CERTIFICATE OF INSURANCE (3)
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PRODUCER
Burke-Lehman Insurance, Inc.
2173 NE Coachman Road
Clearw~ter, Florida 34625
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,
COMPANIES AFFORDING COVERAGE
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COMPANY A
LETTER South Carolina
INSURED
M. Alfred Gregory
DBA Marina Gifts Souveniers
75. Causeway Blvd.,Rooms 5 & 9
Clearwater" Florida 34630
COMPANY B
LETTER
COMPANY C
LETTER
COMPANY D
LETTER
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED, ~
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 CONDI.
TIONS OF SUCH POLICIES,
BOOIL Y
INJURY
(PER PERSON) $
BODILY
INJURY
tJ~DENn $
$
$
$
$
$
$
CO
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TYPE OF INSURANCE
POLICY NUMBER
POliCY EFFECTIVE
OA TE (MMlDDlYYl
POLICY EXPIRA nON
DATE (MMlDDIYY)
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
Ii] OCCURRENCE
OWNER'S & CONTRACTORS PROTECTIVE
SMP4747223
03-14-88
GENERAL AGGREGATE
03-14-8 'RODUCTS.COMP/OPS AGGREGATE
PERSONAL & ADVERTISING INJURY
EACH OCCURRENCE
FIRE DAMAGE IANY ONE FIRE)
MEDICAL EXPENSE (ANY ONE PERSON)
AUTOMOBILE LIABIUTY
ANY AUTO
ALL OWNED AUTOS
SCHEDUL.ED AUTOS
HIRED AUTOS
NON:OWNEDAUTOS -
GARAGE LIABILITY
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CSL
$
PROPERTY
DAMAGE
$
A
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
03-14-88 03-14-89
EACH
OCCURRENCE
EXCESS LIABILITY
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$
$
OTHER THAN UMBRELLA FORM
STATUTORY
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CWC 7454774
$
$,
$
(EACH ACCIDENT)
(DISEASE-POLICY LIMIT)
(DISEASE.EACH EMPLOYEll::
DESCRIPTION OF OPERA nONS / LOCATIONS/VEHICLES/ RESTRICTIONS/ SPECIAL ITEMS
Copy to: Harbormaster'
Clearwater Marina,25 Causeway Blvd.
Clearwater, Florida 34630
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MAR 1 6 1988 C
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City Clerk
Clearwater City Hall
P.O. Box 4748 .
Clea~ater, Florida 34618
SttOULCl ANY OF THE AeOVE DESCRI5E;pdLli:::~-t: C~He-a.:t-{) *I"~P.E THE: ,,;.; ,..
PIRA TION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 OAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
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PRODUCER
Burke-Lehman Insurance, Inc.
2173 NE Coachman Road
Clearwater, Florida 34625
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.
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COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER South Carolina
COMPANY B
LETTER
INSURED
M. Alfred Gregory
DBA Marina Gifts Souveniers
75 Causeway Blvd.,Rooms 5 & 9
Cleawwater, Florida 34630
COMPANY C
LETTER
COMPANY D
LETTER
City Clerk
Clearwater City Hall
P.O. Box 4748
Clearwater, Florida 34618
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTA~~I-,/~~_
AUTHORIZED REPRESENTATIVE
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