Loading...
CERTFICATE OF LIABILITY INSURANCE CERTIFICAT, OF LIABILITY INSURANCEf~E~~l DA~E~~~~;;9 THIS CERTIFICATE IS I UED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT;'~ICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, PRODUCER The Addis Group, Inc. Suite 200 100 Four Falls Corpora~e Ctr. West Conshohocken PA 19428-2976 Phone: 610-832-2100 Fax:610-825-9136 INSURERS AFFORDING COVERAGE INSURED INSURER A: INSURER B: INSURER C: INSURER D: INSURER E: American Zurich American Guarantee & Liabilit Lane Industries, Inc. Lane Hospitality, Inc. Hospita11ty Investment Assoc. One Lane Center 1200 Shermer Road Northbrook, IL 60062 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 S~BJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~ft TYPE OF INSURANCE POLICY NUMBER POLl9~F~~E PJ'Al{~~~~b~~N LIMITS DATE IDD GENERAL LIABILITY --"". EACH OCCURRENCE $1,000,000 - A X COMMERCIAL GENERAL LIABILITY GL06847038 03/01/99 03/01/00 FIRE DAMAGE (Anyone fire) $ 500,000 . i CU\IMS MADE [~J OCCUR _d 10,000 MED EXP (Anyone person) $ ~ EMP BENEFITS PERSONAL & ADV INJURY $1,000,000 LIQUOR LIAB GENERAL AGGREGATE $2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 1,000,000 I nPRO- n POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1,000,000 B ~ ANY AUTO BAP6847040 03/01/99 03/01/00 (Ea accident) ~ ALL OWNED AUTOS I BODILY INJURY I (Per person) $ ~ SCHEDULED AUTOS ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ =1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ :=J OCCUR D CLAIMS MADE AGGREGATE $ $ =1 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND X I TORY'LIMITS I IU1H- ER A EMPLOYERS' LIABILITY WC06847039 03101./!t9 03/01/00 $1..-000,OQO EL. EACH ACCIDENT - .. EL. DISEASE - EA EMPLOYEE $1,000,000 EL. DISEASE - POLICY LIMIT $1,000,000 OTHER B Automobile BAP6847040 03/01/99 03/01/00 Comp Ded: $250 Physical Damaae Coll Ded: $500 DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL 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 y I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CLEAR-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 - 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, Risk Mgmt P.O. Box 4748 REPRESENTATIVES. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE X-J ~ <1:....-; , L...J ~ --- ~ '--- , Garv W. Warren, CPCU ARM ACORD 25-S (7/97) .. ACORD CORPORATION 1991