CERTFICATE OF INSURANCE (2)
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HILTON INN
715 South Gulf View Boulevard
Clearwater Beach, Florida 33515
(813) 447-9566
September 23, 1978
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City of Clearwater
Office of the City Clerk
112 S. Osceola Avenue
Clearwater, Fla. 33516
Re: Certificate of Insurance
Under-Bridge Parking Lot
Clearwater Beach Hilton Inn
Dear Sir,
In compliance with your request we are forwarding herewith the
Certificate of Insurance for the above stated property.
We trust this will suffice your requirements.
If there are any further questions, please do not hesitate to
contact us.
Sincerely,
TER BEACH HILTON INN
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Exeuctive Secretary
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RODGERS & CUMMINGS, INC.
P.O. Box 6600
Clearwater, Florida 33518
COMPANIES AFFORDING COVERAGES
COMPANY
L [TTE R
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B
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AMERICAN STATES INSURANCE COMPANY
COMPANY
LETTER
NAME AND ADDRESS OF INSURED
HILTON INN CLEARWATER BEACH,
Suncoast International Inns Limited, dba
715 So. Gulf View Boulevard
Clearwater, Florida 33515
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
This is to certify that policies of insurance listed below have been issued to the insured named above and are in force at this time.
limits of liability in Thousands (000)
oCCG~~~NCE AGGREGATE
TYPE OF INSURANCE
POLICY NUMBER
POLICY
EXF'IRATION DATE
GENERAL LIABILITY
A
~ COMPRFf'EN,IVF c0q~
LX PREMISES-OPERATIONS
o EXPLOSION AND COLLAPSE
HAZARD
o UNDERGROUND HAZARD
[] PRODUCTS/COMPLETED
OPERATIONS HAZARD
~ CONTRACTUAL INSURANCE
~ BROAD FORM PROPERTY
DAMAGE
o INDEPENDENT CONTfiACTORS
[] PERSONAL INJURY
MP386 770
BODILY INJURY $
1/4/78-81
PROPERTY DAMAGE $
$
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
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.Applies to Products/Completed
Operations Hazard.
AUTOMOBILE LIABILITY
o COMPREHENSIVE FORM
DOWNED
o HIRED
o NON,OWNED
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BODILY INJURY
(lAC H PERSON,'
BODILY INJURY
I EACH OCCUFlRENCE,
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PROPER1 Y DAMAGE
BO[),L Y INJURY AND
PROPERTY DAMAGE
COMBINED
$
$
EXCESS LIABILITY
o UMBRELLA FORM
o OTHER THAN UMBRELLA
FORM
BODILY INJURY AND
PROPERTY DAMAGE
COMBINED
WORKERS' COMPENSATION
and
EMPLOYERS' LIABILITY
OTHER
DESCRIPTION OF OPERATlONS/LOCATIONSNEHICLES
Cancellation: Should any of the above des~rlbed policies be cancelled before the expiration date thereof, the issuing com-
pany will endeavor to mati --L!l- days written notice to the below named certificate holder, but failure to
mall such notice shall impose no obligation or liability of any kind upon the company.
CITY OF CLEARWATER
Clearwater, Florida
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DATE ISSUED' September 13, 1978
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t L, AUTHORIZED REPrNTATIVE
NAME AND ADDRESS OF CERTIFICATE HOLDER:
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