CERTIFICATE OF INSURANCE (7)
PRODUCER 813-796-6666 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
Acordia SE, Central Fla Oivsn
P.O. Box 31666
Tampa, FL 33631-3666
COMPANY
A
FIREMANS FUND-COMMERCIAL DB
INSURED
COMPANY
D
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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.
Alexandra of Clearwater Beach
Inc. dba Pier 60 Concessions
1 0 Pier 60 Orive
Clearwater, FL 34630
COMPANY
B
Fla Restaurant Ass'n Workers
COMPANY
C
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE (MM/DDJYYI DATE CMM/ODJYYI
A GENERAL LIABILITY MZC80363131 2/15/98 2/15/99 GENERAL AGGREGATE 2000000
X COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG $ 2000000
CLAIMS MADE 0 OCCUR PERSONAL & ADV INJURY 1000000
OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE 1000000
FIRE DAMAGE (Anyone fire) 100000
MED EXP (Anyone person) 5000
A AUTOMOBILE LIABILITY MZC80363131 2/15/98 2/15/99
COMBINED SINGLE LIMIT 1000000
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS IPer person)
X HIRED AUTOS BODILY INJURY
X NON-OWNED AUTOS IPer eccldent)
PROPERTY DAMAGE
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
A EXCESS LIABILITY XSC83316919 2/15/98 2/15/99 EACH OCCURRENCE $ 1000000
X UMBRELLA FORM AGGREGATE 1000000
OTHER THAN UMBRELLA FORM
B WORKERS COMPENSATION AND 895-02114 1/01/98 1/01199
-- -EMPLOYERS' LIABILITY ----,._--,-~--- - ---,-- ---,.-- -
THE PROPRIETOR! INCL EL DISEASE - POLICY LIMIT
PARTNERS/EXECUTIVE
OFFICERS ARE: X EXCL EL DISEASE - EA EMPLOYEE
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESISPECIAL ITEMS
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURED
AS RESPECTS GENERAL LIABILITY COVERAGE.
GENERAL LIABILITY COVERAGE EXCLUDES RENTAL OPERATIONS.
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.
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY