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CERTIFICATES OF INSURANCE 1986-1988 ro.o' ,- 'y ..~ TO: FROM: COPIES: SUBJECT: DATE: .'1 CITY I)F CLEARWATER Interdepci.1ment Correspondence Sheet Elizabeth S. Haeseker, Assistant City Ma~a;:?V William C. Held, Jr., Harbormaster ~~ Cyndie Goudeau,VCity Clerk Insurance Policy - Holiday Inn Surfside - Waiver May 4, 1987 I have received and reviewed the insurance policy for Holiday Inn Surfside. This policy meets the requirements of their lease agreement with the city. Expiration date is January 1, 1988. WCH:mm 11 E C I ~~,! i~ -fJ MAY 5 198/ .-; :,,- \l . ,.11 J ~~--/~~~~~.(f) \~l~_",.,-" '.._ :~ .."-1"'0;,.,..,,...., .. ISSUE DATE (MM/DD/YY) 4-30-87 J. Smith Lanier & Company .of Atlanta P.O. Box 80707 Atlanta, Georgia 30366 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 INSURED W.B. Johnson Properties, 3414 Peachtree Road, NE Suite 300 Atlanta, Georgia 30326 COMPANY A LEDER COMPANY B LEDER Inc. COMPANY LEDER COMPANY D LEDER COMPANY E LEDER Aetna Casualty & Surety Company 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 SUBJECTTO ALL THE TERMS, EXCLUSIONS, AND CONDI. TIONS OF SUCH POLICIES. POLICY EXPIRATION DATE (MMIDDIYY) COMPREHENSIVE FORM PREMISES/OPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD X PRODUCTs/COMPLETED OPERATIONS llGL484995SCA X CONTRACTUAL X INDEPENDENT CONTRACTORS X BROAD FORM PROPERTY DAMAGE X PERSONAL INJURY xu al Liabi it AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (PRIV. PASS) ALL OWNED AUTOS (~~7JRp1~~N) HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY 1-1-87 1-1-88 BI & PO $ COMBINED 2 , 000 $ 2,000 PERSONAL INJURY $ 2,000 '," EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM BODILY INJURY $ (PER PERSON) BODilY INJURY $ (PER ACCIDENT) PROPERTY DAMAGE $ BI & PO COMBINED $ BI & PD $ COMBINED $ WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE.EACH EMPLOYEE) :~! OTHER ~ ~r .. ~t .. '~: DESCF.l!~TION QF. OPERA TIQNS/LQCA TIQNSNEHICJ..Es.'SP5CIAL IlEMS Kt: llearwater ~urTSloe HOlloay inn, 400 Mandalay Ave., Clearwater, FL The City of Clearwater, FL is an additional insured with respect to all activities s onsored b the Clearwater Surfside Holidya Inn that take place in public access easement.s . ~~~...~( '-:"'J",:1;~~>-.iilfr~'PiwZi"~"~~~"'ol'.,.,~~-t'P....~" .-..-..............t:IlJJ7' ~~;"i ..;. . :.,r~'~'~........:0. .(~t > ~ ..-1I.:":';r..:~,,;,: J:\-""#I'.,v,~t:~;r~,~,!}';,'.r''r/i'~''''';'''''''!n'', r,;. . .. .:\.. -, f;<. -1....!1;). . ,_.',' " ."C'. ....&W~'t~.~\'~~;;:~~%~i(~:~~;;~1~i;:i~;[~~r:;;~~<i~14f:v;:~: ';:';:~~~i;~:t:~~!,,~'~t~\~f;~~~"-';:';:j;:;?::;3;'. J. Smith Lanier & Company of Atlanta P.o. Box 80707 Atlanta, Georgia 30366 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 INSURED W.B. Johnson Properties, Inc. 3414 Peachtree Road, NE Suite 300 Atlanta, Georgia 30326 COMPANY A Aetna Casualty & Surety LETTER COMPANY B LETTER COMPANY C LETTER COMPANY D LETTER COMPANY E LETTER . . 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS DATE iMMlDDIYY) OA TE (MMlDOIYY) EACH AGGREGATE OCCURRENCE BODILY INJURY $ $ PROPERTY 1-1-87 1-1-88 DAMAGE $ $ GENERAL LIABILITY X COMPREHENSIVE FORM X PREMISES/OPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD X PRODUCTS/COMPLETED OPERA liONS X CONTRACTUAL X INDEPENDENT CONTRACTORS X BROAD FORM PROPERTY DAMAGE X PERSONAL INJURY X AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (PRIV PASS) ALL OWNED AUTOS (~~7JRpl~~N) HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY I1GL484995SCA ~bt~~ED $ 2,00 $ 2,000 PERSONAL INJURY $ BODILY INJURY $ IPER PERSON) BODILY INJURY $ IPER ACCIDENT) PROPERTY DAMAGE $ BI & PO COMBINED $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM ~bt~~ED $ $ WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY $ $ $ (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS RE: Clearwater Surfside Holiday Inn, 400 Mandalay Ave., The City of Clearwater, FL is an additional insured of Clearwater, P.O. Box 4748 Clearwater, FL 33518 J. SMITH LANIER & CO OF ATLANTA P.O. BOX 80707 ATLANTA, GA. 30366 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 fm~~NY A RELIANCE INS~CcBM}.V E I> INSURED W.B. JOHNSON PROPERTIES, INC 3414 PEACHTREE RD. N.E., SUITE 300 ATLANTA, GA. 30326 COMPANY B LETTER COMPANY C LETTER FEB 18 1986 COMPANY D LETTER COMPANY E LETTER CITY CLERK 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 THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS,-AND CONDI- TIONS OF SUCH POLICIES, TYPE OF INSURANCE POLICY NUMBER POliCY EFFECTIVE DATE (MMIOOiYY) POLICY EXPIRATION DATE (MM/OOiYY) LIABILITY LIMITS IN THOUSANDS OCCQ~~~NCE AGGREGATE GENERAL LIABILITY COMPREHENSIVE FORM PREMISES/OPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD PRODUCTS/COMPLETED OPERA liONS CONTRACTUAL INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY BODILY INJURY $ $ PROPERTY DAMAGE $ $ VI 0697643 1-1-86 1-1-87 BI & PD COMBINED $1,000 $1,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (PRIV PASS.) ALL OWNED AUTOS (OTHER THAN) PRIV PASS. HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY PERSONAL INJURY $1,000 BODILY ['<JURY $ ,f'tR f'tRSONI BODILY INJURY $ If'tR ACCIDENT) PROPERTY DAMAGE $ BI & PD COMBINED $ -----.-:-- ---- BI & PD $ $ COMBINED EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY $ $ $ (EACH ACCIDENT) (DISEASE POLICY LIMIT) (DISEASE EACH EMPLOYEE) OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS RE: CLEARWATER SURFSIDE HOLIDAY INN, 400 MANDALAY AVE., CLEARWATER, FL. THE CITY OF CLEARWATER FL IS AN ADDITIONAL WITH RESPECT TO ALL ACTIVITIES CITY OF CLEARWATER, FL P.O. BOX 4748 CLEARWATER, FL. 33518 J. Smith Lanier & Co. of Atlanta P.O. Box 80707 Atlanta, Georgia 30366 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. W~B. Johnson Properties, Inc. 3414 Peachtree Road, NE, Suite 300 Atlanta; Georgia 30326 COMPANIES AFFORDING COVERAGE COMPANY A Reliance Insurance Company LETTER COMPANY B LETTER COMPANY C LETTER COMPANY D LETTER This certificate voids and su ersedes INSURED 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. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS OATE (MM/OOIYY) OATE (MM/DDIYY) EACH AGGREGATE OCCURRENCE BODILY $ $ INJURY PROPERTY $ $ DAMAGE 01/01/86 BI & PD $1,000 $1,000 10/23/84 COMBINED GENERAL LIABILITY X COMPREHENSIVE FORM PREMISES/OPERATIONS UNDERGROUND EXPLOSION & COLLAPSE HAZARD PRODUCTS/COMPLETED OPERATIONS CONTRACTUAL INDEPENDENT CONTRACTORS BROAD FORM PROPERTY DAMAGE PERSONAL INJURY CI5011735 PERSONAL INJURY $1,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS (PRIV. PASS.) ALL OWNED AUTOS.(OTHER THAN) PRIV. PASS. HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY BODILY INJURY $ (PER PERSON) BODILY INJURY $ (PER ACCIDENT) ~~~~~~TY $ RECEIVE ~~t~I~ED $ EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM ~~t~~ED $ WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY STATUTORY ,- $ $ $ (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPEAATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS Clearwater Surfside City of Clearwater, Inn, 400 Mandalay Ave., Clearwater Beach, Florida Additional Insured with respect to all activities k 1 e in ublic access easement. City of Clearwater, Florida P.O. Box 4748 Clearwater, Florida 33518