2013-61 LEASE
THIS LEASE made and entered into this 11th day of June, 2013, by and between the CITY
OF CLERMONT, a Florida municipal corporation whose address is 685 W. Montrose Street,
Clermont, FL 34711, hereinafter "Landlord" and CLERMONT WOMAN'S CLUB, INC. a Florida
Non-Profit Corporation, whose address is 655 West Broome Street Clermont, FL , 34711,
hereinafter"Tenant".
WITNESSETH THAT:
Upon the terms and conditions hereinafter stated, and in consideration of the payment
hereinafter stipulated and the performance by the Tenant of the covenants herein contained, the
Landlord does hereby lease, let and demise unto the Tenant, and the Tenant does hereby rent, lease
and hire from the Landlord, upon the terms and conditions hereinafter stated, the Premises, as
described below. This Lease Agreement shall replace in its entirety that certain lease agreement
between the parties dated October 25, 1990.
1. Premises
The Premises that shall be the subject matter of this lease agreement and to which Tenant
shall be entitled to occupy in accordance with the terms hereof, shall be that certain grounds and
structure located at Lots 8, 9 and 10, Blook 73, City of Clermont, street address: 655 West Broome
Street, Clermont,Florida.
2. Term of Lease
This Lease shall be effective as of the last date of execution by the parties below. The term
of this Lease shall continue as set forth in the 1990 agreement and shall end on December 17, 2045.
The Lease term may, at Tenant's option, be renewed under the same terms and conditions of this
Lease for a period of Ten(10)years. As a condition precedent to Tenant's renewal right hereunder,
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Landlord shall be the owner of the Premises as of the date of the renewal and Tenant shall give
written notice to Landlord of its intention to renew no more then six (6) months nor less than three
(3)months before the expiration of the initial term hereunder.
3. Use and Care of Leased Premises
A. Tenant recognizes and agrees that the Premises have and will continue to be
occupied by Tenant and Tenant accepts the Premises in the condition as is as of the effective date of
this Lease. Tenant shall be responsible for all costs associated with the maintenance and upkeep of
the interior and exterior of structure located on the Premises. Landlord shall be responsible for the
routine maintenance and upkeep of the landscaping and grounds, provided however, that Landlord
shall not be obligated to add to, or replace any existing landscaping.
B. Tenant shall not install or place any signage, either permanent or temporary, of any
kind on the Premises without Landlord prior written approval.
C. The above-described Premises shall be used by the Tenant for Clermont Woman's
Club functions and purposes only, except as may be authorized pursuant to Paragraph 6 below. All
uses shall be in accordance with all applicable laws, ordinances and regulations.
D. The Tenant shall use and occupy the Premises in a careful, safe and proper manner
and shall keep the Premises in a clean, sanitary and safe condition. The Tenant shall not use, or
allow the Premises to be used for any purpose other than Permitted Uses and shall not use, or
permit the Premises to be used for any unlawful, disreputable or immoral purpose or in any way
that will injure the reputation of the Premises or Landlord.
4. Peaceful Occupancy by Tenant
If Tenant shall fully observe and perform all of the covenants and conditions of this Lease
on its part to be performed, the Landlord hereby covenants and agrees that the Tenant shall have the
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peaceful possession and quiet enjoyment of the Premises during the term hereof without any
manner of interference or hindrance from the Landlord or any person or persons, lawfully claiming
by,through or under the Landlord.
5. Lease Consideration .
The parties covenant and agree that in consideration and as annual rent for this Lease,
Tenant shall,pay to Landlord the sum of ONE (1)DOLLAR, which shall be paid on December 1 of
each year hereunder to the Landlord at Clermont City Hall.
6. Rental of Premises
The parties covenant and agree that Tenant shall be permitted to sublet, rent or license the
Premises on a temporary limited basis to third parties for functions and events. In accordance with
the following terms and conditions:
A. Tenant shall ensure that no event permitted pursuant to this section or otherwise
occurring on the premises shall be allowed to occur anywhere upon the Premises after 12-midnight.
B. Tenant shall ensure that no music is played or amplified so as to be audible outside
of the structure after 11:00 p.m.
C. Tenant shall not permit the serving of alcohol or any kind on the Premises, unless
specifically approved by action of the Clermont City Manager.
