ISLAND ESTATES CIVIC ASSOCIATION INC. / CUL-DE-SAC MEDIANS ADOPT-A-STREET AGREEMENT
. .
ADOPT -A-PARK PERMIT
Permission and authority are hereby given and granted by the City of Clearwater, c/o Parks & Recreation Department,
P.O. Box 4748, Clearwater, FL 33758-4748, hereinafter referred to as City, to Island Estates Civic Association, Inc., a
Florida Not For Profit Corporation, hereinafter referred to as "Permit Holder", whose address is P.O. Box 3154,
Clearwater, Florida 33767, to provide, install, and maintain, landscaping, landscape materials, fencing, and decorative
entry way features within the area known as Island Estates, Clearwater, Florida, as provided for in Exhibits A, A-I, B, C,
D, and Dl through D17, together with Exhibits E, F, G, H, and I all being attached hereto and made a part hereof, subject,
however, to the following terms and conditions.
1. Permit Holder, prior to beginning work, shall submit a landscape plan to the City for approval. The City
will review the plan as it relates to the design and types of landscape materials, the impact on utilities, consideration of
site distance problems, etc. Specifications for the size and installation of the landscape material shall be included with the
plan.
2. Permit Holder, shall pay for, install, and maintain at its expense during all times while this Permit is
in effect the landscape plantings, materials, fencing, and decorative entryway features installed by the Permit Holder in
accordance with the design criteria of the approved plan. For the purpose of this Permit, maintain shall mean day-to-day
care as required to keep the landscape plantings, material, fencing, and decorative entryway features in good condition
and shall include, but not be limited to, the following specific duties: planting, clipping, pruning, tending, watering,
feeding, weeding, mulching, spraying, and painting.
3. The City shall be responsible for the installation and renovation of the irrigation systems associated with
the projects. The City shall design the system and be responsible for associated costs including meters, wells, backflow
prevention devices, pumps, electrical service, etc.
4. Permit Holder and City shall be responsible for the special conditions of this Permit as shown on
Exhibits A & C attached hereto and made a part hereof.
5. City shall continue to be responsible for the maintenance of grass, trees, and the irrigation system.
6. City shall pay monthly water and electric bills for the approved irrigation systems.
7. City, at such time as Permit Holder discontinues maintenance of the landscaped area, reserves the right to
maintain the landscaped area, or to remove the landscape material as may be appropriate, at its sole discretion.
8. Permit Holder shall defend, indemnify, save and hold the City harmless from any and all claims, suits,
judgements and liability for death, personal injury, bodily injury or property damage arising directly or indirectly from
performance under this Permit and for the installation and maintenance tasks related to landscaping or landscape material
by Permit Holder and its employees, contractors, agents, and volunteers, including legal fees, court costs, and other legal
expenses. Permit Holder acknowledges it is solely responsible for complying with the terms of this Permit. Prior to any
performance under the terms ofthis Permit, the Permit Holder agrees to provide, at its expense, a policy of general
liability insurance in the amount of $500,000, insuring Permit Holder's obligations to City under this Permit. Said policy
of liability insurance shall name the City as an additional insured and shall protect the City from all property damage and
personal injury claims asserted against the City by third parties by reason of the landscape materials being located within
the public right of way, or relating to the performance oflandscaping or maintenance tasks by the Permit Holder or any
party acting on behalf of the Permit Holder with regard to this project. A Certificate of Insurance or a copy of such
policy of insurance shall be provided to the City for its review and approval.
The City recognizes and appreciates the contributions of the Permit Holder in this landscape effort.
This Permit replaces and supercedes the Permit between the parties dated 12/7/98, a copy of which is
attached hereto as Exhibit E, together with those individual permits attached hereto as Exhibits F, G, H, and I,
more fully identified as follows:
1) Sally Nitka, 878 Harbor Island North, Clearwater, FL, 34630
2) John Chalapis, 324 Windward Island, Clearwater, FL 33516
3) Gina Hawkins, 430 Leeward Island North, Clearwater, FL 33516
4) Clair Johnson, 1 Leeward Island South, Clearwater, FL 33516
This Permit may be revoked at any time by the City Manager of the City of Clearwater, Florida, and said Permit shall not
be assignable by Permit Holder.
