CERTIFICATE OF LIABILITY INSURANCE (8)
A_CORP... CERTIFICATE OF LIABILITY INSURANCE OP 10 1~ CA TE (MMIDDIYYYY)
EAJ:1'H-l 07/06/06
PROtlUCIi:R THIS CERnFICATE IS ISSUED,AS A MAnER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON tHE CER.TIFICATE;
Real :Insurors, :Lnc. HOLDER. THIS CERnFICATE DOES NOT AMEND. ExTEND OR
5005 w. Laurel Street, ste 209 AI. TER THE COVERAGE AFFORDED BY THE POLICIES BEl.OW.
Tampa FL 33607-3836
Phone:813-28a-~000 Fax:913~2al-2422 INSURERS AFFOj:(OING COVERAGE NAte '#
INSURE;D .., ..../"..-.. ......,..
INSURCR A: Weste~ World Ins Co
-.....-, -
INSURCR 13: Surl;i.:ngton Ins Co
,.-.'- ..
Bait House LLC INSUR[R c:
POBOx 3025 ..-- '. n.,.. ....... ,,~-...
INSURER D:
Clearwacer Beach FL 33767-6025 ..."
INSURER E:
COVEFlAGE$
THE POLICn:!> OF INSURANCE L1STCD DCLOW HAVE BEEN ISSUED TO THE INSU~t::O NAMF.D AijOVE; I'OR THC POLICY PERIOD INDICATED. NOTWITHSTANOING
ANy REQUIREM[NT. TeRM OR CONDITION OF ANY CONT~ACi OR o'rHER DOCUMENT wmt RCSPCCT TO WHICH THIS CERT1F'ICATt:: MAY BE ISSUED OR
M/'.Y ~ER'I'AIN, THF. INSURANC[ Ar-FORDED 13Y THE POLICIES DE.SC~laED HEREIN IS SUaJECT TO ALL HIC TCR1.tS, i:XCLUSIONS AND CONDITIONS OF SUCH
POLICIES. ACOREOAtE LIMITS SHOWN MAY I-lAVE; BEEN R[DUCCD OY PAID CLAIMS.
I~~~~~~ .w PD~~1"'MIOOlvYl- 11tlT10t,r -----.-
TYP" Of' .NaURANCI; POLICY NUM[)IiR -cArlf fMMlOOIYYT LIMITS
Ix GENERAL LIA61LITY EACH OCCURRENCE $ 500000
- :~)t;h ~c~~~~~~ncal
A X COMM[RCIAL GCNeRAL L1AIlILITY NPP1055434 07/0~/O6 07/01/07 $ 50000
~ CL.AIM6 MAI)F. ~ OCCUR -.
- MCD exP (Anv one per>lon) $ 5000
PERSONAL&ADVINJURV ,~._500000
--- .--
~ENERALAGGRCGATC $ 500000
G~I'L AOOI'U'nE LlMli APPl.IF.S PI;R: PRODUCTS - COMPIOP AGO S 500000
"HO. n ..
X POLlCV .If'C'J' LOC
~TCMCIIILl;. LIAlIlLlfY COMBINED SINGLE LIMIT $
ANY AUTO lEa acclden!)
-
ALL OWN CD AUTOS OODIL Y INJURY
- $
SCHCDULCD AUTOS (Per personj
-
HIReD AUTOS [lOO Il Y INJURY
- (P'lr accident) $
NON-OWNF,O AUTOS
'-- -.
PROPERTY DAMAGC $
(Par a"r;jejanl)
GARACE LIAIIILITY AUTO ONLY - EA ACCIOENT :$
=j ANY AUTO OTHeR THAN EAIICC $
AUTO ONLY, AOO $
SXOESSIUMBRI'LLA LIABILITY E;ACJoI OCCURRENC[ S
=:J OCCUR D CLAIMS MAPF. ;
AG~F,GATE $
-
.- s
==i Dt:DUCTIF.iL~ $
FlETENTION $ S
WORKERS COIlllPeN:;'ATION AND ITb'~y~~~W6 I ICJ~lt
~IIIlPloyr;~S' L1A91L1TY E.L. EACH ACCIO!;NT $
ANY PROPRIETORIPARTNER/EXECUTIVE -
OFFICERIMEM13CR exCLUDED? to,L. DiSeASE - EA f.Mf'LOYE;E $
Jr~ea. deac.1M un<:W E.L. DISt:ASt: - POLICr LIMIT $
SPECIAL PROVISIONS billow
QTHliiR
B Liquor Liability 503g007456 07/01/06 07/0~/O7 Limit $500,000
ACTQreaate $500,000
DeSCRIPTION OF OPERATICNS I LOCATIONS I vSHIOLIOS/ eXCLUSIONS Aoom BY ENOO~SEMENT I SPIiCW. PROVISIONS
City of Clearwater is Additional I:nsurec:i, General Liability pOlicy.
Location; 46 Causeway rnvd, SHp J.56, Clearwater Beach Fl 33767.
11'727-462-6957
CCLEAR-
CANCEl.LATION
sHOUL.P ANY 01" THI; AeOVE O~SCRIBEO POLICIES BIl CANCDLLIlCl DllflORI THIi ilXPIAA TICN
OATI; TH~R~O~. THE ISSUING INSUltER WILL "NOHAVCR TC MAIL ~ DAVS WRITTEN
NCTICE TC THE CERTIFICATE HOLPIOl'l NAMep TO TOIl; l,EIIT, BUT P'AILUltl! '1'0 DO SO SHAll
IMPOSE NO OIlLIOATION OR L1Allll.l'l"Y 01' ANY KINO UPON THE INSURI!"-I'l'5 AGIINTS OR
REPRESENTATIVES.
AUTHORIZED REPReSENTATiVe
~~
~ /1(.
CERTIFICATE HOLDER
City of Clearwater
Risk Management Depc
Marine & Aviacicn Dept
25 Causeway
Clearwater FL 33767
Marcia M LQwis
ACORD 25 (2001108)
@ ACORD CORPORATION 1988
I rW1I1 rM . rl
llv?-lS2SLS(X\lj)
S.JO....lnSUI 1 ed(:J
99:9L (nHl)9002-90-lnr