CERTIFICATE OF LIABILITY INSURANCE (5)
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CERTIFICATE OF LIABILI1Y INSURANC~g1~ 06 30/03
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLC~A. THIS CGRTlFICATI:! DOIaS NOT AMI!!ND, &XTSND OR
AL 1l;R THE COVERAGE AFFORDED 8Y THE POLICIES BELOW.
PROQUClill
Rea1 XDGuro~e, %~C.
5005 w. Laure1 Stree~. S~e 214
'1'ampa FL 33607-3836
pboue=813-288-1000 Fax=B13-2B1-2411
INSURERS AFFOROING COVERAGE
INSURED
INSU~ A:. Wes te~ world :t;Q.S Co
:Bait Hou.e LLC
J;I 0 :Sox 3025
C1earwa~er Bea~h ~L 33167-8025
I
IN$URER 0: -
INSURER c;
INSU~ 0:
INSURER 10:
COVERAGES
TIt!:': POLICIES Of lN9uAANC~ uS'fED BELOW HAVE I)liliN ISSUED TO TI"1li INSURCD NAMeD A80VE fOR THE POuCY 1"t'.K100 Ir~DlCATED, 1'l0TWITHSTANDING
JUlV REQUIRl:UI:NT. TI:RM OR COJIIDmON Of ANY CONiAACT OR OTHER DOCUMENT wm~ RESPECT TO WIoIICl'I TI11S Cc:mr-I[:A"1'!:': MAY IlE ISSUED OR
MAY PERTAIN, 'rHE: INSu~E AFFORPIOD BY THE POLICIES DIOSCRIDr;D HI:RON IS SU8J[!CT TO ALL THE TEFlMS. EXCLlJ610NS AND COl>lOITIONS OF SUC.I
POLICies. ACGRECATE LIMITS SHOWr.l MAY H",,\1E BEEt! REDUCED 1)Y PAID CLAlMS.
'~i': ...., II. __ I PQLlr~ ~F~~~ I POLl~ItAW~I--"'"''''''
TYPI!: OF INSURANCE pOLICY NUMBER DAYIl uMlOD DATE MlDDIVY UMITS
~I'IE~AI. LIABIUT'Y EACI'I OCCURRENcr; !..5~OOO 00
.-..
A X COU"'E;RCIAL GENERAL LIADILlTY NPP787100 0'7/01/03 0'7/01/04 FIRE DAMAGIO (Any me fire) $ 50000
1 CLAIMS ,UACE [!J OCCUR "'ED EXP (Any gne pe~,,") $ 5000
- PERSONAL & ADV INJURY :5 500000
- Ct:Nt:HAL AOOREGATE 1$500000
ilN'L AOORnE LI"'IT A~~S PER; Pf\ODUCTS - COMf'IOP AGG $ 500000
X pOuCY ~i; lOC
AUTDMODlLE LIABILITY COUOINIiP SINGLE; LIMIT
--- $
ANY AUTO (lOa ,,~r;tdent)
--- ..' ~
--- AI.I. OWNED AUTOS llOClL y IriJUIt:f $
SCHEDULED AUTOS (Per pel1IOI1)
-
1- HIRED ""UTOS IlODILY INJU~ $
NON.oWJIIED AUTOS (Per scdllenl)
-
,. ,. ....... PROPERTY DAMAG[; $
(Pc:r 1I~l;idQnl)
GARAGE UA81LITY AUTO O~Il.Y. EAACCIDENT $
~ ANY AUTO OTHER THAN EA ACe :;
AUTO ONLY: AGG S
EXCESS I.IABII.I1'Y ~H OCCURR!:':NCI: $
,.. -'I OCCUR o CLAIMS MADE AGGR[;GATt: $
__.1................--
. $
=~~ I Dl!DUCTlSlE ____.............&.\1_.. --
$
RETENTION S $
WORKERS COMPEN5AT10N ANti ~9RYLI~L.l1.~:
EUPI.OYEItS" UADlUTY ...- .......,....----...-.......-
~~~':IDGNT S
~~~s....~..E' CA DlPLOVC[ IS
E.". OISeASlO. POLICY LIMIT $
OTHER I
Dl!SCRIPTlON OF OPERATlDNSlLOCAT10NSNEHICLESlEXCLUSIONS ADDED 8Y ENDORSEMEIlfTISPECIAI. PROVISIONs
Cit:y of Clea:water is Additioual J:J:&su:red.
Loc:at:i~n: 46 Causeway Blvd, Slip 156, Clearwater Beacb Pl 33767 .
F.727-4G2-G9S7.BARBARA BORGAN
CERTIFICATE HOLOER I'l'l ~Ol)mOICAl.I"UREOi ItllSUREA l,.I;'m;R; CANCELLATION
CCLEAR- SHOUIJ) AN'( OF THE A80IIE DESeRt.ED POLICIE$ H CAIIlCIil.I.ED BEFORE THe I;xPIllATION
City of clearwater DATE THEMIOF. THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAY:; WRITTEN
Risk Management :oept NgnCE TO 'RiEl CERTlFlCATEl HOI.DIiR NAMll.tI TO '1l1Il. LIl.F'l',liJlIf FAlLURE TO 00 SO SHALL
Ma~:tne & Aviation Dept IMPOSE NO OBt.IGATlON OR UA81UTY Of ANY KINg \lPON THe INSURER, Irs AOI5lol1'S OR
25 Causeway
C~ea:wat:er J'L 33767 REPRESENTATIVES.
AlITHORlZED REPRE9EHTAl1VE ,d,A, ..
I KaZ'c:::ia H :t.ewis '?Jt-III'.
. ItO
ACORD 25-S (7/97)
@ACORD CORPORATION 1988
600/LOO'd
LL176L868L8(XV'.:!)
S..,lO..,lnSUI le~~
08:8L (NO~)8006-08-Nnr
"
IMPORTANT
If the eel1.lllc:ate holder Is an ADDITIONAL INSURED, tho pollcy(lcs) must be ondorsed. A statement
on this eerllneata does not confor rights to tho cortJflcato holder In lieu of such endorscment(s).
It SUBFtOGATION IS WAIVED, .subJeGt to the tomls and conditions or tho policy, conaln pollclos may
roqulro an ondorsomonl. A slatomont on this cal1.lflcalo docs not confor rtghts to tho certlftcate
holdor In lIou of such ondorscmont(s).
DISCLAIMER
The Certificate of Insurnnce on the reverse side of this form does not constitute a contract between
tho Issuing Insurorts). author\zod roprosontatlvo or producor, and tho cerllflcato holdor, nor doos It
amrmaUllely or negatively amend. extend or alter the coverage afforded by the polleles listed thereon.
ACORD 25-5 (7197)
2:00/2:00'd
L L172: L8G8 L8(X\l'.:D
S...lo.JnsuI lE'dl::l
L8:8L (NO~)8002:-08-Nnr