CERTIFICATE OF INSURANCE FOR 90 BELL 206-L-3 N63L
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CITY OF CLEARWATER
INTER-OFFICE COMMUNICATION
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RECEIVED
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CITY CLERK DEPT.
[J PLEASE REPLY ON REVERSE SIDE
l!~A~~ Certificate of Insuratce
This is to certify to City of Clearwater
that
I~UC1 1995
whose address is
P.O. Box 4748
Clearwater, FL 34618
Helicopters, Inc., et al
#14 Omega Drive
Cahokia, IL 62206
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whose address is
R~SI{ M~tt~AGErt'E~~1
is at this date insured with one or more member companies of the United States Aircraft Insurance Group, for the Limits of Coverage stated
below, at the following locations: the United States of America, its territories and possessions, Canada, Mexico, the
Bahama Islands or while enroute between these places.
DescriDtive Schedule of Coverages
Kind of Insurance Policy Number(s)
90 Sell 206L-3. N63L
Expiration Date(s)
Limits of Coverage
Each Person Each Occurrence
AIRCRAFT LIABILITY
Combined Liability Coverage for
bodily injury and property damage
400AC-36444
07/19/96
$ 25,000,000.00
Medical Coverage
$ 15,000.00
AIRCRAFT PHYSICAL
DAMAGE-ALL RISKS
Not in Motion
Deductible
In Motion
Deductible
Amount of Insurance
$
$
$
AIRPORT LIABILITY
Each Occurrence
$
Combined Liability Coverage for
bOdily injury and property damage
Hangarkeeper's Liability
Deductible
$
Each Aircraft
$
Each Occurrence
$
WORKERS' COMPo
EMPLOYERS LIABILITY
Each Occurrence
$
The -Who's covered" section of -Your Liability Coverage" includes CITY OF CLEARWATER, but only while the aircraft is operated by the
Policyholder.
This certificate or verification of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies
listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate or
verification of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all terms, exclusions
and conditions of such policies.
,TAe-Aviation Managers of the USAIG(UnitecfStates Al'rcraffTri-surance Group) agree that in the event of cancellation of the policy(ies), they will
endeavor to give the party to whom this Certificate is issued 30 days advance notice of such cancellation, but the Aviation Managers shall not be
lIab'e '" oey way 10' fa""e to "... ''''" ""<e. ~
UNITED STATES AVIATION UNDERWRITERS, INC., Aviation Managers . "
address: 71 West Port Plaza. Suite 454, St. Louis, MO 63146
by: Gary A. Fey/Assistant Manager
date: July 20. 1995