CERTIFICATES OF INSURANCE
CONDON MEEK INC
1211 COURT ST
CLEARWATER FL 34616-5897
COMPANY
A
BANKERS INS GROUP
INSURED
MARINA GIFTS & SOUVENIRS
CARPENTER ENT INC
25' CAUSEWAY BL
CLEARWATER FL 34630
COMPANY
B
COMPANY
C
COMPANY
D
:~&9!_~!!~~~~~;~iil~~~1~~~~im1tllli@1~~~~~~~~~~~~~~;~il'l~ii~~i~lm$iI'$;' ::;.iW.!IDi:::~ ,.' ..:... ~iWiim~~lli~mlQ.~t*r.~ ....~<~. .
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXClUSIONS AND CONDmONS OF SUCH POUClES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POUCY EFFECT1VE POUCY EXPIRATION
DAn:: (llMlDDlVY) DAn:: (MMJDD/YY)
GENERAl. UABIUTY 09490265900
X COMMERCIAL GENERAl.. LIABILITY
ClAIMS MADE 00 OCCUR
OWNER'S & CONTRACTOR'S PROT
5/19/96 5/19/97
LIMITS
GENERAl.. AGGREGATE $ 1 000 00
PRODUCTS. COMPIOP AGG . 1 000 00
PERSONAL & ADV INJURY $ 1 000 00
EACH OCCURRENCE . 1 000 00
FIRE DAMAGE (Any one file) .
MED EXP (Any one person) $ 1 00
COMBINED SINGLE LIMIT .
BODILY INJURY .
(Per person)
BODILY INJURY .
(Per &OCIdent)
AUTOMOBILE UABIUTY
ANY AUTO
AU. OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
PROPERTY DAMAGE .
GARAGE UA8IL1rY
ANY AUTO
AUTO ONlY . EA ACCIDENT
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
EXCE88 LIA8lLI'rY
fOBM______
OTHER THAN UMBREU..A FORM
W0RKER8 COMPEN8A11ON AND
EMPLOYERS' LIA8lLI'rY
09490265900
5/19/96
STATUTORY LIMITS
EACH ACCIDENT .
DISEASE. POLICY LIMIT .
DISEASE. EACH EMPLOYE .
5/19/97 LI 1,000,000/
THE PROPRIETOR!
PARTNERSlEXECUTIVE
OFFICERS ARE:
OlllER
INCI..
EXCL
* See Below
DESCRIP110N OF OPERAOONSJLOCATlONSIVEHICLESISPEClALITEII8
GLASS COVERAGE
CERTIFICATE HOLDER IS AN ADDITIONAL INSURED - SUBJECT TO COMPANY FORMS
::t€MJmg.~15.:tll~ftMMMmffff:lfMmltMMmlt:MtH.*t'itMw.Mm!mk.J.~tt4;1.l<HHW&MMM@tM;NM1NlilWttMM%MfuMnMlliMiiMlifii:iilli:tili::
SHOULD /1M'( OF THE ABOVE DE8CRIBED POLICIES BE CANCELLED BEFORE 11tE
CITY OF CLEARWATER
HARBORMASTERS OFFICE
25 CAUSEWAY BLVD
CLEARWATER FL 34630) 0_
I Eileen Benne ~
.'io.&ijpWmi:::r....:::::.:.:.:..:..lt:l:mt::lmtflt:f:tllftlltlmttIttllmMll1M1Hl\11Rltft:'tft:tt:l:miIfltH::::::::::fl::t:f:tm::t:tl:,j:m::H1HRWmmrffJ.'Kp":'.JibJfQ.Wi'Q.iji'ft&HtiifiJ:
EXPIRA110N DAn:: THEREOF, THE ISSUING COMPANY WI.J. ENDEAVOR TO MAIL
.l.O- DAYS WRITTEN NOnce TO THE CERTIFICATE HOUlER NAMED TO 11fE LEFT,
BUT FALURE TO MAL SUCH NO NPOSE NO OBUGATION OR UABIUTY
OR
· t ~";~~!!~"!!~!I!!~!!~!!'~!!~":~'!~!:!~~!!!!~~![C;~i~4
SIDE OF THIS FORM.
