POLICY # 21 OOC RB8476
TO:
!ry OF CLEARWATER
I nterdepartment Correspondence Sheet
Elizabeth S. Haeseker, Assistant City Ma~er
Bill Held, Assistant Harbormaster~
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FROM:
COPIES:
Cyndie Goudeau, acting City Clerk
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DATE:
SUBJECT: Clearwater Beach Seafood _ Insurance Policy
August 6, 1985
I have received and reviewed the Insurance policy for the Clearwater
Beach Seafood, Inc..
The pOlicy meets the requirements of their lease agreement and eXPIres
On May 31, 1986.
WCH:mm
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REC.EIVED
AUG 9 1985
CITY CLERK
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THE HARTFORD Z
The companies providing this insurance are members of The Hartford Insurance
Group. Each Company is designated in the Summary Declarations Page by individual
coverage part. (A Stock Insurance Company, herein called the Company.)
INSURANCE PROVIDED
In consideration of the payment of premium, the Company agrees with the named
insured to provide the insurance as specified in the Summary Declarations Page and as
further indicated by a specific premium charge or charges in the coverage part(s)
forming a part of the policy.
The insurance provided under the coverage part(s) or extension(s) thereof is subject to
all of the provisions of such coverage part(s), special conditions applicable to the
coverage part(s) and any general provisions contained in the policy of which the
coverage part(s) form a part.
In witness whereof, the Company has caused this policy to be signed by its president
and secretary, but the same shall not be binding unless countersigned on the Summary
Declarations Page by a duly authorized agent of the Company.
Wu1JA )J~
Michael S, Wilder, Secretary
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Form 4300 (Ed. 11/83) Printed in U.S.A.
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POLICY INDEX
Your policy contains one or more commercial insurance coverages, The coverage(s) you have purchased are
listed in the Summary Declarations Page, followed by the self-contained coverage parts. The following index will
guide you quickly 10 the coverage you are looking for. If you have any questions relating to any portion at your
policy, you should contact your agent.
Summary Declarations Page
1. Your name and address, your producer's name.
2. The policy period (the inception date and expiration date of your policy)
3. Form of business
4. Type of business
5. Summary of Coverage Parts _ In this section are listed the coverages you have selected, the companies in
which they are individually written, and the advance premium for each.
6. Form numbers of Coverage Part(s) and Endorsement(s) applicable to the entire policy.
General Policy Conditions
Included in this section is a description of conditions which apply to the entire policy, Additional conditions or
modifications of these conditions may appear in the specific coverage parts forming a part of the policy or in
endorsements modifying a specific coverage part. The following General Policy Conditions are included:
1. Premium
2. Policy Period and Time of Inception
3. Assignment
4. Insurance Under More Than One Coverage Part or Endorsement
5. Waiver or Change of Provisions
6. Cancellation
7. Declarations
Form 4300 (Ed. 11/83) Printed in U.S.A.
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SEE POLICY IN FILE