CERTIFICATE OF LIABILITY INSURANCE (4)
ACoBD
TM
CERTIFICATE OF LIABILITY INSURANCE
DATE (MM/DDNYYY)
07/17/2004
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 ENTERPRISES INC. DBA MARINA GIFTS
25 CAUSEWAY BLVD.
CLEARWATER, FL 33767-2064
INSURERS AFFORDING COVERAGE
INSURER A: Maryland Casualty Company
INSURER B: Zeni th Insurance Company #040
INSURER c:
INSURER D:
INSURER E:
NAIC#
19356
0041
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.
INSR DD'I TYPE OF INSURANCE POLICY NUMBER PR,W~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY PAs031650B9 07/25/2004 07/25/2005 EACH OCCURRENCE $ 1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 1,000,000
I CLAIMS MADE 0 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 n PRO- n LOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- (Ea accident) $
ANY AUTO
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
HIRED AUTOS BODILY INJURY
-- $
NON-OWNED AUTOS (Per accident)
-
- 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 Z833519708 07/25/2004 07/25/2005 WC STATU- I IOJ~-
EMPLOYERS' LIABILITY -~-!Q~J!Q9
I-B- MJY PROPRIETORlPARUJER/EXECU;J:IVE. ->-....--. E.L. EACH ACCIDENT $
---'--'- .~-- _..--- ---,-- -~ ---.----- ----~ .- - --.- -- --" -
OFFICER/MEMBER EXCLUDED? E.L. DISEASE, EA EMPLOYEE $ 100,000
If yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ertifcate Holder is Additional Insured for General Liability
DER
I N
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
Harbormaster
City of Clearwater
25 Causeway Blvd.
Clearwater, FL 33767
ACORD 25 (2001/08)