BANKERS INS GROUP . MARGBO-3 E
HH.HHHHHHHH' HHi!FFEc'tiViEHH H H' .HHHH. H.HHHHH HHiEXPlRAtioif .
.'H'..H.P"n:H'H . H ...T1.~IL . .. HH H.HHP"TE;. . H'H."H" .."I1MI;.
. X. AM . X .12:01 M1
H?L~r;jI94HH 12: 01 PM ...6/},9Ir;j4H NOON
. THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED
....~. H ~O~~~~ .~~~.~~I~I~GP~~~~.~O:... !\.f> J?:r,. :I:~1\ T:I: () Ii... ..
. DESCRI'110N OF OPERATlONSNEHlCLESlPROPERTY (Including Locatlon)
FIRE
LIABILITY CGL
'. .~E~~.~. .A(;.~~~C3~~~.......... . ~ .1. J.. () ()O ,. ()() 0
. PRODUCTS - COM PlOP AGG. $1 000 000
,........................................... ..... .......J..............,............
~~~SO~~~.AJ)~: I~URY .$~L()()()LO(l()
· EACH OCCURRENCE H.' H H$},,()(){),O(lO
. ARE DAMAGE (Any one flre) $
..................... .
. MEn. EXPENSE (Any one peraon)
COMBINED SINGLE LIMIT
BODILY INJURY (Pet' Peoson)
BODILY INJURY (Pet' aecldent)
PROPERTY DAMAGE
MEDICAL PAYMENTS
.................. .................................... ................... .....................................................
PRODUCER
. COMPANY
.. .HHHHHHHHHHHHHiiiNDERNiiH
CONDON MEEK INC
1211 COURT ST
CLEARWATER FL 34616-5897
CODE SU~ODE
81722
INSURED.. .
MARINA GIFTS & SOUVENIRS
CARPENTER ENT INC
25 CAUSEWAY BL
CLEARWATER FL 34630
~9V~Mij~..;.'i
:::::::::::;:::::;;:::;::::::::::::;::::::~:j:::~:~:i!!!!!j:~::!!::!i!~::::!:!!:!i~~:::!:!;i,
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... ............, ....",.
.....,................. .
.'....................,........,........
.:.-'....-:...:.:::.
........... '..........--"..."....""....
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,......',.,'.;:;.:::.;
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;::::::;:;::"'::.;';,._....
......,'. ::.:::.:.
";:::;;:.;::.:.;;;,;.:.:.:.:.:.:
TYPE OF INSURANCE COVERAGEIFORMS
. PROPERTY CAUSES OF LOSS. ..... ..............Contents.~Rep lacement"'Cost
BASIC BROAD. X SPEC.
AMOUNT
57,000
GENERAL UABIUTY
ClAIMS MADE X OCCUR.
OWNER'S & CONTRACTOR'S PROTo .
· RETRO DATE FOR ClAIMS MADE:
AUTOMOBI.E UABUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
PERSONAL
PROTo
UNINSURED MOTORIST
AUTO PHYSICAL DAMAGE DEDUCTIBLE
COLLISION:
OTHER THAN COL:
EXCESS UABLlTY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
. ALL VEHICLES
: SCHEDULED VEHICLES
. ACTUAL CASH VALUE
RETRO DATE FOR ClAIMS MADE:
: STATED AMOUNT
. OTHER
EACH OCCURRENCE
AGGREGATE
SELF-INSURED RETENTION
STATUTORY LIMITS
EACH ACCIDENT
DISEASE-POLICY LIMIT
DISEASE.EACH EMPLOYEE
WORKER'S COMPEHSAT1ON
AND
EMPLOYER'S UABUTY
SPECIAL CONDmoNSlOlltER COVERAGES
SUBJECT TO COMPANY FORMS
INCLUDES GLASS COVERAGE
<NAME&. ADDRESS)'
..... ..-....- .--.........."... ......
..... ....... .
