CERTIFICATE OF INSURANCE (8)
Oct 01 2003 10:20AM
ALLIED SPECIALTY INSURANC
727-367-1407 p.2
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A CORl)", CERTIFICATE OF LIABILITY INSURANCE I DATE (N1illDDfM'Y)
10/"01/03
PROClUCHAllied Spec~a..Lty Insurance, "Inc THIS CERTlFIC.ATE IS ISSUED AS A MATTER OF INFORMATION
J.0451 Gulf Blvd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
~OLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Treasure Island, FL 33706 II , 1W'l"" ~I ~Il DI:J ^'-u
800/237-3355
IMSURERS AFFORDING COVERAGE NAlC#
1Ij8U1lBO WaveJammerz, Inc. INlUlERA: T . H. E. Insurance Company
466 Purple Finch Way I~B:
Palm Harbor FL 34683 IJIB~C:
'''SURER D,
THE POLICIES Of INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDABO\E FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
ANY REQUIREMENT. TERM OR CONDITION OF NtY CONTRACT OR OTHER DOCUMENT WTIi RESPECT TO \NHrCH ~1S CERTIFICATE MAY BE ISSUED OR ,
MAY PERTAIN, THe INSURANCE AFFORDED BY THe POlICIES DESCRIBeD HERE/!IIS SUSJECT TO AU. lHE TERMS, EXCWSlONS AND CONDmONS OF SUCH
POUCIES. AGGREGATE UMITS SHO'MI MAY HAVE BEEN REDUCED BY PAlO ClAIMS. ,
~~ ~'?~ POI.JCY Nu.&! POLICY I!FFI!C'TMI fIICl.ICV DPIRA 110N LIIlIn.
-!-INERAL LIABILITY ARENCE S 2,000,000
A M3LF8281 04/14/03 04/14/04 Dl\MAG& TO RENTED 50,000
X CON"'eRClALGEN~U1Y s
I Cl.A/MS IMOE X OCQJR MEO EXPtMv onem_ s
PERSONAL & AW IWlRY . 1,000,000
- GENERALAGGAEGAlE S 1,000,000
nLAGlGRMUMrT APPrlER: . CCMPQI>AOO II
POLICY ~~~ lOC ' ..
..M!JOMOB1lE UA8lUJY COIIIW&O &/NaLS UMIT S
Nl'f AUTO (e.~
-
- ALL OWNED AUTOS lIOOILY INJURY S
.....;.., sa4EDULeD AUTOS (Per ......)
- HlREDAUTOlI BOIlK.Y INJUR'I .
NON-OWlED AUTOS lPwllllCldMt.)
t--
t-- PROPI!RTY tMMAGE S
tperacdHnl)
GARI'lGE UASlU'TY AUTO ONLY.I!AACCloeNT $
~- AN't' AUTO - onER 1lIAN fAACC S
AUTO ONLY: AGG I
plalUMBREUAOll1U1Y - I!ACH OCCURReNCE S
OCCUR ClA/WS MACE AGGREGATE ' .
.
q DEDUCTIBLE S
RETEtlTlON . S
WORKERS COIIPENSAnON AND - f we STATU- I I~
IEM"LO'tER:S' L1A8JU1Y I 2.L, EACH ACCICENT $
AI<< PROPRleTORIPARTNERll:XECunve
OFRCERNlEMBER EXCLUDED? EL C1~ASe -I!A EMPLOYEE S
Ir~.. dMClt1lle. under I!-L. aseASE! - POLICY UMIT !II
0T1UiR
,
SCRlP11QN OF OPI!IUlITIONII LOCATlONS I YEHlCLE$1 EXCLU8IONS ADOI!D BY iNDOII8UIENT I SPI!aAL I'IlOVISIClNI
MJDITIONAL INSURED: CITY OF CLEARWATER, MARINE & AVIATION
25 CAUSEWAY BLVD., CLEARWATER BEACH, FL 33767
LOCATION: HILTON CLEARWATER BEACH RESORT
400 MANDALAY AVENUE, CLEARWATER BEACH, FL 33767
ITEMS COVERED: (7) JET SKIS AND (1) BANANA BOAT ONLY (SEE ATTACHED SCHEDULE)
:ITY OF CLEARWATER
o1ARINE & AVIATION
25 CAUSEWAY BLVD.
~LEARWATER BEACH FL 33767
..C)UU) AMY Of"Dtll AIOVI! DESCRIBED POUCII!S" CAHCI!U.2D BEFORE THE EXPlRA1ION
DATI 'ftt1!lllOl". THI!' ......INIURU WI.&. BlDE#lVOR TO MAIL ..lQ.. DAYs WRITTEN
ND1ICIIlO THE CERTlFICA 1E HOUlER HAIlEO 10 TlfE LEFT, BUT FAILUIUi TO DO 10 SIfALl.
IIIPOlIE NO Cl8UGAlION OR LIABIUTY Of ANY biD ~N lHE,1NItJRE1I, ITS AGSN,.. OR
R In:
A R&IIRE8MTATM!
ORn 25 (2D01108)
Oct 01 2003 10:22AM
Date: 10/01/D3
ALLIED SPECIALTY INSURANC 727-367-1407
Allied Specialty Insurance, Inc. Page:
General Liability Schedule
Display
p. 1
1.
User: TM:ANCINI
Policy ~LP8281 Effective Date 4/14/03
Insured Name WavejallllLerz, Ine.
Policy GNL Commercial General Liability
Location 001 Building 001
Expiration Date 4/14/04
Item
Humber Description Including Manufacturer
Serial Number
1 (1) BANANA BOAT
2 (I) POLARIS JET SKI
3 , (1) 2002 KAWASAKI JET SKI
4 (1) 2002 KAWASAKI JET SKI
5 (1) 2002 KAWASAKI JET SKI
6 (1) 2002 KAWASAKI JET SKI
7 (1) 2003 KAWASAKI JET SKI
B (1) 2003 KAWASAKI JET SKI
N/A
USPLE31866DIOl
KAW20421HI02
KAW20401H1.02
KAW20611HI02
KAW20448H102
KAW20229J203
KAN201B5J203