By execution and acceptance of this Permit, the Permit Holder and its duly elected officers acknowledge having
read same and represent to the City that Permit Holder, as a Florida Not For Profit Corporation, has the authority to
execute this Permit and fully agrees to all the terms and conditions contained herein.
2
Dated: -t-\t4 3/ 0 \
Approved By:
,~
CITY OF CLEARWATER
~---
KevlflE. Dunbar, Director of
Parks & Recreation
~ J.y? /~
Mashid Arasteh, Public Works Administrator
ISLAND ESTATES CIVIC ASSOCIATION
INC., orida Not For Profit Corporation
~~
Its Secretary
Note: This Permit is not valid until executed bv the City Manager. City of Clearwater.
S:\Parks\Agreements\Adopt-a-Park Permit-Island Estates Cul-de-sacs
3
. .
EXHIBIT A
ISLAND ESTATES CIVIC ASSOCIATION SPECIAL CONDITIONS
FOR INSTALLATION AND MAINTENANCE
This Exhibit A covers the special conditions for installation and maintenance of landscape material,
landscaping, fencing, and decorative entry way features in the right of way and median located at Memorial
Causeway and Island Way per the attached aerial identified as Exhibit A(l).
Permit Holder:
. Any damage occurring to the permitted landscaping or entry way features from
vehicles, weather, vandals, etc., should be rectified within 20 working days of
written notice to the permit holder from the City. Failure to repair the
damaged landscaping and entryway features within the time frame will be
considered "discontinuance of maintenance."
. Any changes to the approved plan must be resubmitted to the Parks and
Recreation Department for approval prior to changes being made,
. All building and right-of-way permits must be secured by any contractor hired
by the Island Estates Civic Association to perform this work.
. A work schedule should be submitted to the City prior to commencement of work
in the right-of-way areas and realistic time frames set for the construction of
the entry way features.
. If fountains are installed as entryway features, the Association will provide
for all maintenance and repair costs.
. Continue to provide pest control and fertilization to lawn and landscape areas,
City:
. Where applicable, the City will waive permit and building fees.
. Trees damaged will be replaced or repaired by the City.
. Damaged turf will be repaired by the City,
. Irrigation system will be repaired by the City.
. The City will install effluent water lines when available.
. If requested and desired by the Association, the City will establish a donation
account whereby the Association can deposit funds for the project. However,
all items and contracts purchased from this account must meet City purchasing
and legal requirements,
4
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EXHIBIT B
This Exhibit B covers cul-de-sac locations within Island Estates identified as shown below and numbered 1
through 17 inclusive:
Location
Current Caretaker
. Windward North 1 (Hattenburg)
. Windward South 2 (Cole)
. Midway North 3 (N ethercoat)
. Midway South 4 (Briskman)
. Leeward North 5 (Menant)
. Leeward South 6 (Johnson)
. Windward Passage 7 (Brock)
. Dolphin Point 8 (Gramley)
. Skiff Point 9 (Cousins)
. Palm Island SE 10 (Stebbins)
. Palm Island SW 11 (Chaconas)
. Palm Island NE 12 (Wexler)
. Palm Island NW 13 (Albritton)
. Snug Island North 14 (Speck)
. Snug Island South 15 (Bratton)
. Harbor Island North 16 (Nitka)
. Harbor Island South 17 (Keats)
5
'.
EXHIBIT C
ISLAND ESTATES CIVIC ASSOCIATION SPECIAL CONDITIONS
FOR INSTALLATION AND MAINTENANCE
This Exhibit C contains the installation and maintenance requirements for those locations identified in Exhibit
B.
Permit Holder:
. Any damage occurring to the permitted landscaping from vehicles, weather, vandals, etc., should be
rectified within 20 working days of written notice to the Permit Holder from the City. Failure to repair or
replace the damaged landscaping within the time frame will be considered "discontinuance of maintenance".
. Any changes to the approved plans must be resubmitted to the Parks and Recreation Department for
approval prior to changes being made.
. A work schedule should be submitted to the City prior to commencement of work in the right-of-way areas
and realistic time frames set.
. Continue to provide pest control and fertilization to landscape areas.
City:
. Trees damaged will be repaired or replaced by the City.
. Damaged turf will be repaired or replaced by the City.
. Irrigation systems will be repaired or replaced by the City.
. The City will install effluent water lines when available.
. Tree pruning and trimming will continue to be provided by the City.