D. Tenant shall not permit any guests or visitors to the Premises to park any vehicle,
except as in accordance with Clermont parking regulations.
E. Tenant shall maintain for at least a period of three (3) years from the date of any
booking or scheduled detailed records of the event, including the user's name and address, the
length of the use and the general purpose of the event. Tenant shall, upon Landlord's request,
provide to Landlord for review and inspection, copies of all records related to events booked or
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scheduled by Tenant.
7. Utilities and Other Charles
Tenant agrees to pay for all insurance, electric, telephone, Internet, cable television, and
water and sewer charges and cleaning and janitonal services associated with the use of the
Premises.
8. Repairs
A. Tenant shall keep and maintain the Premises in good condition .and repair,
reasonable wear and tear excepted.
B. The Tenant shall act promptly in making all reasonable repairs and shall have a
reasonable time to complete the same unless Tenant is prevented from doing so by reason of strikes,
governmental regulation, inability to obtain materials or other causes beyond the reasonable control
of the Tenant.
C. In the event the Tenant does not make the repairs to the Premises required of it
hereunder, the Landlord, after ten (10) days wntten notice to the Tenant, may proceed with such
repairs and in such event the Tenant covenants and agrees to reimburse promptly the Landlord for
the cost of such repair, plus ten percent (10%) of such costs for supervision. In such event, if
payment of the amounts due the Landlord for paying the performing party is not made by the
Tenant within thirty (30) days after presentation of statements therefore, such amounts shall earn
Interest at the maximum rate allowable by law and shall constitute a default of the terms and
conditions of this agreement.
9. Insurance-Provided by Tenant
The Tenant covenants and agrees to provide and maintain, at all times during the term of
this Lease policies of insurance insuring the Tenant and the Landlord against any and all claims,
4
demands, actions and causes of action whatsoever for injuries received and damage to property in
connection with the use, occupation, management and control of the Premises and the
improvements thereon. Such policies of insurance shall insure the Landlord and the Tenant in an
amount not less than ONE MILLION DOLLARS AND NO CENTS ($1, 000, 000.00) to cover
claims of any one person from any single or specific cause and in an amount not less than ONE
MILLION DOLLARS AND NO CENTS ($1, 000, 000.00) to cover, in connection with any one
particular accident or occurrence, the total aggregate of claims that may arise or to be claimed to
have arisen against the Landlord or the Tenant, as aforesaid. Nothing herein shall be construed as
a waiver, either in whole or in part of Landlord's right of sovereign immunity as provided by
Section 768.28, Florida Statutes, or its successor.
10. Construction Liens
Any consent Landlord may give to Tenant to allow Tenant to construct improvements on
the Premises including any alterations or additions thereto shall not be deemed improvements as
may be required by an agreement between Landlord and Tenant, within the meaning of the Florida
Construction Lien Law. All contractors, subcontractors, mechanics, laborers, matenalmen and
others who perform any work, labor or services, or furnish any material or otherwise participate in
the construction of improvements on the Premises, are hereby given notice that the Tenant is not
authorized to subject Landlord's interest in the Premises to any claim of contractors, sub contractors
laborers, materialmen's liens, or other liens, and all persons dealing directly or indirectly with the
Tenant may not look to the interest of the Landlord in the Premises as security for payment of such
labor, services or materials.
If any Construction or other liens shall be filed against the Premises, or any improvement
thereon by reason of or arising out of any labor or matenals furnished or alleged to have been
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furnished or to be furnished to or for the Tenant or at or on the Premises, at the Tenant's request or
direction or by reason of any changes, alterations or additions to the Premises, then, except for
inchoate liens,the Tenant shall,within thirty(30)days after receipt of written notice from Landlord,
either pay such lien or cause the same to be bonded off the Premises in the mariner provided by law.
The Tenant shall also defend on behalf of the Landlord, at the Tenant's sole cost and expense,
including but not limited to reasonable attorney fees, any action, suit or proceeding which may be
brought for the enforcement of such liens and the Tenant shall pay any damage and discharge any
judgment entered thereon.
