EVIDENCE OF PROPERTY INSURANCE ACC>R"
EVIDENCE OF PROPERTY INSURANCE
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUI NG INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST.
813 639.3DO'D COMPANY
Commercial Limos (8131630-3000 Traveloi s 1 nsw ance Co-
Wells Fargo Insurance Sera ces USA, Inc.
2502 N,Rocky Point Drive,Suite 400,
Tampa,FL 33607
3J35 iB' -Y it clue -lisfaFgO -r-1
orlreqUeSt@,,Vi�7 _C0
'CODE- SUB CoDe
INSURED 01AN HUMMER Y NUMBER
171166
ln�. OBA 40398
Barefoot Beach House, EFFECTWE DATE
EXPIRAT*
0'ONTINUED UN fk
0906,12012 09,10&2013 TERM( A T E 0 1 C"F K E,,%
PO Box 3337
THIS REPLACES PRIOR LVIDLNCE DArCM
Clearwater Beach,Fl-33767 SID1#408231 91IT2012
PROPERTY INFORMATION
LOCATOWDESCRIPTION
Loc 1,Bldg 1:332 South Guff Blvd.,Loc L Bldg 2:332 South Gulf Blvd
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN h-'SUED TO THE It NAMED ABOVE FOR THE POLICY PERIOD INDICATr-'D.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR (-,ONDITI(.-)N OF ANY CONTRAcT OR OTHER nO(-,IJMFN'r WITH RFSP-FCT TO WHICH THIS
EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE[N IS
SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUC14 POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
COVERAGIF INFORMATION
C(WERAGE I PERILS t FORMS AMOUNTOFWSUR Cr DEDUCTIBLE rieriE a k J�ovvn--9 E�2 6di e ffeah,FL, Concessiion Stand.iGift.S�iop
� 7-q
66
ii
CANCELLATION IES 111� rr- �F�_ I-R 11 5XPI 11-11ON OAT F_ THEREOF NOTiClE 'Ofil
I L 11rF_1 F T
FiH 6 VLD ANY F HE AB AVE 0 CRI P 'L'-' AN
DI CC POLI
H
ELI ERE N A ORK)ANC VW I THE Y PR OV S ONS,
ADDITIONAL INTEREST
NAMr AND ADDRE$$ MOR"C FA YE E
88 PASEE
City of Cle"4rovater I
LOAN 0
A Munkipal CorporatJon
25 Causeway Blvd AUT40WZED RePRESEN VAT IVE
Cle,Afvv�-iler,FL,33767
ACORD 27(2009112) 1ho ACID name am,loges cat., fnafRs or ACORD 1953.2009 ACORN CORPORATION. All riglits rose rved.
408232 Tihis evidence replaces evidenceg 408 231 i,sued on 9;7/2012
" ;MD
" El 1KAM,,Ct_,
M Fits"iJ 08 J_21012
F THIS CERTIf li_,A TEIS ISSUED AS A MATTER OF INFORMATION ONLY AND"CONFERS MCI RIGHTS UPON THE C ER ILFICATE HOLDER.THIS
CERTflCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALT PR THE COVERAGE AFFORDED BY THE POLICIE-
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BET1,'2EEN THE ISSUING INSURER(S),AUTHORIZED
REP'PE�EPilTATIYE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: It the certificate holder Is an ADDITIONAL.IN'L1 RED,the po cy(ies)ri,Jst be endor3,�prf, If SUBROGATION IS WAIVED ,,;al;ject to
the lernns and co diflai,s of the {_rcJlac„ certain policies inay ;ecluk e,I ix e, do-isernewl, A staLemen1 cj„this certificate does not t,cwler rights tc th",
certificate holder in lieu of such ed-cfcm'ssnspnt(s1
AY SEX 111 w�J��aNCE. AGENCY INS , PH (PHONE- -,1- � � F �,I ���L a�� , � .,t C
21.0703 P= (8771287 -111312 _ 6 (888) 44,36112 �E U nc, - - -
P ° .�.
PO BOX 33015
EI T C,r IN,", Lr.,_t°i BAREFOOT -
r- C r rr Ipr_r°.
