CERTIFICATE OF INSURANCE (06)
THIS CERTIFicATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLpER. THIS CERTIFICATE DOES NOT AMEND,
EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Bayly. Martin and Fay. Inc:.
4111 No Himes A~ Suft 205
T..... FMrfd. 31614
INSURED
COMPANIES AFFORDING COVERAGE
COMPANY A
LETTER
COMPANY B
LETTER
National Indemnity Company
L'xington Ins. Co.
COMPANY C
LETTER
Accelerated Coach Lines,Inc.
3350 Ulmerton Rd., East Suite 20
Clearwater, Fl. 33515
COMPANY D
LETTER
t .
E
THIS IS TO CE.RTIFY THAT POLICircS OF iNSURANCE L1';' [.c: BLLOW HAVE BEEN ISSUED TO THE lusura', ~.;\,'n:'D ABOVE FOil, HE POLICY PERIOD INDICA TED,
NOTWITHSTANDING ANY REOU!?F'i~'NT, ,U1M OR CO'",,: :'.,/, OF ANY CONTRACT OR OTHER fJOCUMLi;! '.'11TH RESPECT Tn WHICH THIS CERTIFICATE MAY
BE ISSUED OR MAY PERTAIN, T ,it, ;,,;,URMKE AFFO,;"" ,<. 'nE POLICIES DESCRIBED HEREH. 15 S'wo,.i:, ro ALL :i'iL i L1i:i,.;, b:CLU5iQr,S, AND CONDI.
TIONS OF SUCH POLICIES,
TYF'E OF INSURANCE
GENERAL LIABILITY
COMPREH'ENSIVE FORM
PREMISES/OPERATIONS
UNDERGROUND
EXPLOSION & COLLAPSE Hi,:",',
PRODUCTS/COMPLETED ope I'i,
CONTRACTUAL
INDEPENDENT CONTRACl CHo
BROAD FORM PROPERTY 0;:,'1',>1
PERSONAL INJURY
AUTOMOBILE LIABILITY
ANY ,AUTO
ALL OWNED AUTOS (PRI'l f',,-;::;
AlL OWNED AUTOS (OTfiE.G. n".,.'.,',)
PRIV PAc:,
HIRED AUTOS
NON.OWNED AUTOS
GARAGE LIABILITY
EXCESS LIABILITY
UMBRELLA FORM
OTHER THAN UMBRELLA FORM
WORKERS' COMPENSATION
AND
EMPLOYERS' LIABILITY
OTHER
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552-8001-0156
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DESCRIPTION OF OPERA TIONS/LOCA TIONS'VE HICLES/S;'EC, f iH:MS
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10-23-86 ~L....
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AM-St. Petersburg Motot Cl ub
1211 1st Ave. ,North
St. Petersburg, Fl. 33705
Attn: Al Thompkins
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX.
PIRATlON DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
MAIL. tn __DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, ~'l' FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR L1ABILlTY-
OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES
AUTHORIZED REI'RESENfATIVL
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RECEIVED
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APR 18 lS86
89 NATIONAl~NDEMNITY COMPANY
o NATIONAL FIRE & MARINE INSURANCE COMPANY
o COLUMBIA INSURANCE COMPANY
3024 Harney Street Omaha, Nebraska 68131-3580
CERTIFICATE OF INSURANCE
This certificate of insurance is NOT an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwith,
standing 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.
Date
4/14/86
NAME OF INSURED Accelerated Coach Lines. Inc.
P.O. ADDRESS 3350 Ulmerton Road, East Ste 20, Clearwater. FL 33515
POLICY NUMBER KIND OF INSURANCE LIMITS EFFECTIVE EXPIRES
GENERAL LIABILITY
0 Comprehensive Bodily Injury:
0 Premises-Operation Each Occurrence . . . . . . . .$
0 Explosion and Collapse Aggregate . . . . . . . . . . . .$
Hazard Property Damage
0 Underground Hazard Each Occurrence . . . . . . . .$
0 Products/Completed Aggregate . . . . . . . . . . . .$
Operations Hazard Bodily Injury and Property Damage
0 Contractual Insurance Combined Single Limit
0 Broad Form Property Each Occurrence . . . . . . . .$
Damage Aggregate . . . . . . . . . . . .$
0 Owners or Contractors
Protective
0 Personal Injury
Automobile Liability:
Bodily Injury . . . . . . . . Each Person . . . . . . . . . . . . .$
Each Occurrence . . . . . . . . . .$
Property Damage. . . . . .Each Occurrence . . . . . . . . . .$
7BP106496 Bodily Injury and Property Damage Combined Single Limit .$ 1.000.000 CSL 10/23/85 to 10/23
Excess Liability: o Automobile o General Liability
Name of Primary Insurer:
Primary Limits: $
Excess Limits: $
Workmen's Compensation $ Statutory Limits
Employer's Liability $
Other
/8
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES
1)
2)
3)
4)
1970 MCI -
1971 MCI
1970 MCI
1970 MCI
IIS8130
IIS8571
IIS8156
IIS8118
5)
6)
7)
8)
1982 Ford Eldorado - 1I1FDKE3067CHN29022
1983 Eldorado Falcon - 1I1FDKE30L9CHB52962
1970 GMC Bus 11.....5187
1970 GMC Bus - 11.....4905
In the event of any material change in or cancellation of said policies, the COMPANY intends to notify the party to whom this Certificate is addressed of such
change or cancellation, but undertakes no responsibility by reason of any failure to do so.
City of Clearwater
P.o. BOX 4748
Clearwater, FL 33518-4748
M.100g (2/82)
By
Title DANA ROEHRIG
NOTE TO AGENT - Mail Copy to Home Office Immediately.
This Certificate issued to: