INSURANCE CERTIFICATE (21)TO: Elizabe Haeseker Assistant City Manager
/• / W re I I
FROM: Do
Ye/ 0-r-oveivm
COPIES: Bill Held, rarbormaster
SUBJECT: West Coast water sports insurance
DATE: September 29, 1987
I
CITY OF CLEARWATER
Interdepartment Correspondence Sheet
Attached certificates of insurance, dated September 10, 1987 and July 2, 1987,
show a total of $1,000,000 of coverage as required by paragraph 11 of your
agreenent, including parasailing.
Certificate - Logan Insurande - September 10, 1987
Certificate - VIP Underwriters Corporation - July 2, 1987
RECE7VED
OCT 7 1981
CITY CLERK
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 POLICIES BELOW.
Logan Insurance Agency, Inc.
3801 North 9th Ave.
Pensacola, Fla 32503
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY B
INSURED LETTER
West Coast Water Sports, Inc. COMPANY C
2273 Willow Tree Drive LETTER
Clearwater, Fla 33576 COMPANY D
LETTER
COMPANY E
LETTER
Western World/CIS
Adriatica/CIS
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 MAY
BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY '(HE POLICIES DESCRiBED HEREIN IS SUBJECT TO ALLTtIE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES,
LIABILITY LIMITS IN THOUSANDS
POLICY EFFECTIVE
DATE (MM/DDIYY)
POLICY EXPIRATIO~
DATE (MM/DDIYY)
rYPE OF INSURANCE
POLICY NUMBER
EACH
OCCURRENCE
GENERAL LIABILITY
COMPREHENSIVE FORM
PREMISESiOPERA TIONS
UNDERGROUND
EXPLOSION & COLLAPSE HAZARD
PRODUCTSiCOMPLETED OPERATIONS
CONTRACTUAL
INDEPENDENT CONTRACTORS
BROAD FORM PROPERTY DAMAGE
PtRSONil.L INJURY
I BODILY
IN,IURY $
8/27/88 I PROPERTY
DAMAGE $
I-
!
IBI & PO $
COMBINED
I
$
GLA286542
8/27/87
*-
I
500 1$ 500
'ERSONAL !N"UR' t -- - -
--~_..-.- ....~--C__-.7:---
I
._-~
[J1JOIL'i I
INJURY
tR ~~I~n! $.__ __~
I PROPERTY i
l~~~~t,(~~-J~-.- .._~
: B: & PI] I I
! COMBiNLD I $ !
----1-- ---..---------+-----'''- "1 "-.---"-.-.-...
: I ~
I I ! ~6~~~ED I $ - I $
__~_flL2? 18..7 _ L__8/~?L88 Ju~__ .L!?_9.0_T_l. _ 500
L__
I I
._---------I-~-------
I
I
!
I
" _______-L.._
I
i
AUTOMOBILE LIABILITY
o ANY AUTO
~.~ ALL OWNED AUTOS (PRIV PASS)
U' ALL OWNED AUTOS (~~7JRpl~~N) I
HIRED AU IOS I
NON OWNED AU ros I
W~i GARAG::~:~_C_=7=~==-~=-L_ _ __ ~__.___~_~.__________+ _
:rEXCESS LlABII.lTY 'I:
UMBRELLA FORM
C E___~!HER r..~~_~~.f3.R~~ORM ___~ RE 703527
WORKERS' COMPENSATION :
AND I
EMPLOYERS. LIABILITY I
I i
-- u________.____.._._. .-.. .-- ..--4----. . -.~~------t-------- -
I I
] I
i 1
-----1...___ ________.___~.__~..~.__~__ .~_~~~~__._ .__~_ .__
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
$
STP,TUTORY
r--~~---'u
I ,c:;
i fi--
j i$
I in--
! j$
n___ -------t-.---
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City of Clearwater
Clearwateri Fla 33575
(additiona insured)
PRODUCER
VIP Underwriters Corp
470 Nimitz Highway
CERTIF9COE OF INSURANCE
Honolulu HI 96817
ISSUE DATE (MM/DD/YY)
07 02 87
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 POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
LETTER
COMPANY
LETTER
INSURED
SKYRIDER, Beiswenger
Enterprises Corp. , dba
9211 US 19
Port Richey FL 33568
COVERAGES
A COLONY
B
INSURERS, LTD.
COMPANY
LETTER
C
G1i� us Cc��V�i�TER
COMPANY
LETTER
D
COMPANY
LETTER
THIS IS TO CERTIFY THAT 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 SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI-
TIONS OF SUCH POLICIES.
CO
LTR
TYPE OF INSURANCE
POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DD/YY)
POLICY EXPIRATION
DATE (MM/DD/YY)
ALL LIMITS IN THOUSANDS
GENERAL
LIABILITY
COMMERCIAL GENERAL LIABILITYPRODUCTS-COMP/OPS
•
GENERAL AGGREGATE
$
AGGREGATE
$ '
CLAIMS MADE ❑OCCURRENCE
PERSONAL 8 ADVERTISING INJURY
$
OWNER'S & CONTRACTORS PROTECTIVE
EACH OCCURRENCE
$
FIRE DAMAGE (ANY ONE FIRE)
$
MEDICAL EXPENSE (ANY ONE PERSON)
$
AUTOMOBILE
LIABILITY-
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON -OWNED AUTOS
GARAGE LIABILITY
7
CSL
$
BODILY
INJURY
(PER PERSON)
$
BODILY'
�INFJURY
ACCIDENT)
$
PROPERTY
DAMAGE
$
EXCESS
LIABILITY
OTHER THAN UMBRELLA FORM
r
EACH
OCCURRENCE
$
AGGREGATE
$
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
STATUTORY ',•. 9 s
$ (EACH ACCIDENT)
$ (DISEASE -POLICY LIMIT)
$ (DISEASE -EACH EMPLOYEE)
A
OTHER
PARASAILING LIAB
CC 10014 - AH
06/08/87.06/08/88
1,000,000 CSL
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
IT IS HEREBY UNDERSTOOD AND AGREED THAT THE CERTIFICATE HOLDER IS NAMED AS
ADDITIONAL INSURED IN RESPECTS TO THE PARASAILING OPERATIONS 01? THE NAMED
INSURED.
CERTIFICATE HOLDER
CANCELLATION.
CITY OF CLEARWATER
1 MARINA PLACE`
CLEARWATER BEACH
FL 33515
' BOLDER -ID 00_
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL 3 (PAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
0 IIR/ACORD CORPORATION 1985