.-...'..,...._.-.....-.-..-.-............_-.-.._-.---.....-...-...-..-.-.'--.-.-.....'...-.-...-.-.-.-.'.-..,'....'.-.-..-....',.-.....-.-.',......-.-.-....-..-.-.-...-,-'.'..-.-.-.--:.-.-.'.:-
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. ........ ....-.-..-....-.-..-.-...............- ..........."..
.....-- .....-...-"...........,....
.-........,.......-.-,...--.-......-.
..... ......-..... ........--.
.............,..--.
"HH" MORTGAGEE
HH..L~OSS PAYEE
> LOAN.
.,............,...............,.....,......,..
......'......,...............,.,....,...."...
...........-...............,....,......-..,..
... ......... ..............."...............
.......................... ....
..-. -.. ...............-...
. ................
X
ADDrnONALINSURED
CITY OF CLEARWATER
HARBORMASTERS OFFICE
25 CAUSEWAY BLVD
CLEARWATER FL 34630
L1MttS'..}>".,"""" .
COIN9UR.
80
s1 000
$
$
$
$
$
$
$
$
S
$
$
$
> AUlltORIZED REPRESENTATIVE c.
;;;;.. ~ 2/)
( 7 ". /.:s.- ~ <......
Eileen Benner )<.. o. -"- . 1'----
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,.,2,,,,):",,,,,,.,c,,,,,.,,.-.c.,,,' .. ..,. ....~_.. ."... ...... .. ... ... "....c..
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A.~.tltl..
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.;:;..:;::)::);~):{~;:(~~):;;:):);:::;H:;{::H::::::: ' ......... .......... 8 08 9 4
THIS CERTlRCATE IS ISSUED A A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTlRCATE HOLDER. THIS CERTlRCATE
DOES NOT AMEND, EXTEND OR At TER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
ISSUE DATE (MM/DOIYY)
PRODUCER
CONDON MEEK INC
1211 COURT ST
CLEARWATER FL 34616-5897
COMPANIES AFFORDING COVERAGE
MARINA GIFTS & SOUVENIRS
25 CAUSEWAY BL
CLEARWATER FL 34630
COMPANY A
LETTER
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
COMPANY E
LETTER
BANKERS INS GROUP
INSURED
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POUCY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONOlTlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE
POUCY NUMBER
POUCY EFFEC11VE POUCY EXPIRATION:
DATE (MMIOOIYY) DATE (MMIOOIYY)
UMrTS
09490265900
5/19/94
5/19/95 : GEN~~.~.(;(;.R.~(;~!~..........5~L9.qC?L9qC?..
~ PR()[)lJ<::.T~~~/OP AGG. ....5~f.9q9L9q9..
. PERSONAL & AnV. INJ~RY..:~~L9.(?9,C?(?9
: EACH OCCURRENCE : 51 000 000
...:.......,..............t...............
~ ~~~.?~~~~ (~~"~) : 5 ......... ...
MED. EXPENSE (Any one person) . S 1 0 0 0
CLAIMS MADE X : OCCUR.
OWNER'S & CONTRACTOR'S PROTo
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULEO AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE LIABILITY
UMRREUA FORM
OTHER THAN UMBREUA FORM
COMBINED SINGLE 5
LIMIT
BODILY INJURY S
(Per penon)
RODIL Y INJURY S
(Per ooolderrt)
PROPERTY DAMAGE 5
EACH OCCURRENCE 5
AGGREGATE S
WORKER'S COMPENSATION
EACH ACCIDENT
S
AND
EMPLOYERS' UABIUTY
DISEASE-POLICY LIMIT S
DISEASE-EACH EMPLOYEE 5
ornER
DESCRIPTION OF OPERA TlONSILOCA TlONS/VEHlCLESlSPECIAL ITEMS
SUBJECT TO COMPANY FORMS INCLUDES GLASS COVERAGE
ADDITIONAL INSURED ATIMA - LANDLORD - CERTIFICATE HOLDER
CITY OF CLEARWATER
HARBORMASTERS OFFICE
25 CAUSEWAY BLVD
CLEARWATER FL 34630
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY Will ENDEAVOR TO
EPT MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
CITY CLlRK D.. LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHAll IMPOSE NO OBUGATlON OR
LIABIlITY OF ANY KIND UPON THE COMPANY, ITS AGENTS' OR REPRESENTATIVES.
L/L~.,
( . . ,
. ",...""... ," .........- -, ..
.... "............,....-...........-,......'.-............................................................................-.
..,.....................................................,.......................................................................,...............................................,.,.................................... .., ................... .....
.... A.te... ::iINStJilllJll:::':i.I[I!I!II!ii:ii .. .. .'.?::::::::::::::::::?;:::'::::.' '.::1:\:.:::::::.::::' ....: ~UE DA11!(MtM)DIVYl
::::::::::::::::::::::::::::.'\:::::::::::::::::::::::::::::::::::::::::::))):):: ..... ",.....:::....... . .)::))(.:...:::'..'.::::::::'.:. .:. ..........7./.:t. .f3.1. ~.~...
THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE
SIDE OF THIS FORM.
. ....................................-..............................,................... ......................-....................-.....
PRODUCER
'COMPANY
: -..uER NO.
CONDON MEEK INC
1211 COURT ST
CLEARWATER
FL
AfCEIVED
34616 - 5 J U L 2 0 1994 .....?~I~:I~~:~~~.I88UED TO EXT9fD COVERAGE ~ THE ABOVE NAMED
SU~ODI! ' X, COMPANY PER EXPIRING POUCY NO: APPLICATION
... ......c;lTY..CL~~~..I>.~~~.~: DE.CRiPTiOiiio;;OPEiiA~OPERTY.ji;iOiiiii;ijji.OCtiiOnj' .......
. FIRE
LIABILITY CGL
BANKERS INS GROUP : MARGBO-3 E
............. ......... .Efiii!C"iiW......................... .. .,....... ..:.... ...... .EXPMAtiON.............
...... .PAll;..............:............. .l!M~)(1'NA .. ................ QA~............ .:. x. .:::1 NIl:
12 : ol...:..PfA...L...~I:t..~I~.~...... . NOON
CODI!
81722
'MiliREO' .. ...........................
MARINA GIFTS & SOUVENIRS
CARPENTER ENT INC
25 CAUSEWAY BL
CLEARWATER FL 34630
.COYWGES<<
.. ,........,.......-..",.......
..........................-..
......."....,.................,........................,...-....-.--..,.
.....,...............,...............................................
..... . ......... .................................................
. .. .. ...............................................
.. ....................................
. .... ..... .
... ........... "'<<:,,::::::,".liii:'$:>
,DEDUC'TaI! COlNSUR.
AMOUNT
TYPE OF I'ISURANCE COVERAOEIFORMS
PROPERTY CAUSES OF LOSS' ... ... .......contenfs~Repiacement...Cost.
BROAD: X SPEC.
57,000
250
80
CLAIMS MADE : X: OCCUR
OWNER'S & CONTRACTOR'S PROTo
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
GARAGE UABIUTY
, ALL VEHICLES
: SCHEDULED VEHICLES
'.~~~.~.~()~~~~~.... ..... .:.~~ .f.g.c:>.9..f..CJ..c:>.CJ.
.~.~~!~.::-.~~~~~.~()~~:.~! .f.g.c:>. () .f..CJ..c:>.9...
: PERSONAL & ADV. INJURY :'1 0 0 0 00 0
.................... ................... .,.. .....,... ... ....,. .... .........
:~.()<:lc,~R.F.'~~............:..~.:t..,9.qq.,.()qq.. .
: ~~.E~~().e. .(':':! ~ .n.,:,I.. ..:. ~......... ... .........
: MED. EXPENSE (Any one peI8OI'l) :'1 000
:~.~~I~.~.~~~~.~'!...................
:~':lI.L~.~.U.~~(.~..~J...:............
:".o.~I~~.~~~~.~~.~):.~.........
: PROPERTY DAMAGE : .
MED.IeAl.PAYMENTs.........'.......... .
PERSONALij;,Ju.RYPROi' ..:i........ .........
.....................-.................
: UNINSURED MOTORIST ' .
.....................
:.
: ACTUAl CASH VAlUE
RETRO DATE FOR CLAIMS MADE:
AUTO PHY8ICAL DAMAGE DEDUCTIBLE
COWSION:
. STATED AMOUNT .
