CERTIFICATE OF LIABILITY INSURANCE (5)
A CORQM
CERTIFICATE OF LIABILITY INSURANCE
FAX (727)797-8605
Assurance, Inc.
DATE (MMlDDNYYY)
07/21/2005
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
Alley, Rehbaum & Capes
2433 Gulf to Bay Blvd.
P.O. Box 4620
Clearwater, FL 33758
INSURED Carpenter Enterpri ses Inc. and Simp y Dara' s,
DBA: Marina Gifts
25 Causeway Blvd.
Clearwater Beach, FL 33767
INSURERS AFFORDING COVERAGE
INSURER A, Maryl and Casual ty Company
INSURERB: Zenith 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. 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 OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
IN~~ ~'?,'?;~ TYPE OF INSURANCE POLICY NUMBER PR,W~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY PAS031650B9 07/25/2005 07/25/2006 EACH OCCURRENCE $ 1 ,000 , 000
X COMMERCIAL GENERAL LIABILITY DAMAGE ~91=~ENTED $ 1,000,000
I CLAIMS MADE [K] OCCUR MED EXP {Any one person) $ 10,000
A PERSONAL & ADV INJURY $ 1,000,000
I--
GENERAL AGGREGATE $ 2,000,000
r--
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $ 2,000,000
IXl n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
f-- (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 Z833519709 07/25/2005 07/25/2006 X I T~~~T~T,~-"I IOJb'-
EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000
B ANY PROPRIETOR/PARTNER/EXEOUTIVE
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
Property coverage includes glass breakage with no deductible
Harbormaster
City of Clearwater
Attn: Catherine
25 Causeway Blvd.
Clearwater, FL 33767
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICtES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
....!!!..- DAYS WRITTEN NOTICE TO THE CERTIACATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAlL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
ACORD 25 (2001/08) FAX: 462-6957