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2001-019
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2001-019
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Last modified
2/20/2025 10:10:04 AM
Creation date
2/20/2025 10:09:58 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
01/23/2001
Control Number
2001-019
Agenda Item Number
7.C.
Entity Name
Thomas T. Nelson dba Wabasson Golf
Subject
Agreement for Golf Ball Retrieval at the Sandridge Golf Club
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El <br />•.Ai:ilw6li. CERTIFICATE OF INSURANCE <br />DATEIMMIDOIYVI <br />CBR °° <br />NET,9TIt0 03(07(96 <br />THIS CERTIFICATE IS ISSIIED AS A MATTER OF INFORMATION <br />1«OD000I <br />CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Gallo -American -Calder Ins Agcy <br />ONLY AND <br />11OLDER. TRIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />P. O. Box 32099 <br />Palm Beach Gardens rL 33420 <br />COMPANIES AFFORDING COVERAGE <br />Robert L. Galla <br />COMPANY <br />A Auto owners Insuranao Company <br />ftm nn..._9d7A.49_.SL¢� SL_fyLuE <br />INSURED <br />COMPANY <br />B <br />COMPANY <br />C —� <br />Thomas T. Nelson <br />Wabasso Golf <br />P. o. Box 700338 <br />COMPANY <br />Wabaaso rL 32970 <br />D <br />COVERAGES :... -.... -.... .. _... .. <br />THIS IS TO CERTIFY TI . A _ T THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIRE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br />OF ANY CONTRACT oil OTHER DOCUMENT WITII RESPECT TO WIIICII THIS <br />INDICATED, NOTWITTISTANDINO ANY REQUIREMENT, TERM OR CONDITION <br />CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TIIE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TIIE TERMS, <br />EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />__--------- <br />— <br />-_____. <br />POLICY <br />EFFECTIVE <br />POLICY EXPIRATION <br />WAITS <br />CO <br />OR <br />TYPE OF INSLMRANCF <br />POLICY NUMBER <br />DATE lMMlDDIYYI <br />DATE IMMIDDIYYI <br />GENERAL AGGREGATE 11,000,000 <br />GENERAL LIABILITY <br />20424269 <br />OZ ( ( <br />0496 0204 97 <br />( / <br />PRODUCTS-COMPIOP AGO 11,000,000 <br />pERSONALiADV INJURY 4 11 ODD,000 <br />A <br />Y COMMERCIAL GENERAL LIABILITY <br />CLAIMS MADE 5Z OCCUR <br />TACH OCCOMENCE / 1 000 ,000 <br />OWNER'S S CONTRACTOR'S PHOT <br />FIRE DAMAGE 1JIIY en/ IYSI 650,000 <br />MED EXP ww—Paull 05.000 <br />AUTOMOSIU <br />UASIUTY <br />09/16/95 <br />09/16/96 <br />COMBINED SINGLE LIMIT 1 <br />W <br />ANY AUTO <br />20305564 <br />Z <br />ALL OWNED AUTOS <br />BODILY INJURY 1$1,000,000 <br />IPa paS«d <br />SCHEDULED AUTOS <br />Z <br />HIRED AUTO$ <br />BODILY INJURY S <br />IPa AaldaHl <br />Z <br />NOWOWNEO AUTO$ <br />PROPERTY DAMAGE 1 <br />AUTO ONLY• EA ACCIDENT 1 <br />GGE UASIUTY <br />ARA <br />OTHER THAN AUTO OklY1 <br />ANY AUTO <br />EACH ACCIDENT / <br />AGGREGATE / <br />EACH OCCURRENCE 1 <br />F%CF{{ LIABILITY <br />AGGREGATE / <br />UMBRELLA FORM <br />S <br />OTHER THAN UMBRELLA FORM <br />_ <br />6TATUTORY LIMIT$ <br />WORICERS COMPIEN{ANON AND <br />EACH ACCIDENT 1 <br />EMPLOYERS' LIABILITY <br />21SEAI1 -POLICY LIMIT 1 <br />THE PROPRI 0 INCL <br />DISEASE• EACH EMPLOYEE I <br />PARTNER$IEXECUTIVE — <br />LRB AREI EXCL <br />UI <br />TC <br />OLSCWPTION OF OPLRATION SA OC ATIONSNnSCI"ISPECIAL ITVAS <br />Sporting Goods/Athletic Equip. Stores-OOlf Ball Sales <br />A11 Operations/Palm Beach County and elsewhere in the State of Florida <br />32967 <br />Project - Sandrid a Oolf Course, 5300 73rd Street, Vero Beac11, FL <br />Golf Bal Retrieval Service ---- <br />CERTIFICATE HOLDER I CANCELLATION <br />IR00001 SIXIIHD ANY OF TRE ABOVE DEFCN$LD PONCIE{ BE CANCIUM BEFORE TRE <br />LXRHATION DATE TIIUIEOF, 711E ISSUING COMPANY WILL LNDFAVOR TO MNL <br />1 O DAYS WRITTEN NOTICE TO TIIE CORI VICA7E 16OLDET1 NAMED TO 711E ILFT. <br />SU, • w. ALTO MAIL sUCH NOTICE &RALL IMPOSE NO OSUOATION OR UASIUTY <br />INDIAN RIVER COUNTY OF ANY KIND UPON TIIE COMPANY. ITS AGENTS ON REPRESENTATIVES. <br />2625 19th Avenue AUNIORIZ ENr rvE _ <br />Vero Beach FI, 32960 <br />'� eACORD CORPORATION 1993 <br />ACORD 26.8 131331 <br />
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