CERTIFICATE OF INSURANCE (15)
CERTIFICATE OF INSURANCE
CERTIFICATE DATE: 08/08/2006 CERTIFICATE NUMBER: 06-05(Prop)
CERTIFICATE HOLDER: POLICYHOLDER:
City of Clearwater Clearwater Airpark, Inc.
25 Causeway Boulevard 1000 N, Hercules A venue
Clearwater, FL 33767 Clearwater, FL 33765
This is to certify that the following policy(s), subject to the terms, conditions, limitations and endorsements contained therein, and during their effective period, have been
issued by the company(s) indicated below. In the event of materia I change or cancellation of said policy(s), the company will endeavor to notify the certificate holder, but
failure to do so shall impose no liability or obligation of any kind upon the undersigned or the company(s) involved.
Policy Type:
Insurance Company:
Policy Number:
Policy Period:
PROPERTY
The Employer's Fire Insurance Company
Binder
August 3, 2006 to August 3, 2007
RECEIVED
'\ .'3 14 2006
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Clearwater Airpark, Clearwater, FL
Terminal Building Insured Value $250,000
Corporate Hangar Insured Value $300,000
Maintenance Hangar Insured Value $265,000
T -Hangars:
A
B
C
H
I
Shade Hangars:
D
~,.. : E
'.F
G
OFFICIAL RECORDS AND
LEGISlATIVE SRVCS OEPT
Location Covered'
Insured Value $195,000
Insured Value $215,000
Insured Value $235,000
Insured Value $235,000
Insured Value $235,000
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;.'-.'-
Insured Value $185,000
:Insured Value,$185,000
. Insured Value $185,000
Insured Value $185,000
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Causes of Loss:
Special Form Excluding Wind and Hailstorm
80% Coinsurance Clause
\
I
\
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Deductibles:
$1,000 Each and Every Loss
THE FOREGOING EVIDENCE OF COVERAGE IS NOT VERBATIM OF POLICY CONDITIONS, LIMITATIONS OR LANGUAGE; THE POLICY(S) REPRESENTED
BY THIS CERTIFICATEARE NOT AMENDED IN ANY WAY UNLESS SO STATED ON THIS CERTIFICATE.
ADDITIONAL AGREEMENTS:
Loss Payable
Payments for loss covered under the Aircraft Physical Damage coverage will be made payable to
Clearwater Airpark, Inc. and City of Clearwater in an amount not to exceed the Insured Value.
NOTICE Of CANCELLATION: IN THE EVENT OF MATERIAL CHANGE OR CANCELLATION OF SAID POLlCY(S). THE COMPANY(S) SHALL ENDEAVOR
TO GIVE 30 DAYS WRITTEN NOTICE TO THE CERTIFlCA TE HOLDER WlTHTHE EXCEPTION OFA 10 DAY NOTICE FOR NON-PAYMENT OF PREMIUM.
Aviation Insurance Agency, Inc. rJ
. 900 S. Federal Highway, Suite 309 ~~. '1.'.. '. ^ - -
Stuart, FL 34994 ~.' t-J ~
www.avnins.com
Telephone (772) 286-0626 - Facsimile (772) 286-1108
Authorized Signature