CERTIFICATE OF INSURANCE FOR RENTAL OF BEACH UMBRELLAS CHAIRS AND FOOTSTOOLS (4)
!Z/Z&L81 16~8S To:Catherine
From:Shawmia Graham
ClWl
Page 2/3
.,
I
~CORD.
E DATE (MM/ODIYY)
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
IN RER 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
ILlCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TypJ: OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
~'-~ BIND429343 2/15/01 2/15/02 E=ACH OCCURRENCE $
CO"""C,'" "''''''' """'"'' E=IRE DAMAGE (An one fire' $ 1(\(\(\(\(\
CLAIMS MADE W OCCUR MED EXP (Anv one oerson) $ J;(\(\(\
PERSONAL & ADV INJURY $
(',FNERAL AGGREGATE $
-4'L AGGREnE LIMIT APnS PER PRODUCTS. COMP/OP AGG $
pnl I('V ":!l,Q:;. , I nr
..AY: OlW'OBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea aCCident)
-
- ALL OVIINED AUTOS 800fL Y INJURY
(Per person) $
- SCHEDULED AUTOS
- HIRED AUTOS 800IL Y INJURY
(Per accident) $
- NON-OWNED AUTOS
~
PROPERTY DAMAGE $
(Per accident)
~AGE LIABILITY AUTO ONI Y . EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONL Y "'....n ..
~S8 LIABILITY FArH ncrllRREN('1= $
OCCUR D CLAIMS MADE AGGREGATI= $
$
==i DEDUCTIBLE $
RETENTI()N $ $
WORKERS COMPENSATION AND I WC STATU. I IOJ,ti.
EMPLOYERS' LIABILITY E l EACH ACCIDENT
$
E L nISEA<::F. EA EMPlOYE $
I E I OISFA<::F. 0("), Irv , ''''T .
OTHER
:RlPTION OF OPERATIONSn..OCATIONSNEHICLESiEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
RENTAL OF BEACH UMBRELLAS, CHAIRS & FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURE~
AS RESPECTS GENERAL LIABILITY COVERAGE.
Io4nlnll:'D 1 I ,.....,=,.. ,...."...,.. 'J:TTJ:". ,', A'I'InU
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
CITY OF CLEARWATER DATE THEREOF, THE ISSUING INSURER Will ENDEAVOR TO MAil -30.. DAYS WRITTEN
26 CAUSEWAY BLVD. NOTICE TO THE a:RTIFICATEHOLDER NAMED TO THE lEFT, BUT FAILURE TO DO SO SHAll
rl J:ARWATJ:R J:I ~~7A7 IMPOSE NO OBLIGATION OR liABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
~~Q-Oh_O~~1 1~'~~
T~I ~
Tn)rl FARWATFR MARINA
PAGE:002 R=100~
II
)2/26/01 15:05 To:Catherine
,.
From:Shawmia Graham
CLWl
Page 3/3
I
1<
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(iesl must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement{s).
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 endorsementlsl.
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuinginsurerls), 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
IO)CLEARWATER MARINA
PAGE:003 R=100%
II 1IIII11 11111.1111.111