CERTIFICATE OF INSURANCE (4)
... . . ..... ...... . "" .. ......
DATE (MMIDDNY)
03/10/97
PRODUCER TillS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGIITS UPON THE CERTIFICATE HOLDER. TillS CERTIFICATE
Acordia SE, Central Fla Divsn DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
P.O. Box 3 1666 POLICIES BEWW.
Tampa, FL 3363 1-3666 COMPANIES AFFORDING COVERAGE
COMPANY
A ESSEX INSURANCE CO
INSURED COMPANY
Alexandra of Clearwater Beach, B
COMPANY
Inc; dba Pier 60 Concessions C
10 Pier 60 Drive
COMPANY
Clearwater Bch FL 34630 D
:::::PQYillmif!:!!!!!!!!!!!::::!::::!::!:!:::!!::::!!!!!!:!!!!!!!!!!!:::::!:!:!:!!:!!:!!!!!!!!:!!::!:!!!!!!!!!!!!!!!!!!!!!II!!III:I:::::::II:I:!!!!:!!!!!!!!!:!:!!!!!~!!!::!::!!!!!::!::!::::~:::::!:~!::I::!!:!:!~!!!~!:!!::~~!~!:!::::~::I::::::::!:!!!:!:!:::!::!!:!~:::::::!:III:::::::::::::::::::!::!!:!:!:!!:::!!!!!:!:!:!!!::::!!I::::::::::I:::I:::::::::::~:::::::::::i!:::!!:!!!::::!!!!::::::::::!::!!~~::::::!!!!:~::!!:::!::!!!!!!:!!!!:!!!~:~:!!::!~:::!:!::::!!!::!!:!!!::!:::!:!::~:!:::!!:!::::
TillS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TIlE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WillCH TillS
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 NUMBER POLICY EFF. POLICY EXP.
LTR LIMITS
DATE (MMIDDNY) DATE (MMIDDNY)
GENERAL LIABILITY GENERAL AGGREGATE 1000000
A COMM. GENERAL LIABILITY 3AN0493 6/25/96 6/25/97 PROD-COMP/OP AGG. TNrT
CLAIMS MADE [X] OCCUR PERS. & ADV. INJURY 1000000
OWNER'S & CONTRACT'S PROT EACH OCCURRENCE 1000000
-
FIRE DAMAGE(One Fire) ';0000
-
MED EXP(Any one person) 'i000
AUTOMOBILE LIABILITY COMBINED SINGLE
- ANY AUTO LIMIT
-
ALL OWNED AUTOS BODILY INJURY
-
SCHEDULED AUTOS (Per person)
-
illRED AUTOS BODILY INJURY
-
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT
-
ANY AUTO OTHER THAN AUTO ONLY:
-
EACH ACCIDENT
-
AGGREGATE
EXCESS LIABILITY EACH OCCURRENCE
~~BRELLA FORM AGGREGATE
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND I STATUTORY LIMITS
EMPLOYERS' LIABILITY
EACH ACCIDENT
'f:.J~:S~i%RJTIVE--FiiNeb ----- -- - ----- - _n,_ -~- --,- -- -- -- ___on" - ----"., .-
.... c.. ..... DISEASE-POLICY LIMIT
OFFICERS ARE: EXCL DISEASE-EACH EMPL.
OTHER
DESCRIPTION OF OPERA TIONSILOCA TIONSNEillCLES/SPECIAL ITEMS
RENTAL OF BEACH UMBRELLAS. CHAIRS & FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDmONAL INSURED
AS RESPECTS GENERAL LIABILITY COVERAGE.
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SHOULD ANY OF TIlE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF CLEARWATER A MUNICIPAL EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 30 DAYS WRIlTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
-
C/O CITY ATTORNEYS OFFICE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
P.O. BOX 4748 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE ~~
CLEARWATER. FL 3461 8 C~~ }J
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