Certificates of Insurance , 1 / 1 1 1 I 1
LE"AB STOPSAT ARROWS
•
Of CERTIFICATE OF INSURANCE ISS3/25/88 DATE Mrowry
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
Eastman Insurance Agency Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4201 North Federal Highway
Lighthouse Point, Florida 33064 COMPANIES AFFORDING COVERAGE
COMPANY A Pacific Employers Insurance Company
COMPANY B
INSURED LETTER
Hyatt & Hyatt Inc. dba Martha's LETTERNY C
Restaurant & Benihana Restaurant
1801 South Roosevelt Boulevard COMPANY D
CETTPR
Key West, Florida 33040
COMPANY E
LETTER
COVERAGES
THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIODINDICATED.
NOTWITHSTANDING ANY REQUIREMENT,TEAM 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 CONDI.
TONS OF SUCH POLICIES.
12 TYPE OF INSURANCE POLICY NUMBER FOJCY ERFLTNF POLICY EXPIRATIONLIABILITY LIMITS IN THOUSANDS
DATE IMMAANYVI DATE M4Q'YYI EACH AGGREGATE
OCCURRENCE
GENERAL LIABILITY BCOILY
I
COMPREHENSIVE FORM D19843863 7/6/87 7/6/BB IWURY $ $
PREMISES/OPERATIONS pRopfRTv
UNDERGROUND DAMAGE $ $
ELOSDN X CLAPSE HAZARD PRUCTSICOMPLETEO OPERATIONS
BIe PO
CONTCTUAL COMBINED $1,000 1,000
INDEPENDENT CONTRACTORS
OROAD FORMM PROPERTY DAMAGE1,000
PERSONAL INJURY PERSONAL INJURY $
AUTOMOBILE LIABILITYI
EOmY
HWY
NI ANY AUTO PEA RISOM $
■ ALL OWNED AUTOS(PRIV.PASS.) e4gLY
■ ALL OWNED AUTOS(OTHERPTTHAN) Ida i¢tNxR $
■ HIRED AUTOS PROP
ERTY
DAMAG
. NON-OWNED AUTOS E $
■ GARAGE LIABILITY
■ CIBBD
EXCESS LIABILITY
': OA NO M �-COMBINED $ $
OTHER T THAN UMBRELLA FORM
91APD
T , \ B ■
WORKERS' COMPENSATION STATUTORYAND Administrative Services/RI k Mgmt.Div.
3 $ (EACH ACCIDENT)
' '� �. i $ (DISEASE-POLICY LIMLIMIT(EMPLOYERS'LABILITY DATE
��I $ (DISEASE-EACH EMPLOYEE)
'OTHER MISIM`�-
DESCRIPTION OF OPERATIONSILOCATIONSNEHECLESISPECIAL ITEMS
Parking Lot Adjacent to Airport, Monroe County, Florida
CERTIFICATE HOLDER CANCELLATION
Additional Insured: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
County of Monroe MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT,BUT FAILURE T•MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Att: Donna J. Perez, Risk Mgt OF ANY KIND UPON HE COMPANY,ITS AGENTS OR REPRESENTATIVES.
Key West, Florida 33040 AUTHORIZED REPRE/ 415:
�■ , 1s_r
AGGRO 25(8184) IIRIACORD CORPORATION 1984
Of 'I CERTIFICATE OF INSURANCE ISSUE CATE88M/DD""
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
Eastman Insurance Agency Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
4201 North Federal Highway
Lighthouse Point, Florida 33064 COMPANIES AFFORDING COVERAGE
COMPANY
LETTER A Pacific Employers Insurance Company
COMPANY B
INSURED LETTER
COMPANY C
Hyatt & Hyatt Inc. LETTER
3e91 South Roosevelt Boulevard
COMPANY D
Key West, Florida 33040 LETTER
COMPANY E
LETTER
COVERAGES
THIS IS TO CERTIFY THAT 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 CONDI-
TIONS OF SUCH POLICIES.
® FOLIC EFKTN PCLI:N EXPIR4T.ON
TYPE OF INSURANCE POLICY NUMBER PATE,MMm¢'rv, DATE iMMNOw, ALL LIMITS IN THOUSANDS
GENERAL LIABILITY GLNERAL ASGREATE $ 1 000,
A X COMM EACIAL GENERAL LIAO uiY PRDDJC'SCOMP.OPS AGGREGATE $ 1,000,
AIMS MACE X OCLLE4'R ` D19360325 7/6/88 7/6/89 PE9SONAL&ADVERTISING INJURY $ 1 000
OWNERS A CarRACm95 PROTECT OE EACH OCCURRENCE $ 1 000
HRE DAMAGE I NV ONE FIRE, $ 50,
tom CAL EXPENSE I41.Y ONE PERSON, $ 5
AUTOMOBILE LIABILITY �Y
S.
