INSURANCE CERTIFICATE (11)
PRODUCER
~J Specialty
~O . BOX 40250
St, Petersburg, Florida
Inc.
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THIS CERTIFICATE IS ISSUED AS AATTER OF INFORMATION ONLY AND CONFERS ~7'"
NO RIGHTS UPON THE CERTIFICATt. HOLDER. THIS CERTIFICATE DOES NOT AMEND.;/
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. cO.;
i 'NSUAED
33743
COMPANIES AFFORDING COVERAGE
,
COMPANY
LETTER
AT.H.E.
Insurance Company
COMPANY B New E 1 d I t tiS t
LETTER ng an n erna iona ure y,
In
Skyrider Clearwater Beiswenger Enterpris ~OMPANY C
LETTER
Corp. as part of Skyrider Association, I
(Master Policy)
9211 U.S. Highway 19
Port Richey, FL 34668
COMPANY D
LETTER
COMPANY E
LETTER
COVERAGES';"'~'::'~\..l.f:";1..t~~~~~~~",~l~~~~.>"':t.'W;..,~~it:..~~'!~:~...<~ \-~/ ~.?"~.;.: .~"~:.):r". ~:...~ ..' ~. ~ v~,I.., . I v" -. ...........-~ ,1-, l~ ~:;;-', '''-: .t,'[:-~:'~\',.~;;\i;'';;;f~ .
POLICY EFFECTIVE POLICY EXPIRA nON LIABILITY LIMITS IN THOUSANDS
TYPE OF INSURANCE POLICY NUMBER OA TE (MMlDO/YY) OA TE (MMIOOIYY) EACH
OCCURRENCE AGGREGATE
A GENERAL LIABILITY BOOIL Y
COMPREHENSIVE FORM INJURY $Incl. $ N/A
PREMISES/OPERATIONS 8LG92331 6/21/88 6/21/89
PROPERTY
UNDERGROUND DAMAGE
EXPLOSION & COLLAPSE HAZARD
PRODUCTS/COMPLETED OPERATIONS
CONTRACTUAL (Limi ted- ust BI & PO $ 300 $ N/A
COMBINED
INDEPENDENT CONTRACTORS h a v copies
BROAD FORM PROPERTY DAMAGE f contracts)
PERSONAL INJURY PERSONAL INJURY $ Incl.
AUTOMOBILE LIABILITY OCOlY
ItWRY $
ANY AUTO (PEA PERSONI
ALL OWNED AUTOS (PRIV. PASS.) Irol y
ALL OWNED AUTOS (OTHER THAN) IIOJAY $
PRIV. PASS. (PEA ACC1OfNT)
HIRED AUTOS ~' . PROPERTY
NON-OWNED AUTOS DAMAGE $
GARAGE LIABILITY
BI & PO
COMBINED $
EXCESS LIABILITY NESXL083 6/21/88 6/21/89
UMBRELLA FORM BI & PO $ 700 $ 700
COMBINED
OTHER THAN UMBRELLA FORM
De : p. le-ie-r.rC." STATUTORY
WORKERS' COMPENSATION $
.. AND sl€-(l t e-nS (>~ (EACH ACCIDENT)
I r. $ (DISEASE.POllCY LIMIT)
EMPLOYERS' LIABILITY
.... e--IL $ (DISEASE-EACH EMPLOYEE)
~ OTHER Ii.. €-S e- /r e ,.,
E,
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICA TED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE Mil'
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES.
DESCRIPTION OF OPERA TrONS/LOCA TIONSNEHICLES/SPECIAL ITEMS
The above combined coverage provides a total limit
Parasailing & Activities relating to the Operation
$1,000,000 for
Parasailing Business.
City of Clearwater
1 Municipal Marina
Clearwater Beach, FL 33515
--'
I
CITyloF CLEARWATER
Interdepartment Correspondence Sheet
TO: Sue; Operations
FROM: Don Petersen;
Risk Manager ~
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COPIES:
SUBJECT: Certificate of Insurance-West Coast Hater Sports
sub; Skyrider Clearwater Beiswenger
DATE: 7/7/88
Attached certificate of Insurance meets lease specifications, with following
exceptions: None