11. Entry Upon the Premises
The Tenant covenants and agrees that the Landlord, its representatives, successors and
assigns, shall have free access to the Premises at all reasonable times for the purpose of inspecting
the same and for the purpose of making any alterations or repairs to the Premises that the Landlord
may deem necessary for the safety or preservation of the Premises; provided, however, that such
alterations or repairs have not been made by Tenant after written notice to Tenant of the necessity
therefore in the time period specified by Landlord.
12. Hold Harmless
A. The Tenant covenants and agrees that the Tenant will indemnify and save harmless
the Landlord from and against any and all liability,liens, claims, demands,damages, expenses, fees,
fines, penalties, suits, proceedings, actions and causes of action of any kind, whether actual or
alleged, arising from or related to, the use, occupation, management or control by Tenant of the
Premises and the improvements thereon, or which may be the result of any actual or alleged breach,
violation or nonperformance of any covenant, condition or agreement herein contained on the part
of the Tenant except for claims based on the willful or negligent acts or inactions of Landlord. The
6
Tenant covenants and agrees that the Tenant will, at the Tenant's expense, defend any and all such
actions, suits or proceedings which may be brought against the Landlord or in which the Landlord
may be impleaded with others in any such action or proceedings, at all levels, including appeal, to
which the Landlord may be a party.
B. In the Event the Tenant fails to perform under the provisions of A. above, within ten
(10) days after due notice, the Landlord may at its option, take whatever reasonable action the
Landlord reasonably deems necessary to cure the Tenant's failure to perform, and the Tenant agrees
to pay the Landlord as additional rent hereunder for all damages, costs, fees, expenses,judgments,
charges and reasonable attorneys' fees incurred by the Landlord in exercising it rights under this
Lease.
13. . Destruction of Premises
A. The Landlord and the Tenant covenant and agree that in the event the Premises shall
be wholly or partially damaged by fire, windstorm, tornado, flood or by similar causes to such an
extent that the Premises shall be rendered wholly untenable, then Tenant may elect, within twenty
(20) days after such damage, to terminate this Lease by giving the Landlord wntten notice of
termination. If Tenant should so elect, if requested by Landlord, Tenant agrees to restore the
premises to its condition immediately prior to the effective date of this Lease. If the Premises shall
suffer damage but not rendered wholly untenable by any such casualty, or in the event the Premises
are rendered wholly untenable and the option to terminate is not exercised, the Tenant covenants
and agrees to proceed promptly without expense to the Landlord to repair the damage. It is
understood and agreed that the Tenant shall have a reasonable time within which to rebuild or make
any repairs, and such rebuilding and repairing shall be subject to delays caused by storms, shortages
of labor and materials, government regulations, strikes, walkouts and causes beyond the control of
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the Tenant, which causes shall not be construed as limited factors, but as exemplary only. Tenant's
Insurance proceeds shall be used,to the extent available, to effect such repairs.
14. Removal of Personal Property by Tenant
A. Except as hereinabove otherwise provided, all of the furniture, furnishings, trade
fixtures, and other personal property or equipment used on the Premises by the Tenant and paid for
by it shall remain the property of the Tenant and may be removed by the Tenant upon the expiration
of the term, or termination, of this Lease, subject, however, to the limitations that (1) any such
improvements, furniture, furnishings, trade fixtures, and equipment as are affixed to the Premises
and require severance may be removed only if the Tenant shall repair any damage caused by such
removal, and (2) the Tenant shall have fully performed all of the covenants and agreements to be
performed by it under the provisions of this lease.
B. The Landlord, following the termination, abandonment, surrender or release of this
Lease, shall have the right to take possession of any goods, equipment, inventories, fixtures or other
personal property of the Tenant which may be left upon the Premises, and may dispose of said
property at a time and place designated by the Landlord's sole opinion, and upon notice of such
disposition to any necessary parties. Any proceeds from such sale, lease or other disposition of the
said property may be applied to:
1. Any costs incurred by the Landlord in retaking, holding, selling or otherwise
disposing of the said property of the Tenant;
2. Any monies, which may be owing and unpaid under the provisions of this
Lease Agreement;
15. Default
The following events shall constitute defaults hereunder by the Tenant:
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A. Monetary Default. Failure to pay any charges required under the provisions of
this Lease promptly when due;
B. Non-Monetary Default. Failure to fully and promptly perform and comply
with each and every Vim, provision, covenant and condition of this Lease except for a Monetary
Default as defined above.
C. An Event of Default shall have occurred in the event of a Monetary Default by
Tenant and the continuance of such default for a period of three(3)days after written notice thereof,
or in the event of a Non-Monetary Default and the continuation of such Non-Monetary Default for a
period of twenty (20) days after written notice thereof, the Landlord may, at the Landlord's option
and sole discretion, and in addition to any other remedy or right given hereunder or by law, without
further demand or notice terminate this Lease on the date specified in said notice and retake
possession of the Premises, including all improvements thereon. The remedies set forth herein shall
not preclude the Landlord from enforcing any other remedy or right provided to the Landlord
hereunder or by law. In all events, the Tenant shall remain liable for the payment of any and all
reasonable attorneys' fees and costs incurred by Landlord in enforcing any remedy set forth herein
or provided by law or otherwise.
16. Force Maieure
Whenever any non-monetary performance is required of Tenant hereunder, then Tenant will
be permitted to effect such performance within the time period provided therefore in this lease, or
if, for reasons beyond Tenant's reasonable control (including, without limitation, acts of God,
natural disaster, labor unrest, war, declared or undeclared, the existence of injunctions or
requirements for obtaining licenses, permits or other compliance with applicable laws, rules and
regulations), such performance is not reasonably possible within such time periods, then the time
9
for such performance shall be extended until removal of such reasons beyond Tenant's reasonable
control, provided that Tenant commences such performance (or cure) as soon as reasonably
possible and diligently pursues such performance or cure.
17. Bankruptcy of Tenant
To the extent now or hereinafter permitted by applicable law the filing by, or against Tenant
of a petition in bankruptcy or other similar proceedings under law for relief of debtors, or the
involuntary appointment of a receiver, custodian, liquidator, or trustee in bankruptcy of the
Premises and improvements thereon and such petition or petitions is not discharged or vacated
within one hundred twenty (120) calendar days after the filing thereof; or if Tenant becomes
insolvent or unable to pay its debts as they mature or makes an assignment for the benefit of
creditors or request or consents to the appointment of a receiver, custodian, liquidator or trustee in
bankruptcy of any such party's property or files a petition in bankruptcy or other similar proceedings
under law for relief of debtors, then upon the occurrence of any of the above events, Landlord may,
at its option, declare Tenant in default hereunder and immediately give Tenant wntten notice of its
intention to terminate this Lease.
18. Cumulative Rights/Waiver of Covenants by Landlord
The rights of the Landlord under this Lease shall be cumulative and nonexclusive as to
those provided by statute. No consent or waiver by the Landlord to or of any breach of any
covenant, condition or duty of the Tenant shall be construed as a consent to or waiver of any other
breach of the same or any other covenant, condition or duty of the Tenant. No such consent or
waiver shall be valid unless in writing, signed by the Landlord, and no such consent or waiver shall
be implied by the failure of the Landlord to declare a forfeiture or for any other reason.
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19. Subletting of Premises by Tenant
Except as may be permitted in Paragraph 6, Tenant may not assign, transfer, mortgage,
pledge, hypothecate or encumber this Lease, or an interest therein, nor sublet the Premises or any
part thereof, nor permit the use of the Premises by any person other than the Tenant and its
employees, without the prior written consent of the Landlord. Consent to one assignment or
sublease shall not eliminate or waive this provision, and all other assignments and subleases shall
likewise be made only upon the prior wntten consent of the Landlord pursuant to the provisions of
this Paragraph.
20. Surrender of Premises Upon Termination
The Tenant covenants and agrees that upon the termination of this Lease, whether by lapse
of time or otherwise, it will, at once, peaceably and quietly, vacate, surrender and deliver up to the
Landlord, all of the Premises in as good condition and repair as upon delivery of possession to the
Tenant,ordinary wear and tear and damage by fire or other casualty only excepted.
21. Time
It is covenanted and agreed between the parties hereto that time is of the essence in this
Lease and this provision shall apply to all terms and conditions contained herein.
