. 19105
~cr:JVJ:O
MAR 15 1972,
CITY CLERf(
DPENNSYLVANIA GENERAL
INSURANCE COMPANY
~ GENERAL ACCIDENT
FIRE Be LIFE ASSURANCE
CORPORATION. L1M ITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
Thi s is to certi fy to:
City of Clearwater
c/o Rohe~r. Whjteh~Rn - ~ity Cl~r~
P:O. Box u7uRJ Clearwater, Florida
Address
33518
that the company indicated above by the letter X has issued the following described policies:
Inc
CO~""M1UQ R,,:t8li1'a~
. arina ewstan
71-7~ Causeway Boulevard,
I~ ~~rina -Reti La llrahi?
Clearwater Beaoh. Florida
Name of Insured
Address
POLICY
NUMBER
KIND OF INSURANCE
U 467621
* Workmen's Compensation
and Employers' Liability
* Public Liability
Bodi Iy Injury
Property Damage
* AutomobileLiability
Bodily Injury
Property Damage
GLA40-076-94
*
Burglary
*
PG499204
P late Glass
LIMITS EFFECTIVE EXPIRATION
DATE** DATE**
Statutory 11/9/71 11/9/72
Each Person Each Occurrence Aggregate
$ 10 ,000. $ 20 ,000. $20 ,000. 11/9/71
x x x x $ ,000. $ ,000. 11/9/72
$ ,000. $ ,000. x x x x
x x x x $ 000. x x x x
Form Amount
$
- ACV 11
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
!
~...t 8'1c NeWB1;Bn~ ~:j (V/1/t,->,"'&"
'\....."" 16 11 'k ~ ....?-~ J~,_I
I f~.rr~" ...-~ ~ _
ttl ~ ~:f~ TtfJ/-:>
f4~0
Description of Operations Covered:
~
'7..;--
'" ..
1,--1-7
J V":?
.;
,0
/ I, (
j)
I
1,' .
"
.-- ,"
-.'J '../
:.-r .....-.
n J U)
..,'. ..".1 !.A)-.>
" ,}
;"'"
!'.
1/" {)
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy orpolicies
described herein, and is issued subject to the exclusions, condition and other terms of the insurance afforded und policy or policies
hereinbefore mentioned. ~",
Issued at Clearwater I Florida
Date Karch 14, J.972
FORM G-4142 REV, 3/69
~~
Authori zed Agent
"
I ".. "\
CERTIFICATE OF~ INSURANCE
~~ s1cr:UU,w ~~
GENERAL BUilDINGS, PHilADELPHIA, PA. 19105
NOV 29 1971
~1T): cL.f;J{K.
[B GENERAL ACCIDENT
FIRE Be LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
Th is is to certi fy to:
Address
City of Clearwater
c/o Robert Whitehead - City Clerk
P.O. Box 4748, Clearwater, Florida
33518
that the company indicated above by the letter X has issued the following described policies:
Address
Colony Marina Restaurant, Inc.
71-75 Causeway Boulevard
Clearwater, Florida ~~516
Name of Insured
POLICY KIND OF INSURANCE LIMITS EFFECTIVE EXPIRATION
NUMBER DATE** DATE**
* Workmen's Compensation
U 467621 and Employers' Liabi lity Statutory 11/9/71 11/9/72
* Public Liability Each Person Each Occurrence Aggregate
GLA 40-076- Bodi Iy Injury $ Ira ,000. $ 20 ,000. $ 20 ,000. 11/9/71 11/9/72
Property Damage x x x x $ ,000. $ ,000.
* Automobile Liability
Bodily Injury $ ,000. $ ,000. x x x x
Property Damage x x x x $ 000. x x x x
* Form Amount
Burg I ary $
*
PG499204 Plate Glass Scheduled Comprehensive - ACV 11/9/69 11/9/72
* Absence of an entry in these spoces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M" standard time at the address of the named insured as stated herein.
Description of Operations Covered:
Restaurant
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alters the coverage afforded by the policy orpolicies
described herein, and is issued subject to the exclusions, conditions and other terms of the insurance afforded under the policy or policies
hereinbefore mentioned.
