CERTIFICATE OF LIABILITY INSURANCE (4)
",-, -
ACORD". CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIVYYY)
6/22/05
PRODUCER Allied Spec~alty Insurance, Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
10451 Gulf Blvd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Treasure Island, FL 33706 HOLDER. THIS CERTIFICATE DOES NOT AMEDNAh~XTEND OR
AL . D T 'ICe: !:ICI n\AI
800/237-3355
INSURERS AFFORDING COVERAGE NAIC#
INSURED National Watersports, Inc. INSURERA: T. H. E. Insurance Company
7 Cristie Lane INSURER B;
Lake George NY 12845 INSURER C;
INSURER 0:
INSURER E;
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVIIITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT II\IITH 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 CONDITIONS OF SUCH
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CI,.AIMS.
I~~: ~~r;~ POLICY NUMBER POLICY EFFECTIVE P~~ EXPIRATION LIMITS
..QE.NERAL UABIL.ITY EACH OCCURRENCE $ 1,000,000
Jl. X COMMERCIAL GENERAL LIABILITY M5LF7705 06/25/05 06/25/06 DAMAGE TO RENTED 50,000
S
I CLAIMS MADE [KI OCCUR MED EXP (Anyone personl S
PERSONAL & ADV INJURY S 1,000,000
r-- 1,000,000
I--- GENERAL AGGREGATE S
n'LAGGREn LIMIT APPnER; PRODUCTS - COMPIOP AGG S
POLICY P't:-R; LOC ..
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT S
ANY AUTO (Ea accidant)
I--
I-- ALL OIMllED AUTOS BOOIL Y INJURY
(Par panson) S
I-- SCHEDULED AUTOS
- HIRED AUTOS BODILY INJURY
(Par accidanl) S
- NON.-OIMIIED AUTOS
- PROPERTY DAMAGE S
(Par accidant)
~RAGE UABILITY AUTO ONLY. EA ACCIDENT S
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY; AGG S
OESSIUMBRELlA.L1ABILlTY EACH OCCURRENCE $
OCCUR 0 CLAIMS MADE AGGREGATE S
S ..
RDEDUCTIBLE S
RETENTION S S
WORKERS COMPENSATION AND I T~~IfJNs I IOJ~.
EMPLOYERS'. LIABILITY E.L. EACH ACCIDENT S
ANY PROPRIETOR/PARTNERIEXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S
~~~M~scrlba undar E.L. DISEASE. POliCY LIMIT S
OTHER
DESCRIPTION OF OPERA nONS I LOCATIONS I VEHIClES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
OPERATES WAVERUNNERS AT: ROCKAWAY GRILL
7 ROCKAWAY ST.
CLEARWATER, FL 33767
CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED AS RESPECTS THE OPERATIONS
OF THE NAMED INSURED ONLY.
CITY OF CLEARWATER
25 CAUSEWAY BLVD.
CLEARWATER, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ntE EXPIRATION
DATE THEREOF, ntE ISSUING INSURER WILL ENDEAVOR 10 MAIL ~ DAyS WRITTEN
NOTICE TO THE CERnFICA TE HOLDER NAMED TO ntE LEFT, BUT FAILURE TO 00 SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08)