CERTIFICATE OF INSURANCE (14)
AIRPORT LIABILITY
ADDITIONAL INSURED
CERTIFICATE OF INSURANCE
Policy Number UA00153043-00
issued by U.S. Specialty Insurance Company of Houston Texas was issued to:
Named
Insured
And
Address
CLEARWATER AIRPARK, INC.
1000 N. HERCULES AVENUE
CLEARWATER, FL 33765
This certificate of insurance neither
affirmatively or negatively amends,
extends or alters the coverage afforded
by the Policy described herein
And is in force from 04/25/2006 to 04/25/2007 . The insurance afforded by the policy is only with respect to
the Coverages for which a limit is shown under the Limits of Liability column.
Airport: CLEARWATER AIR PARK
LIMITS OF LIABILITY COVERAGES
$ 1,000,000 Each Occurrence A AIRPORT
$ 2,000,000 Aggregate BODILY INJURY AND PROPERTY DAMAGE LIABILITY
$ 100,000 Each Person B PRODUCTS COMPLETED OPERATIONS HAZARD
$ 1,000,000 Each Occurrence BODILY INJURY AND PROPERTY DAMAGE LIABILITY
$ 1,000,000 Aggregate
$ 250,000 Any One Aircraft
$ 1,000,000 Each Occurrence C HANGARKEEPERS LIABILITY
$ 5,000 Deductible
$ 3,000 Each Person 0 MEDICAL PAYMENTS
$ 3,000 Each Occurrence
In the event of cancellation of the above described Policy, the company, if possible, will notify the Certificate Holder, shown
below, 10 days prior to such cancellation.
CERTIFICATE ISSUED TO:
CITY OF CLEARWATER
25 CAUSEWAY BOULEVARD
CLEARWATER, FL 33767
U.S. SPECIAL TV INSURANCE COMPANY
P.O. Box 797408, Dallas, TX 75379-7408
EXECUTED THIS 25th DAY OF May
By
2006
d~_~ 6-.
Authorized Representative
The Certificate holder is included as an additional insured but only with respect to liability arising out of the Named
Insured's maintenance or use of the airport.
This is a Memorandum of Insurance and not a Policy of Insurance and no action may be brought hereunder. It is furnished
only as evidence that the Insurance Policy described herein has been issued by this company.
USS 20012 AL(01/99)