CERTIFICATE OF LIABILITY INSURANCE (11)
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ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYYY)
TM. 01/13/2006
PRODUCER Phone: 941-722-3238 Fax: 941-723-1785 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
MOORE & MOORE INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
601 8TH AVE. WEST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PALMETTO FL 34221-5115 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
INSURERS AFFORDING COVERAGE NAIC#
Agency LiC#: A183018
INSURED INSURER A: Auto Owners Insurance Company
SILVER DOLLAR TRAP CLUB, INC. INSURER B:
12601 SILVER DOLLAR DRIVE INSURER c:
ODESSA FL 34556
INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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 CLAIMS.
INSR I~~~~ TYPE OF INSURANCE POLICY NUMBER Pgi~~~~~~~IE POLICY EXPIRATION LIMITS
LTR DATE IMMfDDNYI
GENERAL LIABILITY 904612-20409507 -06 01/29/06 01/29/07 EACH OCCURRENCE $ 1,000,000
-
.'. . . X COMMERCIAL GENERAL L1ABILlTY- DAMAGE TO RENTED $ 50,000
PREMISES (Ea occurence)
1 CLAIMS MADE 0 OCCUR MED. EXP (Anyone person) $ 5,000
A rrES PERSONAL & ADV INJURY $ 1,000,000
-
GENERAL AGGREGATE $ 1,000,000
-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG. $ 1,000,000
-I n PRO- nLOC
POLICY JECT
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
---'--
ANY AUTO (Ea accident) $
-
ALL OWNED AUTOS BODILY INJURY
- (Per person) $
SCHEDULED AUTOS
-
HIRED AUTOS BODILY INJURY
- $
NON-OWNED AUTOS (Per accident)
-
- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS I UMBRELLA LIABILITY i EACH OCCURRENCE $
~ OCCUR D CLAIMS MADE AGGREGATE $
$
==j. DEDUCTIBLE $
- -T- - RETENIIOti $ ",.' ~ - . .' -- --.-- -"-- $
WORKERS COMPENSATION AND I '!'IC STATU. I I OTHER
TORY LIMITS
EMPLOYERS' LIABILITY
ANY PROPRIETORlPARTNERlEXECUTIVE E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? ! E.L DISEASE-EA EMPLOYEE $
If yes, describe under ,
SPECIAL PROVISIONS below I E.L. DISEASE.POLlCY LIMIT $
OTHER: I
!
DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS
CERTIFICATE HOLDER IS ALSO ADDITIONAL INSURED AS IT PERTAINS TO: PART OF THE SOUTHEAST 1/4 OF SECTION 19, TOWNSHIP 27
SOUTH, RANGE 17 EAST, HILLSBOROUGH COUNTY, FLORIDA
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS
CITY OF CLEARWATER WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE
TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,
ATTN MR. EARL BARRETT REAL ESTATE SERVICES MA IT'S AGENTS OR REPRESENTATIVES.
NAGER AUTHORIZED REPRESENTATIVE
POBOX 4748 ~S::~
CLEARWATER FL 337584748
Attention:
~CORD 25 (2.llll1.l!lal____
___C_~rtificate # 10340
~~--------._-- ---~-----.
@ ACORD CORPORATION 1988