EVIDENCE OF PROPERTY INSURANCE (4) 61689
DATE(M MNVD DID" )
A ei;;L6
EVIDENCE OF PROPERTY INSURANCE 9/9,201 3
THIS EVIDENCE OF PRO ERTY INSURANCE IS 1,,SSUED 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 13Y THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURE R(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST,
AGEWY PHONE
813639.30DO COMPANY
jalLincs (813)639--3000 Phoenix Insurance Company
VVO]s Fargo Insurance Ser-vices USA, Inc,
2502 N.Rocky Point Drive,SUile 400
Tampa,FL 33607
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FA i-ADDRES&X g o,cc'm
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sua CODE;
-AG—ENcy—,
INSUNED LOAN NU MSE R POLICY MUMMER
Alexandra W Clearm.-3 Ier Bpach,Inc.dba 60 CGrC1,S1 I-,)j"S BM 2 13C I IR69A
P-0- Box 3337 ErPECTNVE DATE EXPIRATION DATE CO I N UED LIN I L
091'06d'2013 09/0612014 TERMINATED IF CHFCKED
Clearv,,Mer,Fl-337(-,7 -------
THIS RE FLADES P WO R CVWENC E DATED:
PROPERTY INFORMATION
LOCATIONIDE&GR[PTION
1()Pier 60 Drive
Clearwater Beacl',i FIL-33767
THE POLICIES OF INSURANCE LISTED BELOW HAVE' BEEN €SSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDHION OF ANY CONTRACT OR OTHER DOCUMENT W11H RESPECT TO WHICH THIS
EVIDENCE OF PROPEKI-Y INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DES(-,R RE1FJ HEREIN is
SUBJECT TL)ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUC'H POUCtES, LIM118 SHOWN M&Y HAVE BEEN REDUCED BY PAID CLAIMS,
COVERAGE INFORMATION
ANIOUNT OF WoURANSF DEDUCMLE
�Equiprnent Breakdown-10 Pier 60 Dri,,,e,CleamatorBea0h,FL 300,0001 1,000
REMARKLS IncludlnA -ion
Ceftiticate holder is additiona[insg,ged with regards lo equipn'ient breakdown,
CANCELLATION
11 r7P711� IN DA�IE -1I11-I1F17-FN11Tf1-_W1I Cd L r FF11 E THE RA
OUL AN 0 E ABOVE E I,FLD
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DELIVERED C
E, IN ACC� ORDA W r TIE p ICY PROVISIONS.
ADDITIONAL INTEREST
r AND ADDRCSS
AD i1D
DITIOHA1 WS,
LOSS PAYEE
City of Clearwater
Lo"
A Municipal Corporation
AWHOMZED REPRESENTATIVE
25 Causeway Blvd
CleArwaller,PL 33767
ACORD 27(2009(12) 1 he AGC*-,fD nCrQ and logo are registered marf-,�;of AC13kc) 10D 1993-2009 ACORD CORPORATION, All rights reserved,
502250 !'hi, s ,
, ,e vidn-rice evader,&M' 5u1 r 63 issued 9:6!2013
EVIDENCE OF PROPERTY INSURANCE
916/2013
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION OMLY 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 IINSURANCE DOES NOT CONSTITUTE A.CONTRACT BETWEEN THE
ISSUING INSURER.IS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST.
----------
AGrNCY 8136393000 C;QMPANY
(813)639-3000 Phoenix Insurance Company
W Ils Fargo -Services USA, 1,nc
2502 N.Rocky Point Drive,Suite 400
Tampa,FL 33607
FAX A3-
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INSURED Lt)A N N Ij Wl,S ER POIACY Il4dM BER
A I ex a i-A r,-,i of C lea",va 1,e 6a I n c,d b a P; 60 C'oi
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R 0. Box 333� �-,XPIRATIION DATP
09;06)2013 1 09!06/2014 �ERMA IED HFUXH
CHIC !
aieq, F� 33761,"
THtSREPLACES PRIOR EADENCE DATED:
61DP`58ll7l,5A 916/2013
PROPERTY INFORMATION
LZCATlON(DE3CRIPTl0N
10 Prer 60 Dhve
Cleanivater Beach FL',V,3767
THE POLI(',JES, OF INSUR,kNCE LISTED BELOW HAVE BEEN ISSUED KJ THE INSURED NAMED ABOVE €ti R TI-fF POLICY PERIOD INDiCANED
N0,rvvlTHS_TANF)ING ANY FI-`(),IlIRrxIrN"-, TP;RM C)R CONFHTkON CU7 ANY CC�NTTTACT OR 7FHFR 17)OCUMEN'T WITH RP- PEC'T To WHICH THISQ
EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIPSED HEPE N IS
SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UINA ITS SHOWN NI AY HAVE BEEN REDUCED BY PAiD CLAIMS.
COVERAGE INFORMATION
GGIVERAGe�PEFdLS FORMS AMOUNT OFINSURANCP DEDUCtIBLF,
�.fll,.,rnent Broakdown-10 Fier 60 1:)6ve,C Iearwatef Beach,FIL — -----TO FRF T�0,00
IR E
ARIF�lndqdlrl
CANCELLATION
E T11
NCELLED FO 111E -1
Y�,F A
H I , -"L " '
E I""E D R D EW I }DE 0 Y P OV 0
..........................
ADDITIONAL INTEREST
NAMIE ANU AU4.IKt6ti
ADEITiONAL,,NSURED
LOSS PAYE��
CIty of Cleanvater LOAN#
A KAlunjupad Corpora",icin
A',JTH(_)ROEb,PrP,.,lEsEa'fxnVE
25 Causeway P3!vj
C learnt valter,FL 33767
ACCORD 2712009112 1 he ACCIRL�l name and wo of ACORD, 1993-2009 ACORD CORPORATION, All rlg�its resgarvecl,
58y 77,53 TIis c-j,,1jr,4on,-,-,t?,;-eplacxas Pv!(,knctvI 5817541 _,sued orl 9!6/2()d3'