CERTIFICATE OF INSURANCE (4)
NOV U-t ~UU~ 1-: 1-7PM
Allied Specialt~ Insuranc 727-367-1407
p.2
lCORD. CE
MJCEIt e Spec al ty
10451 Gulf Blvd.
P.O. Box 67008
Treasure Island, FL 33736-7008
800/237-3355
ED National Watersports, Ine.
7 Cristie Lane
Lake George NY 12845
IFICAT OF LIA
Insurance, Inc
INSURERS AFFORDING COVERAGE
I URERA: T. H . B . Insurance
IN8URER B:
INlURERC:
INSURER D:
IERAGES
IE POUClES OF INSURANCE U8TED BeLOW HAVE BEEN ISSUED TO lHE INSURED NAMED ~ FOR ll-IE POliCY PERIOD INDlCI\lED. NOTW1HSTANDING
IYREaUIREMENT, TERM ORCONDlTICII OF ANY CONTRACTOR OTHER DOCUMENTWI'TIf RESPECT TO WHICH lHlSCERTlRCATE MAY BE ISSUB) OR
'Y PERTAIN, lHE INSUAANCEAFFamED BY lliE POlICIES DESCRIBED HeREIN IS SUBJECT TO ALl lHE TERMS, EXCLUSIONS AND CONDITlONS OF SUCH
)UCIEa AGGREGATE UMITS SHOW\/ MAY HAVE BEEN REDUCED BY PAID CLAIMS.
ADD'L POlJGY IiFFECIM! DPRA1IQII
JJAIIIUTY
COMMERCIAL GENERAL LIAIILITY
ct.AIMS WDE [!] 'OCCUR
M.2LF32 0 5
EACH OCCURRENCE
06/25/02 06/25/03 IWW2TORENTED
1,000,000
, 50,000
MEa EXP
1,000,000
1,000,000
AUTOIIOBILE UABrLITY
/W'( AUTO
ALL OVloWED AUTQS
SCHEDtJL.ED.wros
HIRED AlJT08
NON-OWNEDAUT08
OOM8/NEDSINOLE U,.,- .
"E\V l'-8IlllIdtIftl)
RE BODILY INJURY .
(Pw..-nl
M '4082012 BODL Y INJURY .
(Iller -*'entl
C ERK IEPART ENl PRCA5R1Y DAMAGI! .
(Per lCaldentl
NJTO ONLY - EAACCICENT
OTHER THAN
AUTO ONLY:
EACH OCCURRENCE
EOATE
GARAGE UAItIU1Y
/W'( AlJTO
EXCE88IU1IBRELIA UAIIIU1Y
CCCUR 0 CLAIMS IoWJE
DeDUCTIBLe
ENTION .
WORKERS COMPENIAlIOII AND
EIIPl..OYER&' UAIIILI1T
ANY PROI'RIETO_AR1loIEIUEJlECUTIYE
OFACERlMEMBER EXCLUDED?
" deecrlbe under
OTHER
IUPTlON OF OPERA TION8I LOCA'IIONIII VEIlICI.ES, UCll.ll8lClN8 ADDED BYINDORIIillIENT I SPIIaAL PI1OlIla:IIIl8
PERATES WAVERUNNERS AT: ROCKAWAY GRILL
7 ROCKAWAY ST.
CLEARWATER, FL 33767
)DITIONAL INSURED: CITY OF CLEARWATER
25 CAUSEWAY BLVD. CLEARWATER, FL 33767
c [TY OF CLEARWATER
~S CAUSEWAY BLVD.
~EARWATER, FL 33767
8I\0lILD Mr 0fl1lE A8DVIi IBCRlIED POLICllES BE CANCaLm IIEFGIE THE EllPIRATION
DAnllII..... tHE __ DEURER WILL ENDEAVOIt 'lO 11M. 1. 5 DAVI..".
II01lCI! 'RJ TNI CI!RTlFICA1& HOUIIiR NAIlED TO 111& LIFT, BUTFAlLURIl TO DO 50 SHM.L
.I'OII! NO OIIUGATION OR LIIIIILm' OF ANY KIID UPON 1IIE INSURER, ITI AGEN.... OR
IRD 21 (2101108)