CERTIFICATE OF INSURANCE
-
. UFE&CASUALTY
This MEIVI)RANDUM, common
policy corllitions, schedules,
coverage forms, coverage form
conditions and endorsements
complete the POLICY.
FARMING-f. N CASUALTY COMPANY
HARTFOR I, CONNECTICUT 06156
.
A Stock Insurance Company
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~ The A:nterprise 2000 Property/Liability POLICY
E3 NAMED INSURED AND ADDRESS
:a: BILGORE GROVES
~ BILL DONALDSON INC DBA
807 A COURT STREET
CLEARWATER FL 34616
PINELLAS
POLICY NUMBER
023 BO 0020867839 FWF
POLICY PERIOD
From 10/14/90 to 10/14/91 12:01 A.M.
Standard Time at the Insured's
Address Stated Herein.
NAMED INSURED IS
CORPORATION
BUSINESS OF NAMED INSURED
GIFT SHOP - RETAIL
AGENCY
R&C UNDERWRITING AUTHORITY
PREMIUM
In return for the payment of the premium and subject to all the terms of this POLICY the designated company
provides you with the indicated coverages for which a coverage form and any endorsements included at the inception
or during the policy period are attached.
.
Total Advance PREMIUM I
$250.00
This policy is not valid unless countersigned by a duly authorize agent of the designated company.
AGENCY AT AUT
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CLEARWATER,FL
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BUILDING AND PERSONAL PROPERTY COVERAGE
ADDRESS
807 A COURT STREET
CLEARWATER (2) FL 34616
PINELLAS
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COVERAGE
VALUATION
PROVISIONS
REPLACEMENT COST $10,000
ACTUAL LOSS 12 MONTHS
SUSTAINED
LIMIT
BUSINESS PERSONAL PROPERTY
COMBINED BUSINESS INCOME
AND EXTRA EXPENSE
.
AE001 (ED. 02-89)
READ YOUR POLICY CAREFULLY
MEMORANDUM COpy
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PRINTED IN U.S,A.
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DECLARATIONS AND SCHTULES (CONTINUED)
NAM~ - BILGORE GROVES "
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POLICY - 023 BO 0020867839 FWF
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COVERAGE
MONEY AND SECURITIES
WITHIN DESCRIBED
OR BANKING PREMISES
CONVEYED BY MESSENGER
OR ARMORED CAR SERVICE
$2,000
LIMIT
$10,000
PROPERTY DEDUCTIBLE
Building and Business Personal Property
$250 per occurrence
COMMERCIAL GENERAL LIABILITY COVERAGE
COVERAGES LIMITS OF LIABILITY
AGGREGATE LIMITS OF LIABILITY $1,000,000 Products/Completed
Operations Aggregate.
$1,000,000 General Aggregate ( other than
Products/Completed Operations).
COVERAGE A - Bodily Injury and Property $500,000 anyone occurrence subject
Damage Liability to the Products/Completed
Operations and General
Aggregate Limits of Liability.
Fire Damage Liability $50,000 anyone fire subject to the
Coverage A occurrence and
the General Aggregate Limits
of Liability.
COVERAGE B - Personal and Advertising Injury $500,000 anyone person or organization
Liability subject to the General Aggregate
Limit of Liability.
COVERAGE C - Medical Payments $5,000 anyone person subject to the
Coverage A occurrence and
the General Aggregate Limits
of Liability.
THIS POLICY INCLUDES THESE ENDORSEMENTS
AE009 0289
SD012 0190
SD009 0289
SD002 0190
SD003 0190
SM001 0190
SD025 0190
CG2013 1185
TABLE OF CONTENTS - BUILDING AND PERSONAL PROPERTY - SPECIAL AND
COMMERCIAL GENERAL LIABILITY COVERAGE FORMS
LEAD IN LANGUAGE
COMMON POLICY CONDITIONS
BUILDING AND PERSONAL PROPERTY COVERAGE FORM - SPECIAL
COMMERCIAL GENERAL LIABILITY COVERAGE FORM
MERCANTILE PROGRAM ENDORSEMENT
THEFT OF COVERED PROPERTY FROM UNATTENDED VEHICLE EXCLUSION
ADDITIONAL INSURED (STATE OR POLITICAL SUBDIVISIONS - PERMITS RELATING
TO PREMISES)
AE001 (ED. 02-89)
READ YOUR POLICY CAREFULLY
MEMORANDUM COPY
PRINTED IN U.S.A.
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~ DECLARATIONS AND SCH[I)ULES (CONTINUED)
NAMIi= - BILGORE GROVES ,
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THIS POLICY INCLUDES THESE ENDORSEMENTS
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SE007
CG0220
1186
0190
1186
FLORIDA CHANGES
FLORIDA AMENDATORY ENDORSEMENT
FLORIDA CHANGES
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POLICY - 023 BO 0020867839 FWF
,
RMINGTON CASUAL TV COMPANY as insurer for this insurance
AE001 (ED. 02-89)
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READ YOUR POLICY CAREFULLY
MEMORANDUM COpy
PRINTED IN U.S,A.
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I . COMMERCIAL GENERAL LIABILITY
THIS ENDORSEMENl' CHANGES THE POLICY. PLI!ASE READ IT CAREFULLY.
ADDITIONAL INSURED
SUBDIVISIONS- PERMITS
(STATE OR
RELATING
POLITICAL
TO PREMISES)
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This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
WHO IS AN INSURED (Section II) is amended to include as an insured any state or political subdivision shown in the
Schedule, subject to the following additional provision:
This insurance applies only with respect to the following hazards for which the state or political subdivision has issued
a permit in connection with premises you own, rent, or control and to which this insurance applies:
1. The existence, maintenance, repair, construction, erection, or removal of advertising signs, awnings, canopies,
cellar entrances, coal holes, driveways, manholes, marquees, hoistaway openings, sidewalk vaults, street
banners, or decorations and similar exposures; or
2. The construction, erection, or removal of elevators; or
3. The ownership, maintenance, or use of any elevators covered by this insurance.
SCHEDULE
STATE OR POLITICAL SUBDIVISION:
CITY OF CLEARWATER
CG2013 (ED. 11-85)
PRINTED IN U.S.A.