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
RETRO DATE FOR CLAIMS MADE:
'OTHER
EACH OCCURRENCE .
AGGREGATE .
SELF-INSURED RETENTION .
STATUTORY LIMITS
EACH ACCIDENT .
DISEASE-POLICY LIMIT .
DISEASE.EACH EMPLOYEE .
WORKER'S COMPENSATION
AND
EMPLOYER'S UA8LITY
SPECIAL COHDmoN8/0THER COVERAGES
SUBJECT TO COMPANY FORMS
INCLUDES GLASS COVERAGE
..N,4lil$..,40QRESS::.........,
,.._-,---,.....,....................'........'.'..........-..................'.
...."".....-.-.-.......... .......
..........._............'................................_................'.....................
. . . . . - - . . . . . . . . . . . . . . . . . . . . . . . . - - . . . . . . . . . . . . . . .
.........."....,.............,......."........
. ...... ..'.....,.....-.............................................-..........
.. ........................
.... ............
.......
...._..-.-.....-...........-.-....-'.-.'....'..
......................-.....
.....................-.......
...................... -.....
...........-.................
............................
............... ............
.... .......................
...,......-.-_...
.............:.:.:.:.:.:.:.:-:.:.:.:...:.;':.:.:.:.:.:.:.:-:-:-:.:-:.:-:.:.:.:-......:.:.:-:.:.:.:-:-:.;.:.:-:.:.:-.........
.....................................................
....................................................
.."............... .,..............,.....
. ... ..........................
.... ............
.......... ......
.................
..................
. . . . . . . . . . . . . . . . .
..................
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..................
.................... -.........
. . . . . . . . . . . . . . . . . . . . . . . . - . . . . . . . . . . . . . . - .
..........................................-...................................-_...,..
..........................................
.......,....,...."....................
........,..."..................... .
. .... ,-....,................
. ................
: MORTGAGEE
:X:
ADDmONAL INSURED
CITY OF CLEARWATER
HARBORMASTERS OFFICE
25 CAUSEWAY BLVD
CLEARWATER FL 34630
iO~~OS8 PAYEE
.A~~Q:.t.~'ttMr/::::
.................
...,.............
....-.. ---.. ..............
....-..... .................
. . . - .,. - . . - , . . . . . . . . . . . .
.. ---.'........."......
.... ....- .. .............
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...... ...... ............
.. ......... - -.......... - . . . .
.. . . .................
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. . . . . . . . . . . . , . . . . .
........... ......
.. ...........-........................
............. ,....
........,..........
....................
...................
. . . . . . .. .... ..
...
.......
;:::::::::::;:::::::::;::::::::::::::.:::::.:.:.:::::::::::::::::::::.:.:
~
i~~~~jJH)
\: AuntORlZED REPRE8EHTA11VE
Eileen Benner
'.
BANKERSINGURANCECOMPANY
I ST. PETERSBURG, FLORIDA IRE eEl V E D
BUSINESSOWNERS POLICY DECLARATIONYL 2 5 1994
<:;
;o!iNEW
r---
Renewal of Number
;,
Policy No. BP 09-4902659-00
Named Insured and Mailing Address INo.. Street. Town, or City. County. State. ZlpCodel
Condon-Meek, illc.
CITY CLERK DEPT. Agent#09/81-722
Carpenter Enterprises, Inc. dba
Marina Gifts
25 Causeway Blvd.
Clearwater, FL 34630
Policy ~eriod: From 5/19/94 to 6/19/95 at 12:01 A.M. .Stahdard Time at your mailing address shown above.
.Exceptlons: 12:00 noon In Michigan. New Hampshire. North Cerollna and Puerto Rico.