6
EXHIBIT D
The drawings attached hereto are all identified as Exhibit D documents, but each document numbered D 1
through D17 represents landscaping work to be performed by Permit Holder on a specific cul-de-sac median
location as those locations are numbered and identified in Exhibit B. Thus, the numbered locations in Exhibit B
correspond with the drawings D 1 through D 17 and the landscaping work to be performed by the Permit Holder
on each specific cul-de-sac median location identified in Exhibit B is shown in the respective drawing
numbered D 1 through D 17 inclusive.
7
J
1
ADOft A PUK PDMI~
Exhibit E
Permission and authority are hereby given andAr9nted to Island Estates
-:3)..J 4-- ~
Civic Association whose address is P.O. Box J2e7, Clearwater, Florida 33767,
to provide and install landscape material, fencing and decorative entry way
features, and to maintain said material in the right of way and median located
at Memorial Causeway and Island Way (see attached aerial), subject to the
following terms and conditions:
1. Permit Bolder, prior to beginning work, shall submit a pIa:: to the
City of Clearwater for approval.
The City will review the plan as it relates
to the design and types of landscape and construction materials, the impact on
utili ties, consideration of site distance problems, etc.
Specifications for
the size and installation of the landscape material shall be included with the
plan,
2. Permit Bolder, upon completion of the entry way improvements, fencing
and landscape material, shall assume all responsibility for maintaining the
material, installed by the Permit Holder, in accord with the design criteria of
the plan,
3. Permit Bolder shall be responsible for the installation or re:;ovation
of any new irrigation system/s t::at may be associated with the proje:::. The
use of an irrigation system and its design must first be approved by the City.
If approved, the Permit Holder shall, be responsible for associated costs
including meters, wells, backf:~w prevention devices, pumps,
electrical
service, etc.
4. Permit Holder and City shall be responsible for special cc::ditions
attached to this permit,
5, City shall continue to =e responsible for the maintenance of grass,
trees, and an irriga~ion system if such system is existing and operati:-:g prior
to the planting project,
EXHIBIT E
,
6. City shall pay mOllt~ly water and electric billslfor approved systems.
;"l
7. City, at such time as the Permit Holder may discontinue maintenance,
reserves the right to maintain the landscape material and entry way
improvements or to remove same as may be appropriate, at its sole discretion.
8. Permit: Holder(s) shall defend indemnify, save and hold the City
harmless from any and all claims, suits, judgments and liability for death,
personal injury, bodily injury or property damage arising directly or
indirectly from the performance of installation or maintenance tasks related to
landscap:~g or landscape material or entry way improvements by Permit Holder(s)
and his/ber employees, contractors or agents, including legal fees, court
costs, ar.d other legal expenses.
Permit Holder (s) acknowledge that he/she is
solely responsible for complying with the terms of this permit. The
Association further agrees to immediately obtain a policy of insurance in the
amount of $500,000, which policy shall name the City as one of the insureds,
and such policy shall protect the City from all property damage and personal
injury claims made by third parties by reason of the structure being located on
public r:ght of way or relating to the performance of landscaping or
maintenan:e tasks by the Association with regard to this project, A copy of
such poli:y of insurance shall be provided to the City for its review ar.d
approval.
The :ity recognizes and appreciates the contributions of the Permit Holder
in this landscape effort..
This permit may be revoked at any time by the City Manager of the City of
Clearwate=, Florida.
By execution and acceptance of this permit, the Island Estates Civ:.c
Associatic:1 (Fran Briskrnan, Current President) acknowledges having read sar.:e
and repre.:,=::.ts that she has the authority to execute this permit and ful':'y
agrees to all the terms and conditions contained herein,
2
,
6. City shall pay monthly water and electric bills <1'or approved syst......
~
7. City, at such time as the PeIDLit Holder may discontinue maintenance,
improvements or to remove same as may be appropriate, at its sole discretion.
reserves the right to maintain the landscape material and entry way
8. PenUt Bolcler(e) shall defend indemnify, save and hold the City
harmless from any and all claims, suits, judgments and liability for death,
personal injury, bodily injury or property damage arising directly Or
indirectly from the performance of installation or maintenance tasks related to
landscap:~g or landscape material or entry way improvements by Permit HOlder(s)
and his/;er employees, contractors or agents, inClUding legal fees, COurt
costs, ar.d other legal expenses.