22. Mutual Covenants
Except as hereinbefore or otherwise specifically provided, the covenants, agreements,
conditions, obligations and provisions herein contained shall extend to,bind and inure to the benefit
of the parties hereto and their respective personal representatives, heirs, successors and assigns, and
wherever either the word "Landlord" or "Tenant" is used in this Lease, it shall be deemed to mean
"Landlords" or "Tenants", respectively, wherever the context permits or requires, and when the
singular and/or neuter pronouns are used herein, the same shall be construed as including all
11
persons and corporations designated respectively as Landlord or Tenant in the heading of this
instrument wherever the context requires.
23. Attorneys' Fees
Landlord and Tenant each agree to pay to the prevailing party, on demand, all costs and
expenses and reasonable attorneys' fees, including costs and expenses and reasonable attorneys'
fees, at all levels, including bankruptcy and appeal, incurred by the prevailing party with respect to
the enforcement or declaration of any of the rights or remedies or obligations of either of them,
whether arising under this Lease or granted, permitted or imposed by law or otherwise, and with
respect to the collection of any part of said rent or other charges and sums of money herein reserved
or required by either of them to be paid or met.
24. No Partnership
Landlord does not, in any way or for any purpose, become a partner of Tenant in the
conduct of Tenant's business or otherwise, or a joint venturer, or member of a joint enterprise with
Tenant.
25. Liability of Landlord
Landlord shall not be responsible in any manner for any loss of or damage to the
Premises, or injury to persons resulting, occurring on or about the transfer station, by reason of
any future condition, defect, matter, thing, action or inaction, or for the acts, omissions or
negligence of other persons or Tenant in or about said premises, unless said injury or loss results
from the direct negligence of Landlord. Nothing herein shall be construed as a waiver, either in
whole or in part of Landlord's right of sovereign immunity as provided by Section 768.28,
Florida Statutes, or its successor.
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26. Dispute Mediation
Any dispute arising out of this Agreement, the construction, interpretation or performance
thereof, shall be submitted to non-binding mediation by a duly qualified and certified mediator
practicing in Lake County, Florida, and no action at law or in equity shall be filed in any state or
federal court by either party hereto against the other until such time as the mediator has declared
an impasse.
27. Miscellaneous
A. No Discrimination. Tenant agrees that in carrying out its obligations under this
Agreement it will not discriminate in any manner on the basis of race or religion.
B. Tenant Employee Conduct. Tenant personnel shall conduct their actions and
business in accordance with all applicable laws, regulations and policies.
C. Written Notice. Written notice shall be given to the Parties at the following
addresses or such other place or other person, as each Party shall designate by similar notice.
As to Tenant:
Clermont Woman's Club, Inc.
655 West Broome Street
Clermont, Florida 34711
Attention: President
As to the Landlord:
City of Clermont
685 W. Montrose Street
Clermont, Florida 34711
Attention: City Manager
E. Governing Law. This Agreement shall be governed by the laws of the State
of Florida. Venue for any action hereunder shall be in Lake County, Florida.
F. Entire Agreement Severability. This Agreement constitutes the entire
13
agreement between the Parties with respect to the subject matter contained herein and may not be
amended, modified or rescinded, unless otherwise provided in this Agreement, except in writing
and signed by all parties hereto. Should any provision of this Agreement be declared to be
invalid by any act of law or court or administrative determination, the remaining provisions of
this Agreement shall remain in full force and effect unless such provision which is found to be
invalid substantially alters the benefits of the Agreement for either Party.
G. Specific Performance.It is understood and agreed between the Parties that there
will be irreparable damage in the event that this Agreement is not specifically enforced. In the
event any dispute arises under this Agreement, either party hereto shall be entitled to specific
performance of the terms, conditions and agreements set forth in this Agreement. The remedy of
Specific Performance shall be cumulative and not exclusive, and shall be in addition to any other
remedy, which the Parties may have.
IN WITNESS WHEREOF, the Parties hereto have caused this Agreement to be executed
by their duly authorized officers, and copies delivered to each Party, as of the day and year first
above stated.
•
Attest: f
� City of Clermo
Air
Tracy Ackro , City Clerk V Haro d S. Turville, Jr., Mayor
Date: 9J%4LP 1l) 9 /3
ub„. c. 1
Witness Lynn , o i, President �r/
Witness
esL- idecn
Pn =• Name Date: e 030 /3
tness
Printed Name
14
1
L.