��-- T' T- ....q . 1 IFIER.L
., . ,,'IYE4 F
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THI.E" 1`' T o C.EIE FIE4" THAT THE PG€IClE°, OF INSURANCE l.,lS ED BrLOW HAVE BEEN c,,;,t.,i".D TO !HE r?d..t RED NAMED ABOVE FOR THE Pooh.,° PFM 'E;I:
INDICATED. ;.Ir,JTWI-I STANDING ANY CEQUI E9a9ktta"r' TER€u, OR t";4•)r,,U"HION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE ,"Ay` EE ISSUED O P.i EF .�Ih, THE IrEf1s�1#l,:Im r,I C. :T',E BY HE � I..Ec.IFT rzE> E+EF E HEREIN IS tJiJEt,T <rr AIL HE TERMS,
EX(FLUSIONS AND ONDIl iC.aN`.i. J1 T POUCIFS.LIMITS S I_.V^N t'a1t r ,EVE BEEN DEDUCED t PAID CLAIMS,
F _
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C'E!'T'FICAFE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCR12EE4 POLICIES BE CANCELLED �
BEFORE THE EXP11 ATIrON DA'r E THEREOF, NO i ICE'VJILL BE
j ,
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS,
,? { „" , _l r L t t j
Pry B t t 4'748,
L_9.a.AT'CEf�,L L jvf ,_.
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'I 98 201 ry ACORD ElfJN All .w11,t, rese :I `F.
A+ C€,If RD 5 i 1 L 10,0„ he, A C.SRi.i no . , n,i,-I. l fl_ r � .f [,CI ,.ff.... J9 saC0ViiD
'o019r
DATE lhl=Dff��
EVIDENCE OF PROPERTY INSURANCE &3 1,120 1,2'
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER -rHE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER�S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST.
AGENCY =&,,; 813.6393000 rCOMPANY
Commel'cial Lines-(813)639-3000 Citizens PrOIDEFly insurance Corp
Wells Farge,insurance Services USA Inc,
2502 N,Rocky loojr�t Drive,Suite 400
Tdmpd,FL 33607
gacoi
Y37 2
Clearv�,ater Boach',FL 33767 THIS RERA!ii; CD!
PROPERTY INFURMATIUN----
IHE POLICIES OF INSURANCE LISTED 8EL(Yh` HAVE BEEN ISSUED 'ro "rHE INSURED NAMED ABOVE FOR FHE POLICY PERIOD iNI)tGATED,
EVIDENCE OF PROPER"TY INSURANCE MAY BE ISSUED OR MAY PERTAIN,1-HE INSURANCL ArFORDED BY THE POLICIES DESCRIBED HEREIN IS
SUBJEC-r TO ALL THE TERMS,EXCL USIONS AND CONDIT 10 NIS OF SU CH POLI CfES, LIMITS SHOWN MAY HAkG BEEN REDUCED BY PAID CLAIMS.
COVERAGE INPORMATION
LOD 1,Bldg 2:Building 94000 3%,
CANCELLATION
�4N� TFI EXPIIIA7�1-,N�D:IVIE V
ADDITIONAL INTERE$T
L08s PAYE
A Municipal Corporation
25 Cai,.is�,way Blvd
-ite� FL.33767
|
!
'10 7
DAT'E IMMVD1Wy'1_yy)
EVIDENCE OF PROPERTY INSURANCE 8/16[2012
r
THIS EVIUENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW, THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW, THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST,
--------------- --------
AGENCY rp H0?q1__---------
LQAjQjj.Q_LY�0.' S1 639 D D 0 COMPANY
Commercial Lines-(813,)639-3000 Londri-jark American lng(.irance Company
Wells Fargo Inswance Services USA. Inc
2502 N,Rockv Point Drive,Suite 4100 1,00 Summer Sfl-H�et
TaTnpa,FL'13007
Ax E-MM[, clw. lls"ang
B(-.,stor,K,1A 02'1 10
B13.639_718t) i ,()�-_u r
... -------- -------------------------- ..........
aLTB CODE ___
33'l38
---- .......INSURED .---- -
L Wk N MW M 9 E R POUCY NUMBER
IN DSA I BA 1501090'0
B�teroot Bea I}House EFFECTIVF DATE I EXPIRATION DATE
O11 41 2012 31i'l->0" XA4 rINUM'NTH,
TfRt1flNATF(,1
rO box,33,17
THIuREP AGES eIP,°ORE-VtDE?qCE DATED;
Clearwal-r Beach,FL 33767
PROPERTY INFORMATION
LOCATIONID ESGRI
Lc c 1,Bldg 1.332 Gulf Blvd.,Lo-C. 1,BkJq,,2,332 South Guff Blvfj
FHE POLICIE'S (,'IF INSURANCE LISTED BELOW HPo%/E BEE`4 SSI;fED TO THE INSURED NAME D ABONr F(DR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREIVENT. I ERM OR CONDITIDIN OF ANY (--OklfRACI OR OTHER DOCUMENT Wil-H RE8PFCT TO WHICH THIS,
FDADENCE OF PROPERTY I,11JSURP&,ICE MAY BE ISSUED OR NIAY PERTAIN,THE INSiRANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS
SUBJECT TO ALL THE TERMS,EXCLUSIONS PAD CONDITIONS POLICIES. Limi-r• SHOWN MAY HAVE BEEN REDUCED BY PAID CLAiMS,
COVERAGE INFORMATION
GOVERAGF;PEMLS t FORMS AMOUNrOfflM§y,�, DEDUCTIBLE
------------...............
