EVIDENCE OF PROPERTY INSURANCE (3)
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., ...."....;.OiiiWi..I'$EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE
, 'RIGHTSAND PRIVILEGES AFFORDED UNDER THE POLICY.
I PHONE COMPANY
PRODUCER iAiC: No, "-tl, 727-796-6666
. Acardia Southeast, Inc. ZURICH AMERICAN
., pO Box 31 666
.... Tampa, FL 33631 -3666
..
CODE: 09-103150 I SUB CODE:
AGENCY ID #: PER54440
CUSTOMER
INSURED LOAN NUMBER I POUCY NUMBER
PACT, Inc., Performing Arts CP0278060501
Center Foundation, Inc. EFFECTIVE DATE I EXPIRATION DATE
1 1 1 1 McMullen Booth Road 10/01104 10/01/05 I n CONTINUED UNTIL
TERMINATED IF CHECKED
Clearwater FL 33759- THIS REPLACES PRIOR EVIDENCE DATED:
I 10/07/04
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LOCATION/DESCRIPTION
1 1 1 1 MCMULLEN BOOTH RD (RUTH ECKERD HALL)
CLEARWATER FL 34619
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COVERAGElPERILSIFORMS AMOUNT OF INSURANCE DEDUCTIBLE
BUILDINGS - ALL STRUCTURES $ 40425000 5000
CONTENTS - ALL STRUCTURES $ 1240000 5000
WIND & HAIL DEDUCTIBLE - COMBINED PO & BI 850000
SPECIAL FORM. REPLACEMENT COST \ . ~;"'.' ~"N;.'\ .'frD
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EaUIPMENT BREAKDOWN (B&MI "-~-I 10000000 5000
FLOOD I 5000000 50000
OC .' ~.~Ju4 1
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LOSS OF BUSINESS INCOME , i 1841000 72 HRS
WIND & HAIL DEDUCTIBLE - COMBINED PO & BI L... ._-._,........,'~ 850000
TIME ELEMENT DUE TO EaUIPMENT BREAKDOWN PAfn:~. ~).. ;~_~;;!iEAnON 1000000 72 HRS
-
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CITY IS ADDITIONAL INSURED FOR INTEREST HELD IN PREMISES OF G:./~.
RUTH ECKERED HALL. (2{ (; ';. {:J Ao?l<.. "5/',
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*10 DAYS NOTICE OF CANCELLATION APPLIES FOR NON PAYMENT. *
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THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE
POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BElOW 30 DAYS
WRITTEN NOTICE, AND WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT
INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW.
NAME AND ADDRESS MORTGAGEE X ADDITIONAl INSURED .... . ........................ ..,.. ............
CITY OF CLEARWATER LOSS PAYEE
ATTN: LEO SCHRADER, RISK MGMT LOAN #
P 0 BOX 4748
CLEARWATER FL 33758-4748 AUTHORIZED REPRESENTATIVE