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO
PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
..:io.~fNt~~6.i~d~ii~16N::::::::[:[[[[:[:::,:::::.::::::::::::.!![::::::::::::::!:::.:::i::::::[::i:::::::::::!::::::::[i:::::i:[[:[::::::::::::j:::i:i:i:::::::::::::::::::::::i:[:::i::[::::,[::::::::::::,:::::::i[::::[::::::[:::::::::::::::::::::::::::[:'::::::[::::::::[:[:[:::[::::::::[:::[::::::[[::::[::::::::::::::[::::::::::::::::::::::::::::[::j:::i:::::::::[i:::i!:::::::::::i[::::::::::::[:i!::::,:i:::,.:::::!......:::::!:::)\:':::i:!!:,:'
FORM APPLICABLE
Standard .x. Special
Joint Venture _ Partnership ..x. Organization (Any Other)
Limits of Insurance for Buildings (Coverage A)
. Actual Cash Value - Buildings Option (Y/N)
. Automatic Increase - Building limit (Percent)
BuslneS8 Personsl Pro Br (Coverage B)
Deductible $250.
%
%
%
$67000.
.
$
Optlonel Coveragell - Applicable only If an "X" III IIhown below:
1. Outdoor Signs
2.)( Exterior Grade Floor Glass
3. - Burglary and Robbery (Standard Form only) or
- Money and Securities (Special Form only)
4. = Employee Dishonesty
5. Mini-computer
6. -
7.
!::!ttAifilit,tAN6iMmi6it::~Iv.AA~Nts!:::::::@[:i:::::::::::':::[::::::::::::::::::::::::::::::i:::@::i:::::i:::::::::::::i:,::::::::!i:ii:i::::::::::::,i::::::::i::::m:::::::,:::::::.i::.:!.::,!:::::::::::::'::':::::!!;:,::%::!m::::i::i::::::::::::::::ii:::::':':::mt:i:::i::,::::::::i:::!::::,:::'i:::!::!::::'::'::::::[i[:::j:::::::::::;::!:!'!,:::.::!::::'::::.:::!::!:!::::,:.::::::!:.:'::.:::::!!:!::
$
591.
$
$
$
$
Limits of Insurance
l)er occurrence
Square Feet
Inside the Premises
Outside the Premises
per occurrence
per occurrence
."
Except for Fire Legal Liability, each paid claim for the following coveraQes reduces the amount of insurance we provide during
the a Iicable annual eriod. Please refer to Para ra h 0.4. of the Buslnessowners Liabili Covera e Form.
Limits otlnsurance
liability. and Medical Expenses
Medical Expense
Fire Le al Liabilit
Countersigned: July 19, 1994 an
EMPA TF $ 4.00
FCS $ .74
epresentatlve
..
THESE DECLARATIONS, TOGETHER WITH THE COVERAGE FORMIS) COMMON POLICY CONDITIONS AND FORMS
AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY.
Requesls for seMce IInd qUllSlionl reglnllng coverlgll should" direclld 10 your Iglnt. In Ihl liven I of In Imergllncy wh.rll you Irl unlbl.lo con, Ilcl your Iuenl,
JOu mey conllcl us dhcllv It the foUoWIn, number: 18131823-4000. W. Irl unllbl. to Icc.pl .collllct" Clns.
JDt 195 O.X lEd. 1-87) Includell copyright materiel of 'llIurlnellll,,1c1l OfficI, nc~ with It II permllllon. Copyright. 'naurlnel ServlclI OfflcI,lne~ 1984. 198&
..
J
r
'~-
..;
I
I
;
Policy Number: BP 09-4902659-00
BUSINESSOWNERS
THtS ENDORSEMENT CHANGES Tl-IE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED - MANAGERS OR LESSORS
OF PREMISES
This endorsement modifies Insurance provided under the following:
BUSINESSOWNERS POLICY
SCHEDULE*
Deslgnatfon of Premises (Part leased to You):
25 Causeway Blvd.
Clearwater, Fl 34630
Name of Person or Organization (Additional Insured):
City of Clearwater
Harbormasters Office
25 Causeway Blvd.
Clearwater, Fl 34630
Additional Premium:
$30.
A.
The following Is added to Paragraph C. WHO IS
AN INSURED In the Businessowners liability
Coverage Form:
This Insurance does not apply to:
4. The person or organization shown In
the Schedule Is also an Insured, but
only with respect to liability arising out
of the ownership, maintenance or use
of that part of the premises leased to
you and shown In the Schedula.