AGENCY 12-0055-00 POLICY 964682-72537666 13563(8-03)
SS NESBITT & CO INC
3130 CITRUS TOWER BLVD STE B
CLERMONT, FL 34711
x
08-16-2012 �uto-Owners Insurance
Life Home Car Business
7hel16Rverat:l ophe
Your agency's phone number is (888) 998-2188
P 0 BOX 30660, LANSING, MICHIGAN 48909-8160 • 517-323-1200
AUTO-OWNERS INSURANCE COMPANY
AUTO-OWNERS LIFE INSURANCE COMPANY
HOME-OWNERS INSURANCE COMPANY
OWNERS INSURANCE COMPANY
PROPERTY-OWNERS INSURANCE COMPANY
SOUTHERN-OWNERS INSURANCE COMPANY
CLERMONT WOMANS CLUB
PO BOX 120532
CLERMONT, FL 34712-0532
Thank you for allowing Auto-Owners to handle your Insurance needs
Auto-Owners Insurance Group is financially sound with sufficient reserves to be ranked among the leaders'in the in-
dustry for financial security Our A+ + (Superior) rating by the A M Best Company signifies that we have the finan-
cial strength to provide the insurance protection you need
If your policy is an audited policy, the billing of the audit premium will be included in your regular premium billing
account This premium is due in full upon billing and failure to pay as billed may result in the cancellation of all
policies on the billing account If you have questions on your audit or about your insurance needs, please contact
your agent at the telephone number shown at the top of this letter
Auto-Owners Insurance - The "No Problem" People
* * * * * * * THIS IS NOT A BILL. * * * * * * *
IF ADDITIONAL PREMIUM IS OWED, A BILL WILL BE MAILED SEPARATELY. PLEASE
PAY ANY UNPAID BILLS.
Serving Our Policyholders and Agents for More Than 90 Years —
7
'Agency Code 12-0055-00 Policy Number 964682-72537666
59390(7-08)
NOTIFICATION OF POSSIBLE CHANGES IN COVERAGE FOR
TERRORISM
•
Dear Policyholder
The Terrorism Risk Insurance Act (including ensuing Congressional actions pursuant to the Act) will expire on De-
cember 31, 2014 unless the Federal Government extends the Act. What this means to you is the following
1 Subject to policy terms and conditions, the enclosed policy will provide insurance coverage for certified acts of
terrorism as defined in the Act only until December 31, 2014.
2 A conditional endorsement entitled, Conditional Exclusion Of Terrorism Involving Nuclear, Biological Or Chemi-
cal Terrorism (Relating To Disposition Of Federal Terrorism Risk Insurance Act) is enclosed This conditional
endorsement will only apply if the Act is not extended or if the Act is revised to increase statutory deductibles,
decrease the federal government's share in potential losses above the statutory deductibles, change the levels,
terms or conditions of coverage and we are no longer required to make terrorism coverage available and elect
not to do so. It will not apply if the Act is simply extended
3. The conditional endorsement will provide coverage for an incident of terrorism pursuant to the terms and con-
ditions of the policy only if the incident does not involve nuclear, biological or chemical material
4 A premium charge for the conditional endorsement will be applied effective January 1, 2015. The premium will
be prorated for the remainder of the policy term and is one-half of the current premium charge appearing in the
Declarations for TERRORISM - CERTIFIED ACTS. However, it will only be made if the Terrorism Risk Insurance
Act (including ensuing Congressional actions pursuant to the Act) is not extend Revised Declarations will be
mailed to you after January 1, 2015.
5. If the Act is extended without any revision, the enclosed policy will continue to provide coverage for certified
acts of terrorism. The conditional endorsement will not be activated and the changes in coverage or premium
referenced above will not apply.
6. If the Act is extended with revisions or is replaced, and we are required or elect to continue to offer coverage
for certified acts of terrorism, we may amend this policy in accordance with the provisions of the revised Act or
its replacement
This notice is for informational purposes only
If you have any questions concerning your policy or this notice, please contact your Auto-Owners agency.