Permit Holder(s) acknowledge that he/she is
Solely responsible for complying with the terms of this permit. The
Association further agrees to immediately obtain a policy of insurance in the
and Such pOlicy shall protect the City from all property damage and personal
amount of $500,000, which policy shall name the City as one of the insureds,
injury claims made by third parties by reason of the structure being located on
pUblic r:ght of way or relating to the performance of landscaping Or
maintenance tasks by the Association with regard to this project. A copy of
Such policy of insurance shall be provided to the City for its review and
approval.
in this landscape effort..
The :ity recognizes and appreciates the contributions of the Permit Holder
Clearwate=, Florida,
This permit may be reVoked at any time by the City Manager of the City of
Sy Execution and acceptance of this permit, the Island Estates CiVic
As Socia ti C~ ( Fr an Sri s leman, Curren t Pres iden t I acknow I edges having read s ar.:e
and repre,,~ ts that she has the authori ty to eXecute this permit and fully
agrees to all the terms and conditions contained herein.
2
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~
Note: This permit not valid until executed by the City Manager, City of
Clearwater.
3
S:\Parks\Agreements\Adopt-a-Park Permlt-,sla~d Esta:es
"-\~~\..~ ==.,
(J)
PEID-lIT
Permission and authority hereby are given and granted to Mrs. Sally Nitka of
878 Harbor Island to install landscape material and to maintain same in the median
circle which is located at Harbor Island North subject to the fOllowing terms and
condi tions :
1. Prior to planting landscape material, permit holder will request approval
from the Parks and Recreation Department as it relates to the design and type of
landscape material.
2. The Parks and Recreation Department will provide sod and trees for the
project and will maintain the irrigation system.
3. Permit holder will provide and plant flowers and other landscape material
at no cost to the City.
4. Permit holder will assume the responsibility of maintaining the landscape
material and grass on a regular basis.
5. The City will perform repairs to the irrigation system as needed.
6. At such time as the permit holder may discontinue maintenance, the Parks
and Recreation Department retains the right to maintain the landscape material
or to remove same as may be appropriate.
The Permit holder shall save and hold harmless the City of Clearwater for
any injuries or property damage that may result to volunteers or third parties
during the performance of installation or maintenance tasks relating to the
landscape material.
The City recognizes and appreciates the contributions of the permit holder
in this landscape effort.
This Permit may be revoked at any time by the City Manager of the City of
Clearwater, Florida.
By execution and acceptance of this permit, Mrs. Nitka acknowledges having
read same and represents that she has authority to execute this perIni t and fully
agrees to all the terms and conditions contained herein.
Witness:
.",
- , '
~\ ~ 1'1-""'\"-" _.\
\ Mrs. Sally Ni tka\
.....:-.)-.
,\
Reviewed
~
Di~ector, Parks
Date
w~
& Recreation
Permit Authorized, By:
~/~nM
Date
"
. -..'~ to ("--:--7
Ci ty Manag'er
City of Clearwater
'r'
Note: This Permit not valid until executed by the City of Clearwater.
Exhibit F
PERMIT
\.)~~~.
QI}'
(fl)
P~rmission and authority hereby are given and granted to Mr. John Chalapis of
324 Windward Island to install landscape material and to maintain same in the median
circle which is located at Windward Island No. subject to the following terms and
conditions:
1. Prior to planting landscape material, permit holder will request approval
from the Parks and Recreation Department as it relates to the design and type of
landscape material.
2, The Parks and Recreation Department will provide sod and trees for the pro-
ject and will maintain the irrigation system,
3. Permit holder will provide and plant flowers and other landscape material
at no cost to the City.
4. Permit holder will assume the responsibility of maintaining the landscape
material ~.~ ~~~ on a regular basis.
ll-Y
5. The City will perform repairs to the irrigation system as needed.
6. At such time as the Permit holder may discontinue maintenance, the Parks
and Recreation Department retains the right to maintain the landscape material or
to remove same as may be appropriate,
The pernlit holder shall save and hold harmless the City of Clearwater for
any injuries or property damage that may result to volunteers or third parties
during the performance of installation or maintenance tasks relating to the land-
scape material,
The City recognizes and appreciates the contributions of the Permit holder in
this landscape effort.
This Permit may be revoked at any time by the City Manager of the City of
Clearwater, Florida,
By execution and acceptance of this p.ermi t, Mr. Chalapis acknowledges having
read same and represents that he has authority to execute this Permit and fully
agrees to all the terms and conditions contained herein.