1. Any woccurrencew that takes place
after you cease to be a tenant In the..
premises described In the Schedule.
2. Structural alterations, new construction
or demolition operations performed by
or for the person or organIzation
designated In the Schedule.
B. The following exclusions are added:
"
*Informatlon required to complete this Schedule, If not shown on this endorsement, will be shown In the Declarations.
-
BP 04 02 01 87
Copyright, Insurance Services Office, Inc., 1984, 1985
CERTIFICATE OF INSURANCE ,
oi..Af6.. U--1.--~
I
Issue Date 03/27/92
===============================================================================
(25-S 3/88)
Producer
BURKE-LEHMAN INSURANCE, INC.
2173 N.E. COACHMAN RD.
CLEARWATER~ FLORIDA 34625
TELEPHONE(~13)441-4914
FAX*442-2409
Code Sub Code
'This certificate is issued as a matter of
information only and confers no rights upon
the certificate holder.This certiflcate does
not amendiextend or alter coverage afforded
by the po icies below.
Comgany Letter A---------
SEIBELS BRUCE GROUP
Company Letter B------
Company Letter C---------
,Company Letter D--------- - ------------ -
;eompany. Letter E-------- ClIYCLERKDEPT...
I
,
. ~--------------------------------
V Insured
Marina Gift & Souveniers
Car~enter Enterprises Inc DBA
25 Causeway Blv~.,Rooms 5 & 9
Clearwa'ter,-flnrid a-34b3()., ".., ,,'--
COVERAGES=======================================================================
This is to certify that Rolicies of insurance listed below have been issued to
the insured named above for the period indicated notwithstanding any require-
ment, term or condition of-any.-eontract or other document l&J.ith respect--to .,-
,~hich this certificate may be issued or may pertain, the insurance afforded by
the policies described herein is subject to all the terms, exclusions, and
conditions of such policies.Limits shown may have been reduced by paid claims.
------------------------------------------------------------------------------
Exp DatelLiability Limits
--------:-----------------
:General Aggregate
03/14/9311,000~000
Prod-Lomp/Ops Agg
Per.& Adver. Inj.
Each Occurence
1,000.1000
Flre uamage
50,000
Medical E:.:pense
5,000
C:Type of Insurance Policy Number Eff Date
-:------------------------ --------------- --------
'GENERAL LIABILITY
A x Commercial General CB07477068 03/14/92
Liability
Claims Maoe x Occur.
Owner's & Contractors
Protective
------------------------ --------------- -------- -------- -----------------
Comb. Single Lim.
I
,
I
,
IBodily Injury
: (Person/Accident)
I
,
: Property Damage
I
I 1 I I
------------------------1---------------:-------_1_-------:------------------
EXCESS LIABILITY: : :Occurr. Aggregate
I , I
, , I
Other than Umbrella : : :
------------------------1---------------:-------- --------1------------------
WORKER'S COMPENSATION : : lStatutory
AND : I : Each Acc
EMPLOYER'S LIABILITY: : lDis. Lim
::-~I-c~D i 5-.. E.mp-n~__n_
------------------------:---------------;--------:--------1------------------
OTHER I : l :
I I I I
I I I I
I I I I
I I I I
AUTOMOBILE LIABILITY
Any Auto
All O,",ned Au tos
Scheduled Autos
Hired Autos
Non-Ovmed Autos
Garage Liability
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS========
Exterior grade floor glass included
CERTIFICATE HOLDER
------------------------------------------------------------------------------
City of Clearwater
ATTN: Risk Management
P.O. Box 4748
Clearwater,Florida 34618-474S
Should any of the above described policies be
cancelled before the expiration date thereof,
the issuing company will endeavor to mail 30
days written notice to the certificate holder,
but failure to mail such notice shall impose
no obligation or liability of any kind upon the
company, its agents or representatives.
:~ _ _ _ ~:=_ ~~~~c==_~_ ~..= ===~ _ _ _ _ _ _ ~.~ ~~=~~~~~~~~~~EN~~~C{~~~~!~~~~~~~~~~
________________________________________~~_____~1~~________
(J)
jQ-O/3-0 /