'ciOuthern_Owners Page 1 55039 (11-87)
Issued 08-16-2012
INSURANCE COMPANY TAILORED PROTECTION POLICY DECLARATIONS
6101 ANACAPRI BLVD. , LANSING, MI 48917-3999
Renewal Effective 10-01-2012
AGENCY SS NESBITT 8 CO INC
12-0055-00 MKT TERR 051 (888) 998-2188 POLICY NUMBER 964682-72537666-12
INSURED CLERMONT WOMANS CLUB
Company POLICY TERM
ADDRESS PO BOX 120532 Bill 12:01 a.m. 12:01 a.m.
CLERMONT, FL 34712-0532 - 10-01-2012 to 10-01-2013
In consideration of payment of the premium shown below, this policy is renewed. Please attach this
Declarations and attachments to your policy. If you have any questions, please consult with your agent.
COMMON POLICY INFORMATION
BUSINESS DESCRIPTION: Womens Club
ENTITY: Nonprofit Organiz
PROGRAM: Service
THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PART(S). PREMIUM
THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT.
COMMERCIAL PROPERTY COVERAGE $64.00
MINIMUM PREMIUM ADJUSTMENT (CP) 67.00
COMMERCIAL GENERAL LIABILITY COVERAGE 481.00
SURTAX 0.61
FLORIDA EMERGENCY TRUST FUND SURCHARGE 4.00
FLORIDA HURRICANE CATASTROPHE FUND ASSESSMENT 7.00
CITIZENS PROPERTY INSURANCE CORPORATION EMERGENCY ASSESSMENT 5.45
TOTAL $629.06
FORMS THAT APPLY TO ALL COVERAGE PART SHOWN ABOVE (EXCEPT GARAGE LIABILITY, DEALER'S
BLANKET, COMMERCIAL AUTOMOBILE, IF APPLICABLE)
55156 (03-95) IL0017 (11-85)
Countersigned By: SS NESBITT & CO INC
Page 2 54104 (07-87)
SOUTHERN-OWNERS INS. CO. Issued 08-16-2012
AGENCY SS NESBITT & CO INC Company POLICY NUMBER 964682-72537666-12
12-0055-00 MKT TERR 051 Bill
INSURED CLERMONT WOMANS CLUB Term 10-01-2012 to 10-01-2013
- COMMERCIAL PROPERTY COVERAGE
COVERAGES PROVIDED
-
INSURANCE AT THE DESCRIBED PREMISES APPLIES ONLY FOR COVERAGES FOR WHICH A LIMIT OF
INSURANCE IS SHOWN.
LOCATION 001
ADDITIONAL FORMS THIS LOCATION: None
LOC 001 BLDG 001 655 W Broome St
Clermont, FL 34711-2101
OCCUPIED AS: Womens Club
COVERAGE: Personal Property Limit of Insurance $10,770
CAUSES OF LOSS COINSURANCE DEDUCTIBLE RATE PREMIUM
Basic Group I 90% $250 0.403 $43.00
Basic Group II 90% 250 0.155 17.00
Broad 90% 250 0.024 3.00
OPTIONAL COVERAGE:
Inflation Guard Factor
Personal Property
1.037
ADDITIONAL FORMS THIS BUILDING: 55081 (08-88) IL0003 (11-85) IL0175 (09-93)
59350 (01-08) 54355 (07-07) 54093 (03-07) 54850 (08-07) 54851 (08-07)
54343 (08-07) CP0090 (07-88) CP0010 (10-91) 54081 (02-05)
SECURED INTERESTED PARTIES: None
RATING INFORMATION
Territory: 350 County: Lake
Program: Service Construction: Frame
Class Rate - Contents: 0.602
PC: 03 Class Code: 0756
TERRORISM - CERTIFIED ACTS SEE FORM 59350 $1.00
LOCATION 001 PREMIUM $64.00
ciouthern-Owners Page 3 55040 (11/87)
Issued 08-16-2012
INSURANCE COMPANY TAILORED PROTECTION POLICY DECLARATIONS
6101 ANACAPRI BLVD. , LANSING, MI 48917-3999
Renewal Effective 10-01-2012
AGENCY SS NESBITT & CO INC
12-0055-00 MKT TERR 051 (888) 998-2188 POLICY NUMBER 964682-72537666-12
INSURED CLERMONT WOMANS CLUB
Company - POLICY TERM
ADDRESS PO BOX 120532 Bill 12:01 a.m. 12:01 a.m.
