SPECIAL BUSINESSOWNERS POLICY
AM.. ....11' leAN f'ONOMY IHSURAHCE tOf4. 'ANV
INOA~APO~lS. INOIANA .
1SPECIAL eUSINESSOWhERS POll\V
..................... ................ pel. lev NUMBER;
. . OEtt_IATIONS. ~eH6wAL CFI
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PAGE- I-LAST
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~i:RE:~~:~2j:t
A~~REO
AND
AOORESS:
!!!!
l'8 kY\~~Yl ~liOI~ . AGENT: Jae8~IG"~~oAGeNCY :
J3 NORTH FORt HA<<PISON 601 LJNCOlN AWEhUE ~
ClEAAWATE~. Fl 335 , elEA hAteR, fl 33517 ;
09.12603 (311. .
POlICY 'ROM O()-0'9-85 TO 06-09-86' 181 J 44leatf3 I
TEJUU 12101 AM ST _HOARO r (flte AT' OESCRIBeo 'lCCAT lON ENT ITV I PARtNERSHIP
...................................................................................... I
.. .. I
. TOTAL AHN~Al PRtiMl~MI S 4t~~2.00 $
. .
. THE AMOUNT QUE WILL BE lILtED ONDER VARJ-8IlL _ccaUNT . 011001217 · I
. .
.........................................................*.........................
~~ef~H'lO'naIIQ~tl~~ I'tl ~~I~ll~ia I~. AU~~~(~c~to~~~vtOfgwt~~. (l'C~~~ iJ]~~~~ ~A. T. ~H~~E
COVeRAG~s.NO KINOS J, P"O~E. V PCA ..tUeH' PEtlf j liMIT OF llA' llTY !S SHO""I
SU8JECTTO ALl Of THl TE_"$ C THIS 'OlICV, NCLUO ~G fOR~S AND EN ORSEMfNTS MADe
A PARt MEREOF:
\"Q'AIllJU__-1
~f~ii~AfkS~e~fNO STa
JIJ~J"EU
MERtANlflE
JCBECDt~~:S~tIIDB:I::::;~-~:~::::::::::::::4.~::::::- :::tI!ll~:tE:tl1JtLIII:~~~::
tOY. A - eUllDlftG 689,000
autoMATIC INtfolEASE l" INSURANCE 2.0 1 Qtt\lV.
tov. C - LOSS OF INCO-E
~~~~!AA~ T~r I a IlsS"I.i.\.i. "c.I......L..........ft. <",\':..'...........tft.... ......5....1;;..... ................ <M.."............O".....,.....'~;.$....Jt1~~J;~ E 0
~Le~I'wM,R ~G't'.ii;18.
lOSS PA.y'A8lE CJ1..~Y t~ERM 1
CLAUSE' P.. ex" ita .
elf R~ TER, FL 33918
ActUAL LOSS SUSTAINEOf' NeT
eXCEE01HG 12 CONseCUl ve
/ltClt4TH$
8'" Pp,EMlses
FF PiUiM 1 SE S
COV. 0 - MONEY
COy. e ... CCCUflftENCE
OCCUlt"EHCe
COy. F- peRsgN
ACel . ENT
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A ... __._.........-.-.- ~~.. I ...-.. 1.. ..
lDllt~.ISDj'~!IElIDJ:::=---::=-=:::::~
ATTACHEO fORMS: :u~a~ll&iUI '~8al~1181"IH888iI8;91J 9-243!(4182) eU020lC 1175)
-
.~~~_~~_~~~~_~~~~~AGf~T
9-80.UOuut ORLANDO
ell"'. L.O~ ~tF PREPAItEO 04-30-85 '..2E7 SiQ.2258
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