CERTIFICATE OF LIABILITY INSURANCE (2)
ACORD CERTIFICATE OF LIABILITY INSURANCE
1M
PRODUCER ~ 7) 797 - 519 3
All~Rehbaum & Capes Assurance, Inc.
2433 Gulf to Bay Blvd.
P.O. Box 4620
Clearwater, FL 33758
INSURED Carpenter Enterpri ses, Inc.
d/b/a Marina Gifts
25 Causeway Blvd.
Clearwater Beach, FL 33767
FAX (727)797-8605
DATE (MMlDDNY)
08/20/2002
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
Northern Insurance Company
Zenith Insurance Company
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION 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 OFSUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
W~ TYPE OF INSURANCE POLICY NUMBER -DATE '(MMlDDIYY) -cATE (MMlDDIYY) LIMITS
GENERAL LIABILITY PAS031650139 07/25/2002 07/25/2003 EACH OCCURRENCE $ 1000000
-
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 1000000
I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 10000
A PERSONAL & ADV INJURY $ 1000000
-
GENERAL AGGREGATE $ 2000000
-
GEN'L AGGREGATE LIMITAPPLlES PER: PRODUCTS -COMP/OP AGG $ 2000000
Xl .nPRO- n
X POLICY JECT LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- $
ANY AUTO (Ea accident)
I--
ALL OWNED AUTOS BODILY INJURY
I-- $
SCHEDULED AUTOS (Per person)
I--
HIRED AUTOS BODILY INJURY
~ $
NON-OWNED AUTOS (Per accident)
~
PROPERTY DAMAGE $
(Per aCCident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
R ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
tJ OCCUR o CLAIMS MADE AGGREGATE $
$
R DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 833519706 07/25/2002 07/25/2003 X I TORY LIMITS I IVER-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT $ 100,000
B
E.L. DISEASE - EA EMPLOYEE $ 100,000
E.L. DISEASE - POLICY LIMIT $ 500,000
OTHER
DESCRIPTION OF OPERATIONSlLOCATlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
ertifcate Holder is Additional Insured for General Liability
CERTIFICATE HOLDER I X I ADDITIONAL INSURED; INSURER LETTER 1 CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Harbormaster ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City Of Clearwater BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
25 Causeway Blvd. OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
Clearwater, FL 33767 AUTHORIZED REPRESENT~ /l /A~(
, I!h /
. 25.~ (l/lJl} /" ' V' ) IIUN 1lJllt