oc Bldg 1:Buildlrig-Replacement CA)st
1,o 1,Bldg 1-Busines-,Pei-,,o i ial Pr opei Ity-A(Audi Caal i V,agUe _000
Loc,1,Bldg 1-
1 90%Coinsurance,Special Forrn,-Exclud ing Thelft,Excluding 0/ind&!Aail
Loo 1,Bldg 1 Business income w,'Exlr�.,i Expense'-Special F,,orrn Ex.clLiding Thti l 1',5 1,","000
L oc,1, 3Idg'1 "1,u Monthly Lii-nitation
Loc 1,Bldg 2:Building-Replacement Cost 77,000 1 "Joull
Loc 1,Bldg 2:Businesi,Personal Property-Actua]Cash Value 10,00d
Loc 1,bidg 2-190%Comsurance,`special Forra-Excluding'Theft,E,"xcludihng ffind &H-ail
REM I<Elaclu
CANCELLATION
Tl`F _T
SH A T}EE L" C 11 _FL 1 1 5
U D ANY r
ELIVERE IN DA'�'CE� I� THE LIO1 VI�0 F
U-2
ADDITIONAL INTERE$T
NAME AND ADDRESS 1,i0RTGA1-;EE q�OtTKXIAL IN81.jl,�E'D
Nly ol Ge-
arvater LOAN 18
A Muniuipal Corporatkn
AUTHOMZED REPRESENTATNE
25 Canseway 31W
FL 33767
AGO RD 27(20091 2) The AU,0kD rwla Ivd kq'o arc u of N_Y�RD 1993-2009F FOR6 O`R
401024
VA f E IMMIDUe'YY YY,
7 Y"
CERTIFICATE OF LIABILITY INSURANCE E 2012
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTWICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSWNG INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate. holder is an ADDITIONAL INSURED, the pollcy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the terms and conditions of the poticy,certain policies may require an endorsen-ient. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsement(s)-
PRODUCER 1011AII
NAME Certificate Department
:
CornmeFdal Lines-(313i 639-3000 PHONE 8 13,63 9.3 0 0 0 FAX 813,639-7180
'',delis Fargo Insurance Servlceis USA,Inc F-MAIL
corn
Rocky Parit Drive,Suile 400 1INSUIRER,S)AFFORDING COVERLAGE NAiC,ti
fair I,r R 3",607 INSURER A, Lar JrI12Fk Acneri2n I risugance conlPany 313138
INSURED INSURER 6
F','ioid',s,,wic 1-DBA Bei-jd-i Hous(:i INSURER C'
P 1.) Box 31M7
AtSURER p:
NS.YRER E
Cleaivvate, Bdt FL 3376-7 INSURER F
COVERAGES CERTIFICATE NUMBER: 4718823 REVISION NUMBER: See below
THIS 6 10 CERI-IFY THAT TlFiE POLICIES OF INSURANCE LISI'ED EBEI_O'v%I HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR- -r,,HE POLICY PER17613
INDICATE I), REQ01RIE NEW, it_-Hro,.3 r 1(,,N .)I ANY U(JIN I KAU I C'IR U11--iLk, UOCUNIILN' WHI-A KESPLI_,I K) VVI-f[UH [Fili
C
CERI'll-1CAFE MAY BE ISSUED CR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS, SiJSJE,,F 10 ALL 'I H F, I ERM S,
EXCLUSIONS AND CONDITIONS OFSUCH POLK",IES.IAWFS SHOWN MAY--!AVE 61'EN BY PAID CLAIMS.
NSR pf)l!('Y FFF I C Y Fy'P i
LTR I Y f,k�0E I N SOR ANC E POLICY NUMBER LIMITS
GENEkA,LIABiLffY
A EA,'_H 0GI_',)Pi R[NCE �-S
LBA105010900 0 1 -14/2 0-12 01/14,120 13 i
X C0rM,11_'RC'IAL GFNE PAL ABILITY DANIAGE Do RENTELF
0.(Y 0
A I
MEI)i FXP(Any any 21,C,W
PERSONAL 8 ADv Rq UR" 1,01 0 01,01 0
.0
GFNERAI,PGGRFGA'FF
1 GEN'L A(-",GREGATE LIMP Al"PuEs•PER PR LID_iCT s-C 0M Rlii')1'°'+.,{, 'r ;. .L Car;_..
$
--qua ----------------- ......
