CERTIFICATE OF INSURANCE (4)
PRODUCER
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 POUCIES BELOW
THUR J GALLAGHER & CO
HICAGO METRO
ELLY CONRAD 630/9680333
101 31ST ST PO BOX 579
OWNERS GROVE IL 60515
COMPANIES AFFORDING COVERAGE
E INDUSTRIES, INC.
ANE HOSPITALITY, INC.
NE LANE CENTER
200 SHERMER ROAD
ORTHBROOK IL 60062
COMPANY ZURICH AMERI CAN INSURANCE CO
INSURANCE CO
U S FIRE INSURANCE CO
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD
INDICATED, N01WlTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONl1'lACT 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 CONDmONS OF SUCH POUCIES. UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO POlJCY EFFECTIVE POLlCY EXPIRATION
TYPE OF INSURANCE POUCY NUMBER UMITS
TR DATE (MM/DDIYY) DATE (MMIDDIYY)
GL06847038 03/01/96 03/01/97 GENERAL AGGREGATE $ 2 000
COMMERCIAL GENERAL UABIUTY PRODUCTS-COMP/OP AGG. $ 1 000
CLAIMS MADE [iJOCCUR, PERSONAL & ADV. INJURY $ 1 000
OWNER'S & CONTRACTOR'S PROT, EACH OCCURRENCE $ 1 000
FIRE DAMAGE (Anyone fire) $ 100
MED,EXP. (Any one person) $ 5
BAP6847040 3/01/96 03/01/97 COMBINED SINGLE
UMIT $ 1 000 00
ALL OWNED AUTOS BODILY INJURY
SCHEDULED AUTOS (per pllfllon) $
HIRED AUTOS BODILY INJURY
(per accident) $
PROPERlY DAMAGE
$
5530354623 03/01/96 03/01/97 EACH OCCURRENCE
WORKER'S COMPENSAnON WC06847039 03/01/96 03/01/97
AND
DISEASE-POUCY UMIT
EMPLOYERS' UABIUTY
DISEASE-EACH EMPLOYEE
OTH.
DESCRIPnON OF OPERAnONSILOCAnONSNEHICLES/SPECIAL ITEMS
OR OPERATIONS AND ACTIVITIES OF THE LICENSEE DBA HOLIDAY INN SUN SPREE
OCATED UPON THE PROPERTY MORE FULLY DESCRIBED IN THE LICENSE AGREEMT DATED
o 1 96.
CITY OF CLEARWATER
ATTN: MR. LEO SCHRADER
RISK MANAGEMENT
P.O. BOX 4748
CLEARWATER FL 34618-4748
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBUGATlON OR
. ~
UABIUTY OF ANY KIND UPON THE COMPANY, OR REPRESENTATIVES.
IN$URNET2S-S(7/90) .