EVIDENCE OF PROPERTY INSURANCE (6) ALEXANDR4
DATE(MM/DD/YYYY)
ACORDTM EVIDENCE OF PROPERTY INSURANCE 1 03/29/2016
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE
ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST.
AGENCY PHONE 727 447-6481 COMPANY
A/C No Ext
Bouchard Insurance(CLW) Weston Insurance Company
101 N Starcrest Dr. P O Box 971122
Clearwater, FL 33765 Coconut Creek, FL 33073
FAX A/C No):727 449-1267 ADDRESS:cicertsftmyers @bouchardinsurance.com
CODE: SUB CODE:
AGENCY 26284
CUSTOMER ID#:
INSURED Alexandra of Clearwater Beach LOAN NUMBER POLICY NUMBER
dba Pier 60 Concessions CFA14001047
PO Box 3337 EFFECTIVE DATE EXPIRATION DATE UNTIL
Clearwater, FL 33767
03/20/16 03/20/17 TERM INATED IF CHECKED
THIS REPLACES PRIOR EVIDENCE DATED:
PROPERTY INFORMATION
LOCATION/DESCRIPTION
10 Pier 60 Dr
Clearwater, FL 33767
concessions
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
EVIDENCE OF PROPERTY INSURANCE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
COVERAGE INFORMATION
COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE
Commercial Property Location Specific Coverages
Location#: 1 10 Pier 60 Dr Clearwater, FL 33767
Building#: 1 concessions
Coverage: Building 337,653 3%
Cause:Wind
(See Attached Coverage Info.)
REMARKS(Including Special Conditions)
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE
DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.
ADDITIONAL INTEREST
NAME AND ADDRESS MORTGAGEE ADDITIONAL INSURED
City of Clearwater,A Municipal
LOSS PAYEE X Additional Interest
Corporation LOAN#
25 Causeway Blvd
Clearwater, FL 33767 AUTHORIZED REPRESENTATIVE
ACORD 27(2009/12) 1 of 2 S9209 @ 1993-2009 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD VICDE
COVERAGE INFORMATION (Continued from page 1.)
COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE
Coverage: Business Personal Property 52,000 3%
Cause:Wind
SAGITTA 27.3(12/09)2 of 2 S9209 VICDE