ANY—AUTO $
ALL OWNED AUTOS
SCHEDULED AUTOS $
HIRED AUTOS
NON CANNEDAUTOS $
GARAGE LIABILITY RECEIV 7 D
_ 7MONROE COU�NTY $
EXCESS LIABILITY Administrative Services Va" '&m . riv. CUARENCE AGGREGATE
— / i A „y $ $
OTHER THAN UMBRELLA FORM DATE ��� t, •{_ I _ SI Al UT OHw
WORKERS'COMPENSATION TIME 'MAS
$ .EACH ACGIOLNY,
AND $
IDISEA56PDLICY LIMIT,
EMPLOYERS'LIABILITY $
IDISEASEEACH EMPLOYEE,
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS
Parking Lot Adjacent to Airport, Monroe County, Florida
Martha's Restaurant and Benihana Restaurant
CERTIFICATE HOLDER CANCELLATION
Additional Insured: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX-
PIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
County of Monroe MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Att: Donna S. Perez, Risk Mgt LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Key West, Florida 33040 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED : RESENTATIVE
ACORD 25•5(11(85) Ev IIR/ACORD CORPORATION 198
ALOMtII• $ < 4 S $$BE DATE(MM/DDIYY)
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
Eastman Insurance Agency Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
4201 North Federal Highway
Lighthouse Point, Florida 33064 COMPANIES AFFORDING COVERAGE
COMPANY
LETTER A CIGNA Companies
CODE SUBAODE
COMPANY n
INSURED LETTER
COMPANY C
Hyatt & Hyatt Inc. dba LETTER
Martha's Restaurant &
COMPANY D
Benihana Restaurant LETTER
3591 South Roosevelt Boulevard
COMPANY E
Key West, Florida 33040 LETTER
.. g :. e a �9:T': : . 9.h."` +dtw'y"'`r0I e e
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION ALL mays Ill THOUSANDS
LTA DATE(MM/DD/YY) DATE(MMIDD/YY)
GENERAL LIABILITY GENERAL AGGREGATE S 1,000,
A XX.COMMERCIAL GENERAL LIABILITY D19360325 7/6/89 7/6/90 PRODUCTSCOMP/OPS AGGREGATE $ 1,000,
CLAIMS MADE OCCUR PERSONAL&ADVERTISING INJURY S 1,000,
OWNER &CONTRACTOR'S PROT. EACH OCCURRENCE $ 1,000,
FIRE DAMAGE(Any one fire) $ 50,
MEDICAL EXPENSE(Any one person) S 5 r
AUTOMOBILE LIABILITY COMBINED
ANY AUTO SINGLE $
LIMIT
ALL OWNED AUTOS RECEIVED BODILY
SCHEDULED AUTOS MONROE COUNTY (Peep rson)
HIRED AUTOS Administratl�Ja pJpJpJ,��P���rvices/Risk Mgmt.Div. BODILY
NON-OWNED AUTOS (Per esculent)
Y�/ ( / (� INJURY $
DATE X / . X /
GARAGE LIABILITY 1 PROPERTY
TIME U Ik ITIn LS�. /VL. DAMAGE
EXCESS LIABILITY EACH AGGREGATE
OCCURRENCE
S $
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION • STATUTORY
AND $ (EACH ACCIDENT)
$ (DISEASE—POLICY LIMIT)
EMPLOYERS'LIABILITY
$ (DISEASE—EACH EMPLOYEE)
OTHER
DESCRIPTION OF OPERATIONS(LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS
Parking Lot Adjacent to Airport, Monroe County, Florida
Martha's Restaurant and Benihana Restaurant
CERTIpIcATEM ,.DEM ` _. . '�I$N/ : S „ ' ./
Additional Insured: �' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO
County of Monroe MAIL_3D_DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Att: Donna J. Perez, Risk Mgt. LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Key West, Florida 33040 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
AcoRG.RiE?s WO) _ ..�.s,_ =�.�, F e ,. - I n . % . '}-"',,• °
3
ACIIIl11 '`o" ISSUE DATE(MM/DDIYYI
s
PRODUCER j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS
NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,
Eastman Insurance Agency Inc. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
4201 North Federal Highway
Lighthouse Point, Florida 33064 COMPANIES AFFORDING COVERAGE
COMPANY
LETTER A CIGNA Companies
CODE SUB-CODE
COMPANY n
INSURED LETTER
Hyatt & Hyatt Inc. dba Martha's COMPANY
Restaurant & Benihana Restaurant LETTER C
3591 South Roosevelt Boulevard COMPANY ANYD
Key West, Florida 33040
COMPANY E
LETTER
THIS IS TO CERTIFY THAT 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 CONTRACTOR 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICYI EXPIRATION ALL LIMITS IN THOUSAND,
LTR DATE(MM/DD/YY) DATE(MWDDNY)
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000
A X COMMERCIAL GENERAL LIABILITY PRODUCTSCOMP/OPS AGGREGATE E 1,000,
CLAIMS MADE OCCUR. D23523310 7/6/90 7/6/91 PERSONAL&ADVERTISING INJURY $ 1,000,
OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE S. 1,000.
