CERTIFICATE NUMBER 7042 FOR LIABILITY INSURANCE
Mar, 1, 2002-11:58AM~THrfADDIS GROUP
ACORDN (;I:H IIFIC;.( . E UF LIABILITY INSUR
No,7042
Nce OPID
~-01 03/01/02
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFOAMA liON
ONLY AND CONFERS NO RIGHTS UPON THe C~RTII"ICAT~
HOLDER. THIS CEFlTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFmRDED BY THE POLICIES BELOW.
P
1/1
UA I ~ (MM/DDIYY)
PROuUCliR
The Adelis Group, Inc.
2300 Renaissance Boulevard
King of Prussia PA 19406-2772
Phone: 610-279-8550 FaxI610-279-8543
INSURED Lane In ustr~es, Ine .
Lane Hospitality, Inc.
Hospital~ty Investment AsSOC.
Lane Hotel InvBsbments II, L.P
One Lane Center
1200 Sher.mer Road
Northbrook, IL 60062
INSURERS AFFORDING COVERAGE
American zurich Insurance Co.
American Guarantee && Liabilit
INSURER A:
INSURER B:
INSUReR C:
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED Ae0VC FOR THE POLICY PERlOO INDICATED, NOlWlTl-lSTANDING
ANY RE;OUIFlEMENT, TERM OR CONDITION OF /w( CONTRACT OR OTHeR DOCUMENTwtTH RESPECT TO WHICH THIS CERTIFICATE; MAY BE ISSUtD OR
MAY PERTAIN, TI-lE; INSURANCE AFPOADED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmoNS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BJ:::EN REDuceo BY PAID CLAIMS,
~ TYpe OF INSlJRANCE! POLICY NUMBER DATE- /MMiDDIYV\ PATE IUMIODIYYl I.IMITS
~NeRAL L1ABIU'lY eACH OCCUf'lRENCE s 1,000,000
A ..!. 3MERCIAL GENERAL LIABILITY GL06847038 03/01/02 03/01103 FlRE DAMAGE (My one fire) $ 500,000
CLAIMS MADE [!] OCCUR MED EXP (Ally Orl~ p"ISon) :; 10,000
-
..!. EIIP BENEPITS PERSONAL & AnV INJUAY $1,000,000
..!. LIQUOR LI~ GI;NE;AAl AGGREGATE S 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PI;R: PRODUCTS - COMPIOP AGG sl,OOO,Ooo
4 POLICY n ~~8T n LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
- S 1,000,000
B ..!. ANY AUTO BAP6847040 03/01/02 03/01/03 (Ea accident)
..!. ALL OWNED AlJTOS BODILY INJURY
S
..!. SCHEDULED AUTOS (Per perllon)
...!.. HIRED AUTOS BODILY INJURY
(Per al:/:idc>nl) $
~ NON.OWNED AUTOS
- PROPE;RTV DAMAGE :$
(Per accidenl)
GARAGe LIABILITY AUTO ONLY. EA ACCIDENT S
==i ANY AUTO ~ ~ ~ ~ ~ If} ill ...-. EA ACe
; OTHER THAN "
'D I."J AUTO ONLY;
r AGG $
EXCESS LIABILITY t n 11 MAR i E;ACH OCCURReNCE $
, I
=:J OOCUR D CLAIMS MI ~EJ I ' I - I 2002 It::. AGGREGATE $
I!
L__ ,-----~ s
~ DEDUCTIBLE -..---.-,."- "
l .. . ~.. '.~! t R
' c
RETENTION $ UBi :C \','C:i".S n>'!'iiSTRATION $
WORKERS COMPENSATION ANI) X I TORy'L1MITsl ~
A EMPLOYERS' L1ABILlrf WC06847039 03/01/02 03/01/03 E.L. EACH ACCIDENT 81,000,000
E.L. DISEASE - EA EMPLOYE:; s1,000,OOO
E,L, DISEASE. POLICY LIMIT $1,000,000
OiHIOR
B Automcbile BAP6847040 03/01/02 03/01/03 Camp Ded: $250
Physical De,maae Coll DeC.: $500
DESCRIPTION OF OPERATlONSlLOCAllONSlVEHICLESlEXCLUSIONS ADDED BY ENOOflSEMENTISPECIAL PROVISIONS
For operations and activities of the licensee DBA Holiday Inn Sun Sp!;'ee
locatB~ upon the property morB fully described in tbe license agreement
effective 10/1/96. Certificate Holde!;' is reeoguized as additional insurec..
CERTIFICATE HOLDER Iy ADDmONAL INSURED; INSU~ L.UTl;R; CANCELLATION
CLEAR-l SHOULD ANY OFTllli AiIOVE DESCRIBED POUCles BE CANCEI..L.EO el;fOFlE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURB\ WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
R.eal Estate SeJ:'Vices NOllCE TO THE CERTIFICATE HOI..DE1f NAMED TO THE LEFT, BUT FAJLURe TO DO so SHALL.
A'1'T~ Earl aarrett IMPOSE NO OBLIGATION OR UABJUlY OF ANY KIND UPON THE INSURER, ITS AGSIITS OR
P.O. Box 4748
Clearwater, n. 33758-4748 REPRESENT A Tlves,
AUTHORIZED FI~~ 4J. ~~
t IGarv W. Warren. CPCU, ARM
ACORD 25.S (7197)
@ACORD CORPORATION 1988
'JO - 00' r' D!)
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