POLICY
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I 'CITY OF CLEARWATER
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I nterdepartment Correspondence Sheet
Elizabeth S. Haeseker,Assistant City Manager
Bill Held, Assistant Harbormaster
Lucille Williams, City Clerk ~
SUBJECT: Insurance Policy - Marina Gift Shop
DATE:
May 8, 1985
I have received and reviewed the insurance policy renewal for the
marina gift shop. The coverage on this policy meets the requirements
of their lease agreement and expires on March 14, 1986.
WCH:mm
r:,ECEIVEO
MAY 9 1985
CITY CLERK
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.(J BUSINESSOWNERS STANDARD POUCY,{,; ;;ii~ili':~!';;:~r:~';~,',1 NT"",~'!Nf'4M," 'I' E7"0A," '8TES,;,~t:$1 ~!\~~~~LA,t1~tNTNO.
IX] BUSINESSOWNERS SPEtlAL POLlCY:"-:" "''''jlf','h e:;, "<E'leas., ,',., ,::" ','?"Renli::wcu."
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This Declarations Page With ''Policy Provisions" completes'the below 'numbered' pOliCy ,:,.......,. ,.. ...-
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Item DECLARATIONS POLICY NUMBER BO 772 4412
1. .NameJ JnsureJ M. Alfred Gregory d/blaMar~ Gift Souven1ers
:'1. 75 Causeway Boulevard'ROomS'S & 9 .''',
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Mailing Address Clearwater, Florida
(Number, Street, City or Town, County, State & Zip No.1
2. Policy 'Period: ~~.:~: ::: ~:~~,.:, :!, =r',,~I:O;: ,~i,~~I~t~l,o&:.o:: From: . 1/1/, Jr:l.r::. To: 1. J lh./Rf.
REPRESENTATIVE: Agent or Broker . Burke-Lehman Insurance, Inc.
Office Address . 09-162 C,ITY Qt CLEARWATER
Town and State . _4 1i'1~-.f~~ 1.1.r::.1"
~r MAY 2 1985
HARBORMASTERS OFfiCE
INSURANCE COMPANY
"..CUI( N[W '0" K 1 ) 2 Q 1
3. The Named Insured is: 1&1 Individual o Partnership o Corporation
o Other (Specify)
4. Mortgagee's Name and Address None
5. Business of the Named Insured (!.f{:t- C:'hnn
6. In Consideration of the premium Insurance is provided the named insured with respect to those premises described in the Schedule below and with
respect to those coverages and kinds of property for which a specific limit of liability is shown, subject to all of the terms of this policy including
forms and endorsements made a part hereof:
SCHEDULE-SECnON I-8UllDING, BUSINESS PERSONAl PROPERn, lOSS OF INCOME. tt MONEY .. UCURITIES "
Described Premises Umits of liaIIillty
COy. A-Building(s) Replacement Cost 0 ACV 0 $
Location of Premises: Same as Above $
$
Cov, B-Business $ 35,000.00
Personal Property $
Personal Property $
Automatic Increase in Insurance. Coverage A-Buildingls) shall be automatically increased by 2% or %, -,,-
whichever is greater at the end of each period of three months after the inception date of the policy,
COY, C-Loss of Income Actual Loss Sustained, Not exceeding 12 Consecutive Months,
Cov, D-Money and Securities "NOT APPLICABLE FOR On Premises- $10,000
STANDARD POLICY" Off Premises- $ 2,000
SCHEDULE-SECTION II COMPREHENSIVE BUSINESS LIABILITY COVERAGE
limits of liability
COy, E-Business liability $ 300,000.00 each
The limit of liability with respect to the completed operations and products hazards combined is an aggre- occurrence
gate limit for all occurrences during the policy period. ,.
Fire Legal Liabilit~ $50,000 each occurrence
Coy, F-Medical Payments $1,000 each person
$10,000 each accident
7. Optional Coverages: The following optional coverages are afforded under this policy only when designated by an "X" in the box(es) shown below,
limits of liability
Employee Dishonesty $5,000 each occurrence
Exterior Signs $
, Exterior Grade Floor Glass Included under Coverage A or Coverage B
Other (DeScribe) $
Additional Insured X See Form 0402
8. Policy forms and endorsements BU0002(5/76),BU0003(5/81) ,BU0134(10-r83) ,BU0122( lU75WUQ2.Q~75) ,
attached at inception, if any: IL0002(1/77).BU0404(8/79),BU0402(8/76) ,50277(6/ 8i~UOO04(4/84))
9. Annual Premium for the M Standard POlicY70016~~/802 $
X S . I P r anll 0 IOnal overages $ 554.00
pecra 0 ICY
tt NOT APPLICABLE FOR STANDARD POLICY,
Countersigned By
Cd--nu'(.'-Lcl. k? &u.L
, Authorized Agent
Form No. B0700.1O Rev. 8/82
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9USINESSOWNERS The "Persons Insured" provision is amended to include as an Insured the person
COMPREHENSIVE or organization designated below, but onlywith respect to liability<arisingout of
BUSINESS LIABILITY' the ownership, maintenance or use of that part of the p"remises designated below
ADDITIONAL leased to the named insured, and subject to the following additional exclusions:
INSURED EN. The insurance does not apply:
(DpORS~MENLT d t 1. to any occurrence which takes place after the named insured ceases
remises. ease 0 .. '
the Named Insured) to be a tenant In said premises: or
2, to structural alterations. new construction or demolition operations
performed by or on behalf of the person or organization designated
below.
SCHEDULE
Designation of Premises
(Part Leased to
Named Insured)
Name of Person
or Organization
(Additional Insured)
Additional
Annual Premiums
75 Causeway Boulevard
Rooms 5 & 9
Clearwater, Florida
City of Clearwater -
$15.00
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This Endorsement must be attached to Businessowners Policy Change Endorsement when issued after policy is
written.
au 04 02 (Ed. 08 76)
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r-uuCYNUrn-De-FlSU'772 -/tit; lfSSlIed to' -'. . . ." ,..... '.......... .,: '.' ". '.' . _.',_.;:,.~.:..~..',.,:.,!!;.i"'."'~. '.>:\.;.~..'.":.~:.'..""".:.".i,,',.,;,',"',"""';'.' ....:....".:'~... '
by: EXCELSIOR INSURANCE'COMpl~Alfred Gregory d/b/a~~ina.Gife~':SOuv~~e:tS~l:"':;1
It is hereby understood and agreed that under form BU0002, Page 8 of 23, the
deductible clause is corrected as follows:
This deductible clause does not apply to coverage as provided for Loss of
Income.
1. With the exception of loss by theft, the sum of $250.00 shall be
deducted from the amount of loss of property in anyone occurence.
This deductible shall apply:
a)
separately to each building, including personal property
therein;
separately to personal property in each building if no
coverage is provided on the containing building;
separately to personal property in the open (including
within vehicles).
b)
c)
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INSURANCE COMPANY
Syracuse, New York 13203
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Authorized Representative