INSURANCE BINDER (2)
A I M I nsurance Agency, I nc.
P.O. Box 5025
CLearwater, FL. 33518
CanaL IndemnLty Insurance Co.
Effective 12: 01 am 6-31,19 85
Expires [X] 12:01 am D Noon 7-31,19 85
o This binder is issued to extend coverage in the above named
company per expiring policy #
NAME AND MAILING ADDRESS OF INSURED
Description of Operation/Vehicles/Property
(except as noted below)
CLearwater Beach Seafood, I nc.
37 Causeway BLvd.
CLearwater, FL. 33515
LLquor LLabLLLty
Type and Location of Property
Coverage/ Perils/ Forms
Coins.
%
Type of Insurance
Coverage! Forms
Limits of Liability
Each Occurrence
Bodily Injury $
[J Scheduled Form D Comprehensive Form
D Premises/Operations
D Products/Completed Operations
D Contractual LLquor LLabLLLty
[J Other (specify below)
D Med. Pay, $
D Personal Injury
Per
Person
$
Per
Accident
DA
[.I B
Dc
Property Damage $
Bodily Injury &
Property Damage $ 300,000
Combined
Personal Injury
Limits of Liability
Bodily Injury (Each Person)
Bodily Injury (Each Accident)
$
$
A I D
U I D
T i
olD
M --
o D
~ D
L D
E D
D
Liability D Non-owned
Com prehen sive-Ded uct i bl e
CQ.tLLsiQ D: Q e JJ u.9 tip I ft, __,
Medical Payments
Uninsured Motorist
No Fault (specify):
Other (specify):
D Hired
$
$
$
..$...--
$
$
Property Damage
$
Bodily Injury & Property Damage
Combined
$
WORKERS' COMPENSATION - Statutory Limits (specify states belowl
[] EMPLOYERS' LIABILITY - Limit
$
SPECIAL CONDITIONS/OTHER COVERAGES
NAME AND ADDRESS OF D MORTGAGEE
[J LOSS PAYEE
[Z] ADD'L INSURED
CLty of CLearwater
P.O. Box 4748
CLearwater, FL. 33518
LOAN NUMBER
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