CERTIFICATE OF INSURANCE (2)
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ACORDg
CERTIFICAli
OF LIABILITY INSU
NCEAsR GW
~E-01 02/24/00
THIS CERTIFICATE IS I UED 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.
DATE (MM/DDIYY)
PRODUCER
The Addis Group, Inc.
2300 Renaissance Boulevard
King of Prussia PA 19406-2772
Phone: 610-279-8550 Fax:610-279-8543
INSURED Lane Indus tr1es , Inc.
Lane Hospitality, Inc.
Hospita11ty Investment Assoc.
Lane Hotel Investments II, L.P
One Lane Center
1200 Shermer Road
Northbrook, IL 60062
INSURERS AFFORDING COVERAGE
INSURER A:
INSURER B:
INSURER C:
INSURER D:
INSURER E:
American Zurich
American Guarantee & Liability
COVERAGES
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'~f: TYPE OF INSURANCE POLICY NUMBER 6X-\"il'MMlDOlvYi . DATE '/~'f'r#~N LIMITS
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
-
A X COMMERCIAL GENERAL LIABILITY GL06847038 03/01/00 03/01/01 FIRE DAMAGE (Anyone fire) $ 500,000
-- .c.... _.... . LCiJl,lMS.MADE..c.bi} QGGUB - ------,,---._--- ,--~_.--- "~---"- -- . .. - d_ MED ~P(l\nyon.eperson) $ ~O.J' 00_0.
X EMP BENEFITS PERSONAL & ADV INJURY $1,000,000
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...!.. LIQUOR LIAB GENERAL AGGREGATE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COM~OPAGG $1,000,000
I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000
-
B ...!.. ANY AUTO BAP6847040 03/01/00 03/01/01 (Ea accident)
X ALL OWNED AUTOS BODILY INJURY
- (Per person) $
...!.. SCHEDULED AUTOS
X HIRED AUTOS BODILY INJURY
- (Per accident) $
...!.. NON-OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
=l ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
=l DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND X I TORY L1MrrS I IUE~-
A EMPLOYERS' LIABILITY WC06847039 03/01/00 03/01/01 $1,000,000
E.L. EACH ACCIDENT
-_.... ---- - --- ----- f------------- .-. "-..--.--- ..- .- .._-~... ---- ~.LUlSEASE 'EA-cMPLOYEE 11,000,0-00 - -
E,L. DISEASE - POLICY LIMIT $1,000,000
OTHER
B Automobile BAP6847040 03/01/00 03/01/01 Comp Ded: $250
Physical Damage Coll Ded: $500
DESCRIPTION OF OPERATlONSlLOCATlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS
For operations and activities of the licensee DBA Holiday Inn Sun Spree
located upon the property more fully described in the license agreement
effective 10/1/96. Certificate Holder is recognized as additional insured.
CERTIFICATE HOLDER I N I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION
CLBAR-1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
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NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
City of Clearwater IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ATT: Earl Barrett, Eng Dept
P.O. Box 4748 REPRESENTATIVES.
Clearwater, FL 33758-4748
I Garv W. Warren. CPCU. ARM
ACORD 25-5 (7/97)
@ACORDCORPORATION 1988