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CERTIFICATE OF LIABILITY INSURANCE (3) ACORQM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) 07/18/2003 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER (727)797-5193 FAX (727)797-8605 Alley, 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 INSURERS AFFORDING COVERAGE INSURER A: Maryl and Casualty INSURERB: Zenith Insurance Company INSURER C: INSURER D: INSURER E: NAIC# COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN 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 OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I,N~~ ~~1 TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE P~~!fJ' EXPIRATION LIMITS GENERAL LIABILITY PAS031650B9 07/25/2003 07/25/2004 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 1,000,000 I CLAIMS MADE [K] OCCUR MED EXP (Anyone person) $ 10,000 A PERSONAL & ADV INJURY $ 1,000,000 - GENERAL AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2,000,000 Xl .nPRO- nLOC POLICY JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - (Ea accident) $ ANY AUTO - ALL OWNED AUTOS BODILY INJURY - '. (Per person) $ SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY - (Per accident) $ NON-OWNED AUTOS - - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ~ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ ~ OCCUR o CLAIMS MADE AGGREGATE $ $ ~ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND Z833519706 07/25/2003 07/25/2004 X I WCSTATU., I IOJ~- EMPLOYERS' LIABILITY 100,000 B ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100,000 +-. n-ye~, d__.)clib" ....,.J"', --~.._:~-- -.-.. -~---~.~~ 1-- -----._.. -- ---- ------ SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ~ertifcate Holder is Additional Insured for General Liability Harbormaster City of Clearwater 25 Causeway Blvd. Clearwater, FL 33767 CANCELLA TI SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ...!!!..- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY ACORD 25 (2001/08)