FIRE DAMAGE(Any one lire) E 50,
MEDICAL EXPENSE(Any one person) E 5
AUTOMOBILE LIABILITY COMBINED '
ANY AUTO SINGLE E
IMIT
ALL OWNED AUTOS BODILY
SCHEDULED AUTOS (Per)penpn) E
HIRED AUTOS BODILY
NON OWNED AUTOS INJURY f
Per
GARAGE LIABILITY
PROPERTY
DAMAGE
EXCESS LIABILITY EACH AGGREGATE
OCCURRENCE
$ $
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY
(EACH ACCIDENT)
AND Received
EMPLOYERS'LIABILITY (DISEASE—POLICY LIMIT)
Risk Mg [. & ss Control E (DISEASE—EACH EMPLOYEE)
OTHER DATE
INITIAL
Cl
DESCRIPTION OF OPERATION&/LOCATIONSEXICLE$/RESTRICTIOH85 ITEMS
EM3 I �/J
Parking Lot Adjacent to Airport, Monroe County, Florida L�F/,_�J"
/V
Martha's Restaurant & Benihana Restaurant
. . .. cAti ^`Y ik3 \lgtrifitait" d ,7:��`:" .''is�' 11/414nOSI-WkWi4Rvz
County of Monroe ?' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Administrative Services, Risk Mgt Divisi0A EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
Wing 2, Room 207, Public Service Bldg MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
Stock Island LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
Key West, Florida 33040 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPR TATIY��
ACORDA' d.s Tn. ' .. . ,„`��! ' r{(1i✓�;°.,�^/a^ ,'1
MINIM
ISSUE DATE(MM/00/VV)
.,,F � .. = 9/6/91
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
EASTMAN INSURANCE AGENCY INC CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
4201 NORTH FEDERAL HIGHWAY POLICIES BELOW.
LIGHTHOUSE POINT, FLORIDA 33064 COMPANIES AFFORDING COVERAGE
CLETTER OMPANY A CIGNA FIRE UNDERWRITERS INSURANCE COMPANY
COMPANY B INSURANCE COMPANY OF NORTH AMERICA
INSUREDMP
LETTER
HYATT & HYATT INC DBA CO TEERNY C
MARTHA'S & BENIHANA RESTAURANTS
3591 SOUTH ROOSEVELT BLVD LETTER Y D
KEY WEST, FLORIDA 33040
COMPANY E
LETTER
.. _
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
LTR DATE(MM/DD/VV) DATE(MM/DO/VV)
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
A. g COMMERCIAL GENERAL LIABILITY PRODUCTS.COMP/OP AGO. $ 1,000,000
CLAIMS MADE X OCCUR. D23523310 7/6/91 7/6/92 PERSONALSADV.INJURY a 1,000,000
OWNER'S&CONTRACTORS PROT. EACH OCCURRENCE $ 1,000,000
EIRE DAMAGE(Any one fire) $ 50,000
MED EXPENSE{Any one person) S 5,000
AUTOMOBILE LIABILITY
COMBINED SINGLE
ANY AUTO LIMIT
ALL OWNED AUTOS
BODILYI
SCHEDULED AUTOS (Perrper personon))
HIRED AUTOS
BODILY INJURY
NO&OWNED AUTOS IPer accident)
GARAGE LIABILITY
PROPERTY DAMAGE S
EXCESS LIABILITY EACH OCCURRENCE $ 1,000,000
B g UMBRELLA FORM G151729E8 7/6/91 7/6/92 AGGREGATE $ 1,000,000
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY LIMITS
AND 12^^--'4,1 EACH ACCIDENT
Dagr li.Ot LOSS Control DISEASE—POLICY LIMIT $
EMPLOYERS'LIABILITY
l DISEASE—EACH EMPLOYEE $
OTHER
'AL
DESCRIPTION OF OPERATIONS/LOCATIDXBIVEXICLE818PECIAL ITEMS Pt XL G LOT—AD nIRA,RY, nBbnBE FLORIDA
PARKING LOT LEASED TO HYATT & HYATT INC DBA MARTHA'S RESTAURANT & BENIHANA RESTAURANT
ADDITIONAL INSURED, COUNTY OF MONROE, PER ATTACHED ENDORSEMENT CG2011
CBWIIPfC4TE NOLbIN and :zugO s om
COUNTY OF MONROE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
ADMINISTRATIVE SERV, RIST MGT DIVISION EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
WING 2, RM 207, PUBLIC SERVICE BLDG MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
STOCK ISLAND LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
KEY WEST, FLORIDA 33040 LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTHORIZED REPRESENTA
CACORD CORPORATIONf19YD
POLICY NUMBLR. 823523310 COMMERCIAL GENERAL LIABILITY
• Tills ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
ADDITIONAL INSURED-- MANAGERS OR LESSORS OF
PREMISES
This endorsement modifies insurance provided under the following.