Is su ed at
Date
Clearwater, Florida
11/24/71
,'. L~" ) /
~/A~' . c.-', //;(;~d:
ftfr6des "wurance Agency
Authori zed Agent
FORM G-4142 REV, 3/69
!
CERTIFICATE OF INSlJRANCE
. .
rg~ slccuient rg~
GENERAL BUilDINGS, PHilADELPHIA, PA. 19105
DEe ~~'[ ~,970
CIT'{ i.:, ,,'
[!] GENERAL ACCIDENT
X FIRE 8: LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
Thi s is to certi fy to:
Address
City of Clearwat~r
c/o Robert Whitehead - City Clerk
P.O. Box 4748, Clearwater, F1o~1da 33518
that the company indicated above by the letter X has issued the following described policies:
Address
Colony Marina Restaurant Inc.
71..75 Causeway Bou1evaT'd
Clearwater, Florida 33516
Name of Insured
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
EFFECTIVE
DATE**
EXPIRATION
DATE **
* Workmen's Compensation
U 474468 and Employers' Liability
* Public Liability
Bodi Iy Injury
GLA -614-80 Property Damage
* Automobi e Liability
Bodily Injury
Property Damage
Statutory
Each erson Each Occurrence
$ 10 ,000. $ 20 ,000.
x x x x $ , 000 .
11
Aggregate
$ 20
$
,000.
,000.
11/9/70
11/9/71
$
, 000 . $
XXXX $
,000.
000.
x x x x
x x x x
*
Fonn
Amount
Burglary
$
*
PG49 204
Plate Glass
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M., standard time at the address of the named insured as stated herein.
Description of Operations Covered:
Restaurant
This Certificate of Insurance neither affirmatively nor negatively amends, extends or alt s the coverage afforded y the' policy orpolicies
described herein, and is issued subject to the exclusions, conditions and oth.;,'" er so the insurance afforded def/fhe policy or policies
hereinbefore mentioned. /
Is su ed at
Date
Clearwater, Florida
12/18/70
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Authori zed Agent
FORM G-4142 REV, 3/69
'if
CERTIFICATE OF I~SURANCE
~?U'~ si~nt ~~
GENERAL BUILDINGS, PHILADELPHIA, PA. 19105
iNDY;, 1959
ClT)' Ci...t:!,-.\:
~ GENERAL ACCIDENT
X FIRE 8c LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
D PENNSYLVANIA GENERAL
INSURANCE COMPANY
This is to certify to:
Address
CITY OF CLEARWATER
R. G. Whitehead - City Clerk
P. o. Box 4748. C1earwater~F1orida 33518
that the company indicated above by the letter X hos issued the following described policies:
Address
COLONY MARINA RESTAURANT, INC.
71-75 Causeway Boulevard
C1earwate14-F1orida 33516
Name of Insured
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
* Workmen's Compensation
U 439390 and Employers' Liability
* Public Liability
Bodi Iy Injury
GLA 38-894-52 Property Damoge
* Automobile Liability ---,.
Bodily Injury
Property Domage
-----
Burglary
STAWTORY
Each Person Each Occurrence
$ 10 ,000. $ 20,000.
)( x x x $ ,000.
$ ,000. $ ,000.
x x x x $ 000.
Form Amount
$
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*
PG 499204 Plate Glass SCHEIULED
-,----~~~~~=-~~--,-,--,.----.--_L__~~-C
11/9/69
11/9/70
* Absence of an entry in these spaces means that insurance is not afforded with respect to the coverages opposite thereto.
** Policy is effective and expires at 12:01 A.M" standard time at the address of the named insured os stated herein.
Description of Operations Covered:
Date _
FORM G-4142 REV. a/69
CERTIFICATE OF INSURANCE
(ge1UJd s&cUknP (g~
GENERAL BUILDINGS, PHilADELPHIA, PA. 19105
N 0 V 1t. 1958
CJTY CLERK
[!] GENERAL ACCIDENT
X FIRE Be LIFE ASSURANCE
CORPORATION, LIMITED
DTHE CAMDEN FIRE
INSURANCE ASSOCIATION
DPOTOMAC
INSURANCE COMPANY
DPENNSYLVANIA GENERAL
INSURANCE COMPANY
This is to certify to:
Address
city of Clearwater
P. O. Box 4748
Clearwater. Florida
33517
(Attn: Mr. \1.hitehead, City Clerk)
that the company indicated above by the letter X has issued the following described policies:
Address
Colony Marina Restaurant, Inc.
71-75 Causeway Blvd.
Clearwater, Florida 33516
Name of Insured
POLICY
NUMBER
KIND OF INSURANCE
LIMITS EFFECTIVE EXPIRATION
DATE DATE
STATUTORY 11/9/68 11/9/69
Each Person Each Occurrence Aggregate
$ 10,000. $ 20,.000. $ 20,000. 11/9/68 11/9/69
x x x x $ ,000. $ ,000.
$ ,000. $ ,000. x x x x
x x x x $ 000. x x x x
Form Amount
$
Warkmen's Compen sat ion
Public Liability
Bodi Iy Injury
Property Damage
Automobile Liability
Bodily Injury
Property Damage
GIA-38 041 77
Burglary
Plate Glass
Scheduled
11
Description of Operations Covered:
Ii'
>.. 1.,. ~ 0'
\\
I ssued at
Date
FORM G.4142 10,66
,CERTIFICATE' OF .INSURANCE
GENERAL
ACCIDENT
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FIRE AND LIFE ASSURANCE CORPORATION, LIMITED
GENERAL BUILDINGS. PHILADELPHIA, PA. 19105
This is to certify to:
Address
City of Clea~ater
Pa O. Rox 4748
C1p.aTWatp.~, F10Tina
,3517
that the following described policies have been issued:
Name of Insured
Address
COT,ONY MAHTl$A HFmATTRAWP, TNCl.
71-75 Ca.lls~waiY Bon] ev~rd
Clearweter, Pi~e]]asJ Florida
335) 6
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
EFFECTIVE EXPIRATION
DATE DATE
Plate Glass
STATUTORY 11/9/67
Each Person Each Accident Aggregate
$ 10,000. $ 20,000. $ 20,000.
xxxx $ ,000. $ ,000.
$ ,000. $ ,000. x x x x
x x x x $ ,000. xxxx
Form Amount
$
Schedule 11 9 67
11/9/68
U 268722
Workmen's Compensatian
Public Liability
Bodily Injury
GLA 36-328-76 Property Damage
Automobile Liability
Bodily Injury
Property Damage
Burglary
PG
11 9 68
Description of Operations Covered:
I ssued at
Date
Clearwater, Florida
11/13/(,7
This Certificate of Ins....ance is issued subject tothe exclusions./O'onditions and other
terms of the insurance afforded under the
'ORM G.3059 REVISED 6.60 (1)
CERTIFICATE' OF 1NSuRANCE
~ ~....,
GENERAL
.
ACCIDENT
FIRE AND LIFE ASSURANCE CORPORATION, LIMITED
OBNERAL BUILDINOS. PHILADBLPHIA
This is to certify to:
City of Clearwater
P. O. Box 1348
Clearwater, Florida
ATTN: City Attorney - Herbert Brown
that the following descri bed pol icie. have been issued:
Name of Insured Colony Marina 'Re~t.:=ll11":=lnt" Tnc_
71....71) r.ause-way BonlevAm - ~t.n1"A #'
Clearwater, Pinellas, FlO1"id~
Address
Address
POLICY KIND OF INSURANCE LIMITS EFFECTIVE EXPIRATION
NUMBER DATE DATE
U Workmen's Compensation ~ATUTORY 11/9/66 11/9/67.-_
Publ ic Liabi Iity Each Person Each Accident Aggregate
GIA36-443-69 Bodily Injury $ 10 ,000. $ 20 ,000. $ 20 , 000 .
Property Damage xxxx $ 000. $ 000. 11
Automobile Liability
Bodily Injury $ ,000. $ ,000. x x x x
Property Damage x x x x $ 000. x x x x
Form Amount
Burglary $
PG 471281
Plate Glass
See Schedule Attached
Description of Operations Covered:
I ssued at
Date
Clearwater,
10/12/66
FORM G-30119 FlEVISED 6.60
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September ZZ, 1966
Colony Marina Restaurant,
Marina Building
Causeway Boulevard
Clearwater, Florida
Inc.
Gentlemen:
\
,
\.
