CERTIFICATE OF INSURANCE (8)
PRODUCER 813-796-6666 THIS CERTIFICATE I ISSUED AS A MAnER OF INFORMATION
ONLY AND CONFI:RS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS C TIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COV RAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
Acordia SE, Central Fla Divsn
P.O. Box 31666
Tampa, FL 33631-3666
COMPANY
A
ESSEX INSURANCE CO
INSURED
COMPANY
o
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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 Drive
Clearwater Bch FL 33767
COMPANY
B
COMPANY
C
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE POLICY EXPIRATION
DATE IMMIDDNYl DATE IMM/DDNYI
LIMITS
A GENERAL LIABILITY BIND290676
X COMMERCIAL GENERAL LIABILITY
CLAIMS MADE 0 OCCUR
OWNER'S & CONTRACTOR'S PROT
2/1 5/98
2/15/99
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG $
PERSONAL & ADV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Anyone flrel
MED EXP (Anyone person)
1000000
INCLUDED
1000000
1000000
50000
5000
AUTOMOBILE LIABILITY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE LIMIT
BODILY INJURY
(Per person)
BODILY INJURY
(Per accident)
PROPERTY DAMAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT
AGGREGATE
EACH OCCURRENCE
AGGREGATE
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY-
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE:
OTHER
INCL
EXCL
EL DISEASE - POLICY LIMIT
EL DISEASE - EA EMPLOYEE
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL rrEMS
RENTAL OF BEACH UMBRELLAS, CHAIRS & FOOTSTOOLS.
THE CITY OF CLEARWATER A MUNICIPALITY IS NAMED AS ADDITIONAL INSURED
AS RESPECTS GENERAL LIABILITY COVERAGE,
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SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
CITY OF CLEARWATER A MUNICIPAL EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
C/O CITY ATTORNEYS OFFICE ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
P.O. BOX 4748 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
CLEARWATER FL 33758 OF KIND UPON THE COMPANY rrs AGENTS OR REPRESENTATIVES.
, AUTH IZ EP ENTA ~/l
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TH IS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED, IS IN FORCE, AND CONVEYS ALL THE
RIGHTS AN D PRIVILEG ES AFFORDED UNDER THE POLICY.
PRODUCER I r~gN~n ~...I, 81 3-796-6666 COMPANY
Acordia SE, Central Fla Oivsn I nterstate Fire & Casualty
P.O Box 3 1 666
Tampa, FL 3363 1 -3666
CODE: I SUB CODE:
AGENCY BEA22770
:
INSURED LOAN NUMBER I POLICY NUMBER
Alexandra of Clearwater Beach 051 02271 7
I nc. dba Pier 60 Concessions EFFECTIVE DATE I EXPIRATION DATE
1 0 Pier 60 Orive I CONTINUED UNTIL
2/1 5/98 2/1 5/99 n TERMINATED IF CHECKED
Clearwater FL 33767- THIS REPLACES PRIOR EVIDENCE DATED:
I
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LOCATION/DESCRIPTION
1 0 PIER 60 DRIVE
CLEARWATER BEACH, FL 33767
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COVERAGElPERILSIFORMS AMOUNT OF INSURANCE DEDUCTIBLE
BUILDING 300000 2500
CONTENTS 71450 2500
SPECIAL FaRM EXCLUDING WINO
REPLACEMENT COST
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THE POLICY IS SUBJECT TO THE PREMIUMS, FORMS, AND RULES IN EFFECT FOR EACH POLICY PERIOD. SHOULD THE
POLICY BE TERM INATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW 30 DAYS
WRITTEN NOTICE, AN D WILL SEND NOTIFICATION OF ANY CHANGES TO THE POLICY THAT WOULD AFFECT THAT
INTEREST, IN ACCORDANCE WITH THE POLICY PROVISIONS OR AS REQUIRED BY LAW.
NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED
CITY OF CLEARWATER, A MUNICI- LOSS PAYEE
PALlTY, % CITY ATTY'S OFFICE LOAN #
P. 0 BOX 4748