Witness:
ev~,
~
. JO~ Chalapis ..
0.....,~.
(/
..........,
Reviewed by:
Pa~ks and Recreation
Date
Note: This Permit not Va.... _,dl executed by the City of Clearwater.
Exhibit G
\...1.~~S "'~J
PERMIT
Exhibit H
Permission and authority hereby are given and granted to Mrs, Gina
Hawkins, 430 Leeward Island N. to install landscape material and to
maintain same in the median circle which is located at Leeward Island
North subject to the following terms and conditions:
1. Prior to planting landscape material, permit holder will request
approval from the Parks and Recreation Department as it relates to the
design and type of landscape material,
2. The Parks and Recreation Department wiIl provide a planting
area in the center of ~edian and plant palm trees and will provide
and maintain the irrigation system.
"I
3. Permit holder will provide and plant flowers and other land-
scape material at no cost to the City,
4, Permit holder will assume the responsibility of maintaining
the landscape material and grass on a regular basis.
5, At such time as the permit holder may discontinue maintenance,
the Parks and Recreation Department retains the right to maintain the
landscape material or to remove same as may be appropriate,
The Permit holder shall save and hold harmless the City of
Clearwater for any injuries or property damage that may result to
volunteers or third parties during the performance of installation
or maintenance tasks relating to the landscape material.
The City recognizes and appreciates the contributions of the
permit holder ~n this landscape effort.
The Permit may be revoked at any time by the City Manager of
the City of Clearwater, Florida.
By execution and acceptance of this Permit, Mrs. Hawkins acknow-
ledges having read same and represents that she has authori~y to
execute this Permit and fully agrees to all the terms and conditions
contained herein.
Wi~~ ,:L;/'
~bY:
~ w/
Direct:r, Parks & Recreation
)<
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I
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ry~/Lv,,<, ...I
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f I Date
Permit ~. ized. BY:, .' /
,./AI ~~
City Manager
City of Clearwater
3j;{I(Y~/
Date
- _,._Note :._-.1'.hUi_J'E;:rmit _n9 t.....Yg 1 id !J11 t i 1 . ~~1J te<.Lbv the Ci: ty. gLc:J~51F-'i!'.!tg]:'_~._..._
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....----~ .
PERMIT
Exhibit I
Permission and authority hereby are given and granted to Mrs. Clair Johnson, 1 Leeward
Island South, to install landscape material and to maintain same in the median circle which
is located at Leeward Island South, subject to the following terms and conditions, ~
1. Prior to planting landscape material, permit holder will request approval from the
Parks and Recreation Department as it relates to the design and type of landscape material.
2. The Parks and Recreation Department will provide a planting area in the center of
median and plant one oak tree, and will provide and maintain the irrigation system,
3. Permit holder will assume the responsibility of maintaining the landscape material
and grass on a regular basis,
5, At such time as the permit holder may discontinue maintenance, the Parks and
,
Recreation Department retains the right to maintain the landscape material or to remove same
as may be appropriate,
The Permit holder shall save and hold harmless the City of Clearwater for any injuries
or property damage that may result to volunteers or third parties during the performance of
installation or maintenance tasks relating to the landscape material,
The City recognizes and appreciates the contributions of the permit holder in this
landscape effort.
The Permit may be revoked at any time by the City Manager of the City of Clearwater,
Florida.
By execution and acceptance of this Permit, Mrs. Johnson acknowledges having read same l
and represents that she has authority to execute this Permit and fully agrees to all the
terms and conditions contained herein,
Witness.: " /}
~~'
."...,. y
~:' // : ..' / /-
~
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C.-t'tL-l'i' ~~~-vv
Permit Holder
fUj:V /~?
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Reviewed by:
D~,~ a&~
9/;qJp9
!)ate /
Permit Authorized by:
~7(-z5?~
City Manager..
City of Clearwater
r;Jd;/JC;
,Date. I
Note: This Permit not valid until executed by the City of Clearwater
!"....
ACORD. CERTIFICATE OF LIABILITY INSURANCE CSR LS I DATE (ll1IIDDIVY)
ISLAN-7 01/19/01
.- THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Carlisle Fields & Company, Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
P.O. Box 7910 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Clearwater FL 33758-7910 INSURERS AFFORDING COVERAGE
Phone: 727-797-0441 Fax: 727-725-3663
INSURED INSURER A:. Cincinnati Insurance Company
INSURER 8:
Island Bstates Civic Assoc. ,
Inc, .......'"
