CERTIFICATE OF INSURANCE (17)CERTIFICATE OF INSURANCE
CERTIFICATE DATE: 04/17/2009
POLICYHOLDER:
CERTIFICATE HOLDER: Clearwater Airpark, Inc.
City of Clearwater 1000 N. Hercules Avenue
25 Causeway Boulevard Clearwater, FL 33765
Clearwater, FL 33767
This is to certify that the following policy(s), subject to the terms, conditions, limitations and endorsements the eomdan a will endeavor to nodfythe certifperiod, have icate holder bb t
issued by the company(s) indicated below. In the event of material change or cancellation of said policy(s), the comp y
involved.
failure to do so shall impose no liability or obligation of any kind upon the undersigned or the company(s)
Policy Type: AVIATION GENERAL LIABILITY
Insurance Company: StarNet Insurance Company through Berkley Aviation, LLC
Policy Number: BA09MI327S
Policy Period: April 25, 2009 to April 25, 2010
LOCATION
PREMISES LIABILITY
Clearwater Air Park
Clearwater, FL
$1,000,000 Each Occurrence
SO STATED ON THIS CERTIFIC TEpOGICY(SJ REPRESENTED
THE FOREGOING EVIDENCE OF COVERAGE IS T NOT OT ERB AMENDED IN ANY WADY UNLESS
BY THIS CERTIFICA
ADDITIONAL AGREEMENTS:
Additional Insured
City of Clearwater is included as an Additional Insured for Liability Coverages, but solely with
respect to operations of the Named Insured, subject to all policy terms and conditions.
A I I AhinFA VnR
NOTICE OF CANCELLATION: IN THE EVENT OF MATERIAL CHANGE OR CANCELLATION
TO GIVE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER WITH THE EXCEPTION OF A 10 DAY NOTICE FOR NON-PAYMENT OF PREMIUM.
Aviation Insurance Agency, Inc. _ n
2580 S. E. Aviation Way, Suite 101 /WICIj
Stuart, FL 34996 ii••JJ
www.avnins.com
Telephone (772) 286-0626 - Facsimile (772) 286-1108 Authorized Signature