CERTIFICATE OF LIABILITY INSURANCE (2)
06/28/01 15:00:58
From:(727)577-5775
To: 18132812411
Hull & Company, Inc.page:002/002
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PRODUCER
REAL INSURORS
5005 W. Laurel St
Suite 214
Tampa, FL 33607-3836
DATE (MM/DD/YY)
6/28/2001
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
COMPAtJY
A SCOTTSDALE
INSURED
Bait House, tic
P.O. Box 3025
Clearwater, FL 33767
COMPANY
B
COMPANY
C
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REOUIREMENT, 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO
LTR
POLICY EFFECTIVE POLICY EXPIRATION
DATE (MM/DD/YY) DATE (MMIOD/YY)
TYPE OF INSURANCE
POLICY NUMBER
LIMITS
GENERAL LIABILITY
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
7/1/2002
GENERAL AGGREGATE $
PRODUCTS. COMPIOP AGG $
PERSONAL" ADV INJURY $
EACH OCCURRENCE $
$
$
CPS0440322
7/1/2001
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
80DIL Y INJURY
iPer person)
800ILYINJURY
(Per a!Xldenl)
PROPERTY DAMAGE
GARAGE LIABILITY
ANY AUTO
AUTO QtjL Y . EA ACCIDENT $
OTHER THAtJ AUTO ONLY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THANUMBRELLAFORM-- - --
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
EACH ACCIDENT $
AGGREGATE $
EACH OCCURRENCE $
AGGREGATE
THE PROPRIETORI
PARTNERSiEXECUTIVE
OFFICERS ARE
OTHER
$
EL DISEASE POLICY LIMIT $
EL DISEASE EA EMPLOYEE $
ECEIVED
DESCRIPTION OF OPERATIONSlLOCAT10NSNEHICLESiSPECIAL ITEMS
CCr-( C_ C6l1L
CC ~ r<J 5 K; f\t\ ?r<2--1 ,J e--
JUL 02 ?iHl1
RISK MANAGEMENT
CITY OF CLEARWATER
RISK MANAGEMENT DEPT
PO BOX 4748
CLEARWATER, FL 33758-
$
500000
500000
500000
500000
50000
5000
EXCLUDED
$
EXCLUDED
$
EXCLU OED
$
EXCLUDED
EXCLUDED
EXCLUDED
EXCLUDED
EXCLU OED
EXCLU OED
$ EXGlUDE8
$
EXCLU OED
EXCLUDED
EXCLUDED
RECE~VED
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
JUL 0 8 2001
/---- ~ OF ANY KINO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
iAi~;~!~;:;;:~;',.':.:::S~:::<:'TY CLERK .DEPARTMENT. '"'"0'"" "'''''"''''''........~~.~~bi~t@Nhm
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
~..
':f'tlJ;.,. ~M,;,~~'J:i.<,.~ ':1'1;: ':\11 ";;;::l!k,1, ,:"'.r"':'l;f~" ',,' '., ~r,;';..c;,C;!J~" ::;r1': :'~," t'J' ;' : '",~";~-'~,3.,': "'Z"":", ,~", .' ,oo, ~"
. ~1.. .1 .;; J . '{,. ~ .'t'~" ,'t.,.. I' ,~. ,I, ~., I. I'" . '.' I L':" . '
~t...... Ol ..-~ { 1iJ \ ".,~ ~ \ "'~ I ; 1 ~ ":l, ef:'~ ~ . ~ ~ ~'l ti;; { P f .. i> J," ~, - {. A. "
tiil., 1" < "f.. "J; it, .' ",: ','~d, '.'. 1 ~1_ <" ,.1' ,'}'...-.+k.,"J: t.-"'~"S;""',,!'l" 0,~'";,,L, ," .~
\:t "" /' . .,*".. .. ..~~ -" . ..:l:l..... """,1 """ ltt~",... <... I"~' ......"f_c-,,,"",.,. "'.....~..,
DA T! (MIIIDtVYY)
7/12/2000
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
N..tJalilr ~,.,;:;;
PRODUCER
REALINSURORS
5005 W. Laurel St.
Suite 214
Tampa, FL 33607-3836
COt.4PANY
A SCOnSDALE INSURANCE COMPANY
INSURED
Bait House, LLC
P.O. Box 3025
Clearwater, FL 33767
COt.4P ANY
B
COt.4PANY
C
~ ~
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID ClAIMS.
co TYPE OF INSURANCE POLICY HUMBER POUCY EFFECTIVE POUCY EXPlRATlON UMITS
LTR DATE (WMlXliYY) DATE (MIIIDtVYY)
GENERAL LIABILITY GENERAL AGGREGATE $ 500,000.
X COMMERCIAL GENERAL LIABILITY PROOUCTS-COMP~PAGG $ 500,000.
A CLAIMS MADE m OCCUR CPS309899/00 7/112000 7/112001 PERSONAL & ADV INJURY $ 500,000.
OWNER'S & CONTRACTOR'S POOT EACH OCCURRENCE $ 500,000.
ARE DAMAGE (Any one ftre) $ 50,000.
MED EXP (Any one person) $ 5.000.
AUTOMOBILE UABlLITY EXCLUDED
COMBINED SINGLE LIMIT $
ANY AUTO
ALL OWNED AUTOS BODILY INJURY EXCLUDED
$
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY EXCLUDED
(Per accident) $
NQN-OWNED AUTOS
PROPERTY DAMAGE $ EXCLUDED
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ EXCLUDED
IJJolY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $ EXCLUDED
AGGREGATE $ EXCLUDED
EXCESS UA8IUTY EACH OCCURRENCE $ EXCLUDED
UMBRELLA FORM AGGREGATE $ EXCLUDED
OTHER THAN UMBRELLA FORM $ EXCLUDED
WORKERS COMPENSATlON AND
EMPLOYERS' LIABILITY EXCLUDED
$
THE PROPRIETORI INCl El DISEASE - POLICY LIMIT $ EXCLUDED
PARTNERSlEXECUTlVE EXCLUDED
ClfACERS ARE: EXCL El DISEASE - EA EMPLOYEE $
OTHER
DESCRIPTION OF OPERATlONSI\.OCA TIONSNEHIClESlSPEClAL ITEMS
CERTIFICATE HOLDER IS SHOWN AS ADDITIONAL INSURED ON THE POLICY.
~i:Uwf'ftl:D
~~.~.,
q.vtCElMlIO.H~:t~~~\i:i;
$HOUU) ANY OF ntE ASOW DESCRIBED POLICIES BE CANCELLED BEFORE ntE
EXPIRATION DATE ntEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO .....IL
~ DAYS WRITTEN NOTICE TO ntE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FALURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
CITY OF CLEARWATER
RISK MANAGEMENT DEPT.
POBOX 4748
CLEARWATER, FL 33758-4748
OF ANY KIND UPON ntE COMPANY, ITS AGENTS OR REPRESENTAT1VES.
AUTHORIZED REPRESENTA lIVE
'cflaAfi r 4J-O
. ACORDCOAPORATION 1988
I
ACORD 25-8(111II)