CERTIFICATE OF LIABILITY INSURANCE (6)
ACORDTlI CERTIFICATE OF LIABILITY INSURANCE I DATE /MM/DDNYYY)
6/2l/06
PRODUCER Allied Specialty Insurance, Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
10451 Gulf Blvd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Treasure Island, FL 33706 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
AI ' Dn'-.I'II=C::: RI=I nw
800/237-3355
INSURERS AFFORDING COVERAGE NAIC#
INSURED National Watersports, Inc. INSURER A: T.H.E. Insurance Company
7 Cristie Lane e-lli-S\JRER B:
Lake George NY 12845 INSURER C:
INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVVITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT \/IJITH 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 Sl,ICH
POLICIES. AGGREGATE LIMITS SHOV\iN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I~~ ~~~~ POLICY NUMBER P~.~Y EFFECTIVE POLICY EXPIRA TION LIMITS
~NERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A X COMMERCIAL GENERAL LIABILITY M6LF1406 06/25/06 06/25/07 ~~~~~~JO RENTED $ 50,000
I CLAIMS MADE []] OCCUR MED EXP (Anyone person) $
PERSONAL & ADV INJURY $ l{OOO,OOO
~~ERALAGGREGATE $ 1,000,000
~'LAGGREn LIMIT APPnER: PRODUCTS - COMP/oP AGG $
POLICY ~~,9;: LOC
I ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accident)
-
ALL OWNED AUTOS BODILY INJURY
- $
SCHEDULED AUTOS (Per person)
-
- HIRED AUTOS BODILY INJURY
(Per accident) $
- NON-OWNED AUTOS
- PROPERTY DAMAGE $
(Per accident)
~GE LIABILITY AUTO ONLY - EAACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
~ESSIUMBRELLA LIABILITY ~_H OCCURRENCE $
OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND 'I T~~Tf:"!,~;, I IOJ~-
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNERIEXECUTIVE EL EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
I ~~~~,~~scribe under 'h.'nw E.L. DISEASE - POLICY LIMIT $
OTHER
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
OPERATES WAVE RUNNERS AT: ROCKAWAY GRILL
7 ROCKAWAY ST.
CLEARWATER, FL 33767
CERTIFICATE HOLDER IS NAMED ADDITIONAL INSURED AS RESPECTS THE OPERATIONS
OF THE NAMED INSURED ONLY.
CITY OF CLEARWATER
25 CAUSEWAY BLVD.
CLEARWATER, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
NOTICE TO THE CERTIFICA TE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08)
AU