INSURANCE CERTIFICATE (8)
l~-=-______________________________ _____
It CORD..
Alley Rehbaum &
P.O. Box 4620
Clearwater, FL
CERTIFICA1=OF LIABILltvJNSURAft,CE,. ~tfg'~r)
:.- ,..'- .<-: -".''''''''/' '.:....,'.. -"_. ._.....-:-:'.......'~..~,...,u...'.':..,.......:;'.::.-:........~.-".-... _ _ '. ".,.,.-,:_~_>., _.._...,.,-.
.....,...du,i!M,,'-' ,...... ^.. .............-..,..- THIS CERTIFICATE I~SSUED 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
Capes
. PRODUCER
,
i
I
. INSURED
!
34618
COMPANY
A
TIG Insurance Company
North Beach Rentals, Inc.
d/b/a Makin Waves
470 No. Gulfview Blvd.
Clearwater, FL 34630
COMPANY
B
COMPANY
C
COMPANY
D
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
i INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
I CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
I ~CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I co ; TYPE Of INSURANCE POUCY NUMBER POlICY EffECTIVE. POUCY EXPIRATION I
! L TR ! I DATE (MWDDIYV) ! DATE (MMlDDIYY) i
I : GENERAL UABIUTY Ii: GENERAL AGGREGATE 1$1,000,000
Inn I I I I
A !.COMMERCIALGENE~~IUTY i 608/95-080 8/16/96 '.'8/16/97 ' PRODUCTS-COMPIOPAGG. $ None
I riL'<:; ow~~~:S~:~~:R'::~: I !: :::=U&R:~~~~URY :: 1 ~~~; 000
!, ; I : fiRE DAMAGE (Anyone fire) ; $ None
, MED EXP ( one person) ! $ None
, AUTOMOBILE UABIUTY I
n . COMBINED SINGLE LIMIT
I ANY AUTO
i---j
: : ALL OWNED AUTOS
q SCHEDULED AUTOS
L-....i HIRED AUTOS
: i NON-owNED AUTOS
:-i
LIMITS
s
BODILY INJURY
(Per person)
,s
BODILY INJURY
: (Per accident)
i$
~
: PROPERTY DAMAGE
i
's
GARAGE UABIUTY
. AUTO ONLY - EA ACCIDENT '$
: OTHER THAN AUTO ONLY: I:::: ...... ..
EACH ACCIDENT ; S
AGGREGATE $
I EACH OCCURRENCE i s
i AGGREGATE
· ANY AUTO
:---;
; I
-----'
i !
, EXCESS UABIUTY
;----,
~ UMBRELUI fORM
. OTHER THAN UMBRELUI fORM
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
I
I
-'INCL i
, WC STATU-
. TQRY LIMIT
EL EACH ACCIDENT
THE PROPRIETOR!
PARTNERSlEXECUTIVE
OffICERS ARE:
OTHER
EXCL
.s
$
EL DISEASE. EA EMPLOYEE S
EL DISEASE. POLICY LIMIT
i
I
DESCRIPTION OF OPERA TIONsiLOCA TIONSlVEHICLESlSPEClAL ITEMS
RE: Aqua Rental
Clearwater Beach Hotel
470 No. Gulfview Blvd.
CERTIFICATE HOLDER
. . .' -.................
'. .. .........
.. ". .......-..
....:,.-.......
..
:.;::: ..::": -'. -.:}:::::.;:::::::}:::~::::;-:~:;:::;::::~::::::~~ :~::::::::.:::-: ::; '. ::- :.... '.
.......... .. ,-"........
.. ........-.-.......
......'............
.. --........ .......
. ._,,- - .......
.. ".. ... ...., -..,
.............. ......
.. --.............
,... . --......
CANCELLATlON
'.' '.~'. .'..-'.. .'.-.. .-.'... . . - ".
.:1
City of Clearwater
Harbor Master
25 Causeway Blvd.
Clearwater, FL 34630
SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEfORE THE
ey'tfATION DATE THEREOf, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
DAYS WRmEN NOTICE TO THE CERTifiCATE HOLDER NAMED TO THE LEfT,
BUT fAil RE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION DR LIABILITY
OR REPRESENTATIVES. I
I
I
I
t9ACORD CORPORATION 1988
'.j
ACORD 25-S (1/95)
_.. ...-0_- __.~_________ ___.____ .__. __ _____., _. .____________~.