Laserfiche WebLink
AIRPORT LIABILITY POLICY <br /> DECLARATIONS -PART ONE j <br /> Company: G <br /> U.S. SPECIALTY INSURANCE COMPANY Your Policy Number: UA00167344-07 <br /> • Administrative offices: 13403 Northwest Freeway, Prior Policy Number: UA00167344-06 <br /> • Houston, TX 77040 <br /> ITEM NAMED INSURED AND ADDRESS YOUR AGENT'S NAME AND ADDRESS � <br /> � Skydive City, Inc. Falcon Insurance Agency, Inc. Individual <br /> P. O. Box 291388 Q Partnership <br /> Kerrville,TX 78029 or Joint <br /> 4241 Sky Dive Lane Venture <br /> Zephyrhills, FL 33542 Q Other <br /> 2 POLICY PERIOD: 12:01 a.m. standard time at our above address FROM: 02/18/2017 TO: 02/18/2018 <br /> 3 BUSINESS OF NAMED INSURED: <br /> 4 , . PART OCCUPIED BY NAMED INSURED'S <br /> L:OCATION OF AIRPORT INSURED BY THIS POLICY NAMED INSURED INTEREST -- <br /> -. ZEPHYRHILLS MUNI,ZEPHYRHILLS, FL Portion Tenant <br /> 5 <br /> LIMITS OF INSURANCE, COVERAGES AND PREMIUMS This insurance is only with respect to the following coverage(s) <br /> for which a premium charge is shown in the premium column.Absence of a premium charge means that no insurance is <br /> provided by the policy for that coverage. , <br /> LIMITS OF INSURANCE " COVERAGES PREMIUM- <br /> $ 100,000 Each Person AIRPORT <br /> $ 1,000,000 Each Occurrence - A gODILY INJURY AND PROPERTY DAMAGE LIABILITY <br /> $ 2,000,000 A re ate 1,200 <br /> $ Any One Aircraft <br /> $ Each Occurrence C HANGARKEEPER'S LIABILITY <br /> $ Deductible <br /> COVERAGES APPLICABLE TO ALL AIRPORT(S) INSURED BY THIS POLIGY - � � <br /> LIMITS OF INSURANCE,COVERAGES AND PREMIUMS:This insurance is only with respect to the following coverage(s) <br /> 5 for which a premium charge is shown in the premium column.Absence of a premium charge means that no insurance is <br /> rovided b the olic for that covera e. <br /> LIMITS OF INSURANCE - - • � COVERAGES _ PREMIUM <br /> $ Each Person PRODUCTS COMPLETED OPERATIONS HAZARD <br /> $ Each Occurrence B BODILY INJURY AND PROPERTY DAMAGE LIABILITY <br /> $ A re ate <br /> $ Each Person p MEDICAL PAYMENTS <br /> $ Each Occurrence <br /> 6 Premium for Endorsement s $ 0 <br /> Forms and Endorsements attached: TOTAL POLICY PREMIUM 1,200 <br /> Form Name Form Version Form Title Form Premium <br /> 20702 (04/11) ASBESTOS EXCLUSION <br /> 20001 (08/10) AIRPORT POLICY CONDITIONS <br /> i <br /> - 20003 (OS/10) AIRPORT LIABILITY POLICY JACKET I <br /> 20080 (08/10) PROTECTING THE PRIVACY OF INFORMATION I <br /> I <br /> 20002 (08/10) Document Number: 1212021 CA Page 1 of 2 � <br /> � <br /> i <br /> � <br />