CERTIFICATE OF LIABILITY INSURANCE (8)
A CDRDr.. CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYY)
07118/06
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
IMA of Kansas, Inc. (Wichita) ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
PO Box 2992 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Wichita, KS 67201
316267-9221 INSURERS AFFORDING COVERAGE
INSURED INSURER A: Markel Insurance Company
Clearwater Beach Seafood, Inc. INSURER B:
Po Box 99 INSURER C:
Indian Rocks Beach, FL 33785 INSURER 0:
I INSURER E:
Client#. 27616
CLEABEA
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR TYPE OF INSURANCE POLICY NUMBER Pg~.fEYf:.,';6gTWr p~~fJ f~JJo~~N LIMITS
TR
A GENERAL LIABILITY APP264916 07/20/06 07/20/07 EACH OCCURRENCE 51.000 000
-
X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone Pre) $100000
~ tJ CLAIMS MADE W OCCUR MED EXP (Anyone person) 5Excluded
~ PERSONAL & ADV INJURY 51 000 000
GENERAL AGGREGATE 52.000.000
I---
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COM~OPAGG 52 000.000
h POLlCV(l ~~~T n LOC
~TOMOBILE LIABILITY COMBINED SINGLE LIMIT $
ANY AUTO (Ea accidenl)
f--
I--- ALL OWNED AUTOS BODILY INJURY
$
SCHEDULED AUTOS (Per person)
-
'-- HIRED AUTOS BODILY INJURY
$
NON-OWNED AUTOS (Per accidenl)
'--
"'- PROPERTY DAMAGE 5
(Per accidenl)
~AGE LIABILITY AUTO ONLY- EA ACCIDENT 5
ANY AUTO OTHER THAN EA ACC 5
AUTO ONLY: AGG 5
EXCESS LIABILITY EACH OCCURRENCE 5
~'OCCUR 0 CLAIMS MADE AGGREGATE S
S
=1 DEDUCTIBLE S
RETENTION $ S
WORKERS COMPENSATION AND WC STATU- I IOJ~-
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT 5
E.L. DISEASE - EA EMPL OYEE 5
E.L. DISEASE . POLICY LIMIT $
A OTHER APP264916 07/20/06 07/20/07 $420,000 Bldg Limit
$210,000 Contents Limit
$1,000 deductible
DESCRIPTION OF OPERATIONSfLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
Certificate Holder is Additional Insured (Landlord) as respects the referenced location:
37 Causeway Blvd; Clearwater Beach, FL 33767
CERTIFICATE HOLDER I I ADDmONALINSURED'INSURERLETTER: CANCELLATION
SH OULD ANYOFTHE ABOVE 0 ESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater Marine DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TOMAIL3D--OAYSWRITTEN
Property NOTlCETOTHE CERTIFICATE HOLDER NAMED TOTHELEFT. BUTFAlLURE TODOSOSHALL
25 Causeway Blvd IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO UPON TH E INSURER,ITS AGENTS OR
Clearwater Beach, FL 33767 REPRESENT ATNES.
I A~~RE~RESENTATlVE
ACORD 25-S (7/97)1 of 2
#S306358/M306357
BJH
@ ACORD CORPORATION 1988
"-
IMPORTANT
If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement
on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).
If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may
require an endorsement. A statement on this certificate does not confer rights to the certificate
holder in lieu of such endorsement(s).
DISCLAIMER
The Certificate of Insurance on the reverse side of this form does not constitute a contract between
the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it
affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon.
ACORD2S-S(7/97)2 of 2 #S306358/M306357
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Processed by:
Flood Insurance Processing Center
~.o. Box 2057 Kalispell MT 59903-2057
POLICY #: 87027678772006
For payment status, call. (888) 245'7274
THE X
lIA.RTFORD
FLOOD POLICY DECLARATIONS New Policy
TYPE: GENERAL
POLICY PERIOD: 5/31/2006 to 5/31/2007
These Declarations are effective as of: 5/31/2006 at 12:01 AM
PRODUCER NAME & MAILING ADDRESS
1,11..1",1.,1.111"""11,,1.11.1..1.1,...1.11.1,,..1.1...111
INSURED NAME & ADDRESS
PRODUCER#: 02688-00000-000
lMA OF KANSAS INC
PO BOX 2992
WICHITA, KS 67201-2992
CRABBY BILL'S
PO BOX 99
INDIAN ROCKS BEACH, FL 33785-0099
POLICY INFORMATION
PREMIUM PAYOR: Insured
COMMUNITY NAME
CLEARWATER, CITY OF
COMMUNITY NUMBER
1250960102G
INSURED PROPERTY ADDRESS
37 CAUSEWAY BLVD
CLEARWATER BEACH, FL 33767-2003
POLICY TERM: One Year
BUILDING DESCRIPTION
Non-Residential
One Floor
No Basement
Coverage Limitations May Apply, Refer
to your Standard Flood Insurance
Policy for details.
CONTENTS LOCATION
N/A
PROGRAM
Regular
FLOOD ZONE
AE
CONSTRUCTION
Pre-Firm
Construction
COVERAGE & RATING INFORMATION
BUILDING
CONTENTS
PREMIUM PAID
Coverage: $242,000
Deductible: $5,000
coverage: N/A
Deductible: N/A
Rates: .830/ .710
Rates: N/A
Premium Subtotal:
Previous Premium Subtotal:
ICC Premium:
CRS Discount:
Expense Constant:
Federal Policy Fee:
Endorsement Amount:
Total Premium:
$1,661.00
$1,661. 00
$75.00
$260.00
$.00
$30.00
$.00
$1,506.00
FIRST MORTGAGEE
2ND MORTGAGEE
BLD
This Declarations Page, in conjuncion with the policy. constitutes your Flood Insurance Policy.
IN WITNESS WHEREOF. we ~haV~_~i=.thiS policy below and he);; ;.:/;~_ this Insurance Agreement.
(!i~---- /~l/U--~ PRODUCER COPY
Presi '- SecretaLY 6/12/2006
Hartford Fire Insurance Company 3X