CERTIFICATE OF LIABILITY INSURANCE
"-#
J2/26/01 16:05 To:Catherine
From:Shawmia Graham
CUll
Page 2/3
~ CORD.
E DATE (MMIDDIYYI
02/26/01
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
'UCER
ACORDIA EAST - TAMPA BAY
P.O. Box 31666
Tampa, FL 33631-3666
727-796-6666
INSURERS AFFORDING COVERAGE
Alexandra of Clearwater Beach,
Inc. dba Pier 60 Concessions
POBox 3337
learwater FL 33767
INSURER A
INSURER B
INSURER C
INSURER D
RED
......... ,..~".
IE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
~Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
'Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH
'L1CIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Pi>H9~Y EXPIRATION LIMITS
~'-~' BIND429343 2/15/01 2/15/02 EACH OCCURRENCE $ 1
OMMERCIAL GENERAL LIABILITY FIRE DAMAGE IAn" one firel $
CLAIMS MADE W OCCUR MED EXP (Anv one oerson) $ s;nnn
PERSONAL & ADV INJURY $ 1
GENERAL AGGREGATE $
~'L AGGREnE LIMIT APAS PER PRODUCTS - COM PlOP AGG $
P()I Irv ~9~ I "r
-AY..: 0111' OBlLE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO lEa acCI dent)
-
- ALL OWNED AUTOS BOOIL Y INJURY
(Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS BOOIL Y INJURY
(per accident) $
~ NON.OWNED AUTOS
~
- PROPERTY DAMAGE $
(Per aCCIdent)
~AGE LIABILITY AUTO ONL Y . EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y AGG $
~ss LIABILITY FACH nrrtlRRFNrF $
'OCCUR D ClAIMS MADE Ar,c.REGA TF $
$
==1 DEDUCTIBLE $
RErEN TION $ $
WORKERS COMPENSATION AND I ~S;,:>!r:T,~;..1 IOJ~'
EMPLOYERS'LIABlLITY F I EACH ACCIDFNT
$
E L nlSFAsF . EA FMPLOYE $
F I rllC:F.o.C:F. "'"" S
OTHER
:R1PTION OF OPERATIONSILOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPEClAL PROVISIONS
RENTAL OF BEACH UMBRELLAS, CHAIRS & FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURE~
AS RESPECTS GENERAL LIABILITY COVERAGE.
...........&..... I I '''''''DC:n. -- u_P'-I.6.TION
SHOULD ANY OF THE ABOVE DESCRlBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL -3Q... DAYS WRITTEN
25 CAUSEWAY BLVD. NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURETO DO SO SHALL
rl ~ARWAT~R ~I ~~7Fl7 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
~~O-~~-~~~1 1~~~~
T~I ~
Tn)rl FARWATFR MARINA
PAGE:002 R=100%
J2/26/~1 16:95 To:Catherine
From:Shaw.ia Graha.
ClW1
Page 3/3
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy{ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement{sl.
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy. certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement{s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer{s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
t
FEB-26-2001 15:55
TEl)
1
ID )cL~TER MARINA
PAGE:003 R=100::