P.O. Box 3154 .......<>
Clearwater FL 33767
I .........
COVERAGES
DE POI.JCIES C1F Nlt.RANCE USTED BELOW ~VE BEEN lSSUEDTO THE INSURED NAMED ABOVE FOR lIE POlICY PERIOD 1NOK:ATa). NOTWmtSTNONG
Nt( AEaUIREMENT, TERM ORCClNDI1lON OF ItH't CONTRACT OR otHER OOCUMENTV\Imt RE8PECTlOWHIOl THIS CER11F1CATE ~y BE ISSUED OR
MAY PERTAIN. DE INSURANCE AfFORDED BY THE POUOES DESCRIBED HEREJN IS SUBJECT TO ALL TIE TERMS, EXa.US1ONB AND COtClfTlClNS OF SUQi
POIJCES. AGGREGATE L.MTS SHOWN MAY""VE BEEN REDUCED BY PAlDQ.AIMS.
..... POUCY....CT1YE POUCY ........T1OII
LTR TYPE OF INSURANCE POUCY_"" DATI!~ DATE (ll1IIDDIYY) UII1T8
........... UA8lLfTY EACH OCCURRENCE $ 1,000,000
-
A X COMMERCIAl. GENERAL. UABtUTY CAP7869968 01/14/00 01/14/03 FIRE DAMAGE (Anr aM 1ft) $ 100,000
I ClAIMS MADE [!]OCWR MEn EXP (Any eN~) $ 5,000
PERSOfrW.. a ADV INJURY $1,000,000
-
GEJrERAL AGGREGATE $
-
GEM. AGGREGATE UMIT APPUES PER: PRODUCTS. COMPIOP AGO S 2,000,000
IPOUC.Y n: nLOC
AUTOUOBlLJ: LIABILITY COMBINED SINGlE UMIT
- $
ANY AUTO lEa-I
-
ALL OWNeD AUTOS BODILV INJURY
- $
8CHEIlULSl AUTOS (Pw_1
- ,lA!\
HIRED AIJT09
- IlOllIl.Y I>UURY S
flON.OWNED AUTOS (Pw-l
-
t-- PROPERlY DAMAGE S
(Pw-l
GAIIAOE UA8IUTY AUTO ONly. EA ACCIDENT $
R ANY AUTO Cln<ER ....... EA ACe S
AUTOOM..Y: AGO S
EXl:EII UA8lLfTY EACH OCCURAENCE $
OOCWR o aAlMS MADE IoOClREDATI! $
$
R= $
$ S
I WCSTA1\J. 1 10:
WORKERS COIIP2N8ATION AHD TORY U"""
EMPLOYERS" UABIUTY
E.L EACH ACCIDENT $
E.L. DISEASE. &It EWIlOYEE $
E.L DISEASE. POIJCY LMT $
OTHER
Hi ~\f'~ ,.". ",
'i ir- .". i......
DESCRIPTION Of OPERAnoNM..OCAl1ONINEHICUSl!XCI.USION:I ADDED BV EHDOItSEMIN1'II PRCMIIONI
City of Clearwater is listed as additional insured. MAR 07 lOll.
CITYCLf:"L!:' -
I.. : ,,~ ,
CERTIFICATE HOLDER I y 1-----.....- CANCELLATION
CI'l'YC-1 INOULD,., OF TME A80VI DEICRdIID POt..IClES U CANCIUED IIEPORE THE EXPIItA110N
DATI'IItEIIEOF, TIll! IllUING INSUReR WILL ENDEAVOR TO IIAIL. *30 DAYS WRfn'EN
NOTICE TO". CERTlFtCATI HCtI.DER NAIlED TO THE LEfT, BUT'AILURI! TO DO 10 IKALL
City of Clearwater
Dept of Parks & Rec WOllE NO 08LIGA11ON OR LlABJUTY OF NfY KIND UPON nil INIURI!R.II'I MENta OR
P.O, Box 4748 ......ENTATNEa.
Clearwater FL 33758 ~"i1 (rhl ..~ in
I
ACORD 25-5 (7/97) v v.... -- D C<mP'ORA TION 1988