COMMERCIAL GENERA! LIABILITY COVERAGE PART.
SCHEDULE
1. Designation of Premises (Part Leased to You):
2. Name of Person or Organization (Additional Insured): COUNTY OF MONROE
3. Additional Premium-
(If no entry appears above.the information required to complete this endorsement will be shown in the Declara•
Lions as applicable to this endorsement.)
WHO IS INSLIRED(Se.l ion II)is amended to include as This insurance does not apply to:
an insured the pe,son or organization shown in the 1. Any "occurrence" which takes place after'you
Schedule but only with respect to liability arising out cease to be a tenant in that premises.
of the ormership. maintenance or use of that part of
the premises leased to you and shown in the Schedule 2. Structural alterations. new construction or dem-
and subject to the following additional exclusions: olition operations performed by or on behalf of
the person or organization shown in the Sched-
ule.
CG 20 11 11 85 . Copyright. Insurance Services Office, Inc.. 1984
APflRD k q$UE DATE IMM/OD Y'Q
(tomt5, M .'�.X<• 7/21/92
PRODUCER D 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
RASTtlAN INSURANCE AGENCY INC POLICIES BELOW.
4201 NORTH FEDERAL HIGHWAY COMPANIES AFFORDING COVERAGE
LIGHTHOUSE POINT, FLORIDA 33064
COMPANY
LETTER A CIGNA FIRE UNDERWRITERS INSURANCE COMPANY
COMPANY B Received
INSURED LETTER Risk Mgmt. & ss ntrol
HYATT & HYATT INC DBA COMPANY DATE 7 ..2•7
MARTHA'S RESTAURANT AND LETTER G / �
BENIHANA RESTAURANT COMPANY G (/ NITIAI tC/1
3591 SOUTH ROOSEVELT BOULEVARD LETTER D v (JAJf 'r
KEY WEST, FLORIDA 33040 COMPANY E CAC' (_�yy' 'r"
LETTER
COVERAGES
THIS IS TO CERTIFY THAT 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTR DATE WM/DONT) DATE IMM/UDIYY)
GENERAL LIABILITY GENERAL AGGREGATE $2,000,000
A KK COMMERCIAL GENERAL LIABILITY PRODUCTS COMP/OP AGG. $2.000,000
CLAIMS MADE KK OCCUR. D23523310 7/6/92 7/6/93 PERSONAL ADV.INJURY $1,000,000
OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE $1,000,000
FIRE DAMAGE(Any one lire) $ 50,000
MED.EXPENSE(My one person) $ 10,000
AUTOMOBILE LIABILITY COMBINED SINGLE
LIMIT
ALL OWNED AUTOS
BODILY INJURY
SCHEDULED AUTOS (Per person)
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident)
GARAGE LIABILITY
PROPERTY DAMAGE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA FORM AGGREGATE $
OTHER THAN UMBRELLA FORM
WORKER'S COMPENSATION STATUTORY LIMITS
EACH ACCIDENT $
AND
DISEASE—POLICY LIMIT $
EMPLOYERS'LIABILITY
DISEASE—EACH EMPLOYEE $
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
TWO RESTAURANTS AT 3591 SOUTH ROOSEVELT BOULEVARD, KEY WEST, FLORIDA 33040 AND PARKING LOT
ADJACENT TO AIRPORT, MONROE COUNTY, FLORIDA LEASED TO HYATT & HYATT INC
CEiMtIFR`. EiiOLOEM. / ramaaa-miint 0,0141014110N < . s
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
COUNTY OF MONROE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO
ADMINISTRATIVE SERV, RISK MGT DIVISION MAIL ID DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
WING 2, RH 207, PUBLIC SERVICE BLDG LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
STOCK ISLAND LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES.
KEY WEST, FLORIDA 33040
AUTHORIZED REPRESENTATI E
ACORD 2¢41:0190) .. JIiYi' 'CORPORATIOM 1950