CERTIFICATE OF LIABILITY INSURANCE (7)
DATE (MM/DD/VY'fY)
06/08/2007
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
ACORQM
CERTIFICATE OF LIABILITY INSURANCE
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.
I~~: ~~~~ TYPE OF INSURANCE POLICY NUMBER ~H~Y EFFECTIVE POLICY EXPIRATION LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
- DAMAGE T9_ RENTED
COMMERCIAL GENERAL LIABILITY $
I CLAIMS MADE D OCCUR MED EXP (Anyone person) $
A X PERSONAL & ADV INJURY $
~
GENERAL AGGREGATE $
I-
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
h .nPRO- nLOC
POLICY JECT --
AUTOMOBILE LIABILITY f<ll-r ~r-n p COMBINED SINGLE LIMIT
c-- -. Y I: (Ea accident) $
ANY AUTO
I--
ALL OWNED AUTOS "~; 1 q 200 I BODILY INJURY
c-- ...... . r:.. I (Per person) $
SCHEDULED AUTOS
i--
HIRED AUTOS OFFIC IAL RECORDS I BODILY INJURY
c-- ND (Per accident) $
NON-OWNED AUTOS LEGIS
- ATIVE SRVCS 0 rpT
l--- PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
~ ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
=:J OCCUR D CLAIMS MADE AGGREGATE $
$
~ DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION AND Z833519711 07/25/2007 07/25/2008 I T~g~n~I,':i." I 10J~-
EMPLOYERS' LIABILITY 100,000
A ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100,000
If yes, describe under
SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000
OTHER
~ESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
ertifcate Holder is Additional Insured for General Liability
'roperty coverage includes glass breakage with no deductible
PRODUCER (727)797-5193 FAX (727)797-8605
Alley, Rehbaum & Capes Assurance, Inc.
2433 Gulf to Bay Blvd.
P.O. Box 4620
Clearwater, FL 33758
INSURED Carpenter Enterpri ses Inc. and Simpl y Dara' s,
DBA: Marina Gifts
25 Causeway Blvd.
Clearwater Beach, FL 33767
COVERAGES
CE TIFICA TE HOLDER
Harbormaster
City of Clearwater
Attn: Catherine
25 Causeway Blvd.
Clearwater, FL 33767
ACORD 25 (2001108) FAX: 462-6957
INSURERS AFFORDING COVERAGE
INSURER A: Zeni th Insurance Company
INSURER B
INSURER C:
INSURER D:
INSURER E:
NAIC#
0041
CANCELLATIO
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL
~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
Si nature on file
@ACORD CORPORATION 1988