AUTOMOBILE LiABILITY LiMi I
ANY AOTC, BO,,:-,iLY 9NJUitY(Per perror� $
ALL-Zo'Vi4FD
BCOILY WILIRY $
Y,)T D All 0,8�
AIRFD fCY; *)N-0'AY4EL) PROPERTY DAMAGE
(Pei acadent}
UMBRELLA LIAS
OCIA)IR, EAGI-iCICCiRRENCE $
EXCESS LIAB
$
DLL' i RETENTIQN S
l WORKER-SCOMPENSIATION 7-
AND EMPLOYERS'LIABILITY L'.1-1 OTH,Sh
YIN -------
...........
E Filuh AGC',9D-_N I'
QFFICER'MFrA&FR EXCL,t)DEE") N I A
(Mandaric',ry In NH)
EL.NISEASE-EA EMPLILIY L
11'�el_Aescribe ijrd(,i
'IiSEASE-P,.Liar LIFIff 5
DESrfRnPnONOPOPERATONS Lt-rCATIONS VEH CLES
Rentai of Beach Criciirs,61rn1:)re1las and Cabanas,
f-'Llearwater is addiflr_)nal ine;iired r�General LiabiUv,
CERTIFICATE HOLDER CANCELLATION
City cle'.:Arvvelltl 3HOULD ANY OF THE ABOVE DFSCRIBED POLICIES BE CANCELLED BEFOPE
A Municioal I-_',rIpor,3!Jc)n THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POO
LY PROVISIONS,
25 CaUsewav Blvd.
Clsar,v,allcr,FL 33767 AUTHORIZED REPRESEKTATrVE
AIR
fEl e A C',OR C id K,w. 3.Ck t c, i i a c'A C(-'I EI 1988-2010 ACORD CORPORATION, All rk 'Served,
rL
1%C 0 PS) .25 2 010 0 5)
Fidelity NatIonal Indemnity insurance Company
P.O.6tox 33003 FFL 99.001 0212
St Petersburg, FL 33733-8003 0084316
1-800-820-3242 1/10/12
FIDELITY 2000 11523 FLD R.0-LR
>1 AL DE 7A,r j ffy N Su
F1,00D DECLARATIONS PACE Policy Type
L�n p "C
8
C1 115 0"2"2 5
0 1156t 885 02 9P
d� ,
To
P '6 'P
�
2�/2 1 "/23„f;
2 3 1�131'2
Agent (8 5i 639-30,00
WELLS FARGO INSURANCE SERVICES FIELDS INC DBA
USA INC PO BOX 3337
PO BOX 30001 CLEALRWATER BEACH FL 33767-8337
TAMPA FT, 33630-3001
in wred[,c dfi on tit othor than ab ow�� Addre&�may ha� lo n&,2 n god 3n accorda n ce Mth US PS sta n dard�.
332 S GULF BLVD, GENERAL DELIVERY, CLEARWATER BEACH FL 33767
Community Name: CLEARWATER, CITY OF
Grandfathered: No Community #: 125096
Building Description: Non-Residential Map Panel/Suffix: 0102 G Condo Type: N/A
# of Floors: One Floor Community Rating: 07 / 15%
9 a S e Ine n t/En C 10aUrew None Pyogram Status. Pe ulcer AdJacent Grade, 0.
Rating plead Zone; kE Elevation Diff: N/A
Location Descripti=2 CONCESSION STANID/GIFT SK()P
77- 77
BUILDING $165,000 $2,000 $1,815.00
CONTP,NTS �52,500 $2,000 $11 ,124 .00
PROBATION SURCHARGE: $.00
AIMUAL SUtTOTALt $2, 939.00
I-E
--7 P,DEDUCTIBL CRRI)I T i $.00
ICC PRRMIUMi $70.00
DEAR MORTG AGEE COMMUNITY DISCOLTNT� $452.00
The Reform Act of 1994 requves you to notify I
the WYO company for this policy within SO days I
of any diariges In the semc&j oil ffirs judri- TOTAL WRITTEN PREMILTM; $2,557,00
The above message applies only vale,;ffiaFe is FEDERAL POLICY SERVICE FEE $40,0t
a rnr rtUaUec,on tho inr�ffad location,
TOTAL PREMIMIS: $2,597, 00
Premium Paid by: Insured
____.........
This policy coveys oniy one building, If YOU have more than orQ building on your propeny, please make sure,they are all covered. See Ill. Propeily
Covemd within your Flood policy for the ARP definifion M"buM ing"nr nx-int8nt ynid agAnt,hrnkp.r, or inFzuranr>4 nnrnpany, t:ovporag,.�R I-irnitafinnp,
may apply, Please refer to your Flood Insurance Policy for details,
FFLC99.100 0503 0503 FFL 99,310 0709 0707 FPL 99.116 1005 1005
this poficy is issued by
Fido,lity National lnde�anity Tr-surance Co
Copy Sent To: As indicated cun. back or anditional pages, if any,
008433,609115022888512010 ON1,1100S