We have been advised by the City Clerk that under date of
July IS, 1966, you were requested to furnish to the City of Clearwater
'a certificate of insurance for the liability insurance and plate glass window
insurance which your lease requires you to carry.
As of this date, we have not received this certificate. It is necessary
that this certificate be in our files. We, therefore, request that you send
the same to the City Clerk on or before ten days from the date of this letter.
Your cooperation and assistance in this matter will be greatly
appreciated.
Very truly yours,
R
Herbert M. Brown
City Attorney
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.na17 15,1966
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We note tiIa, ~ t ot JOUl' MIbl.... with Btttbvpl"
ot '-. 1M." " ' ....,..".un . l1ab111s, lzuhtNllOe
u4 pl.'. alt.. .JUIow,".......oe.
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cu.'l 01.. .. oWUftoate Ibo_. ... ,Mob 1na"nnoe 1e
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1t. o. 1ft'll.......
C1 t, Clerk
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ERTIFICA'E' 0' 1NSURAHCE
GENERAL
ACCIDENT
GENERAL BUILDINGS. PHILADELPHIA
V..ECfJVEO
OC1 5 \966
\.Ul K..
crf"i' C
FIRE AND LIFE ASSURANCE CORPORATION, LIMITED
This is to certify to:
City 01 Clearwater
P. O. Box 134B
Address Clearwater, F1orid.a
ATTN: City Attorney - Herbert Brown
that the following described policies have been issued:
Name of Insured Colony Marina R8st.AU'rAnt., Tnc.
71-'15 Causeway 'Roulava.rd - store #1
Address C1lila:rw:t&~, Pine] lAs, Florida
POLICY
NUMBER
KIND OF INSURANCE
LIMITS
STATUTORY
Each Person Each Accident Aggregate
$ 10,000. $ 20,000. $ 20 ,000.
xxxx $ 000. $ 000.
$ ,000. $ ,000. x x xx
xxxx $ 000. x x x x
Form Amount
$
EFFECTIVE EXPIRATION
DATE DATE
OLT18-312-59
Workmen's Compensation
Public Liability
Bodily Injury
Property Damage
Automobile Liability
Bodily Injury
Property Damage
11/9/65 1~9/66
U 290232
11/9/65 11/9/66
Burglary
Plate Glass
Description of Operations Covered:
I $Sued at Clearwater.
Date 10/5/66
This Certificate of Ins..-ance is Iss..d subject tothe exclusions, c ition. and~r '//
terms of the insurance affcrded under the policy or ~.. . einbefcre menti ed.f / ~
Florida ~ ___ ~'
Odes Insurance Agency
Author ized Agent
FORM G.301l9 FlEVISED 6.60
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.. . , " ,~ERTIFICA'tE. OS "NSURANCE I I
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GENERAL . ACCIDE~Ilv!o
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1",.""",
FIRE AND LIFE ASSURANCE CORPORATION, LIMITED oei ~ '966
GENERAL BUILDINGS. PHILADELPHIA, PA. 19105
This is to certify to: ern: Ct:i':'l.:':'~
City of Clearwater
P.o. Box 1348
Address r.1earwater, Florida
A'T"T'N~ r.ity Attorney - Herbert Brown
that the following described policies have been issued:
Name of Insured Colony Marina Restaurant, Inc.
71-'75 Causeway Boulevard - store #1
Address Clearwater. Pinellas. Florida
POLICY KIND OF INSURANCE LIMITS EFFECTIVE EXPIRATION
NUMBER DATE DATE
Workmen's Compensation STATUTORY
Public Liability Each Person Each Accident Aggregate
Bodily Injury $ ,000. $ ,000. $ ,000.
Property Damage xxxx $ ,000. $ ,000.
Automobile Liability
Bodily Injury $ ,000. $ ,000. x x x x
Property Damage xxxx $ ,000. x x x x
Form Amount
Burglary $
PG 464178 Plate Glass Schedule "'\ 11/9/65 11/9/66
Description of Operations Covered; I II-
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terms of the insurance affarded under the policy ar I' ereinbefare mentione . /' '
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~:t:ed a~OJjn6ter, Florida ~----- "'- <.. '?-;f7 -
\ ~ ee Insurance Agen""
FORM G.3059 REVISED 6.60 IT) , Authorized Agent
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