CLERMONT, FL 34712-0532 10-01-2012to 10-01-2013
In consideration of payment of the premium shown below, this policy is renewed. Please attach this
Declarations and attachments to your policy. If you have any questions, please consult with your agent.
COMMERCIAL GENERAL LIABILITY COVERAGE
LIMITS OF INSURANCE
General Aggregate $1,000,000
(Other Than Products-Completed Operations)
Products-Completed Operations Aggregate 1,000,000
Personal Injury And Advertising Injury 1,000,000
Each Occurrence 1,000,000
Damage to Premises Rented to You (Fire Damage) 50,000 Any One Premises
Medical Payments 5,000 Any One Person
Twice the "General Aggregate Limit", shown above, is provided at no additional
charge for each 12 month period in accordance with form 55300.
AUDIT TYPE: Non-Audited
FORMS THAT APPLY TO THIS COVERAGE: 59350 (01-08) IL0021 (11-85) IL0017 (11-85)
55146 (06-04) 55160 (12-04) 55300 (07-05) 55296 (09-09) 55376 (04-11)
LOCATION OF PREMISES YOU OWN, RENT OR OCCUPY
LOC 001 BLDG 001 655 W Broome St
Clermont, FL 34711-2101
TERRITORY: 006 COUNTY: Lake
Premium
Classification Subline Basis Rates Premium
CODE 41667 Area Each 1000
Clubs - Civic, Service Or Social - Prem/Op 1,612 281.326 $453.0
Having Building Or Premises Owned Or
Leased
Including Products And/Or Completed
Operations
(For-Profit)
CODE 44276 Area Each 1000
Halls Prem/Op 380.727 $1.0
Including Products And/Or
Completed Operations
(For-Profit)
• Page 4 55040 (11/87)
SOUTHERN-OWNERS INS. CO. Issued 08-16-2012
AGENCY SS NESBITT & CO INC Company POLICY NUMBER 964682-72537666-12
12-0055-00 MKT TERR 051 Bill
INSURED CLERMONT WOMANS CLUB Term 10-01-2012 to 10-01-2013
COMMERCIAL GENERAL LIABILITY COVERAGE
-
CODE 48557 Locations Each 1
Social Gatherings And Meetings-On Prem/Op 1 23.145 $23.0(
Premises Not Owned Or Operated By
The Insured-Including Products And
Or Completed Operations
(For-Profit)
TERRORISM - CERTIFIED ACTS SEE FORM 59350 $5.00
LOCATION 001 PREMIUM $482.00
Agency Code 12-0055-00 Policy Number 964682-72537666
59350 (1-08)
CAP ON LOSSES FROM CERTIFIED ACTS OF TERRORISM
AND
IMPORTANT INFORMATION REGARDING TERRORISM RISK INSURANCE COVERAGE
It is agreed.
1. With respect to any one or more certified acts of terrorism, we will not pay any amounts for which we are not
responsible because of the application of any provision which results in a cap on our liability for payments for
terrorism losses in accordance with the terms of the federal Terrorism Risk Insurance Act of 2002 (including en-
suing Congressional actions pursuant to the Act)
2. Certified act of terrorism means any act certified by the Secretary of the Treasury, in concurrence with:
a. the Secretary of State; and
b. the Attorney General of the United States
to be an act of terrorism as defined and in accordance with the federal Terrorism Risk Insurance Act of 2002
(including ensuing Congressional actions pursuant to the Act).
3. Under the federal Terrorism Risk Act of 2002 (including ensuing Congressional actions pursuant to the Act) a
terrorist act may be certified.
a. if the aggregate covered commercial property and casualty insurance losses resulting from the terrorist act
e ccee f$5 million, and
b. (1) if the act of terrorism is.
a) a violent act, or
b) an act that is dangerous to human life, property or infrastructure, and
(2) if the act is committed:
a) by an individual or individuals as part of an effort to coerce the civilian population of the United
States, or
b) to influence the policy or affect the conduct of the United States government by coercion
All other policy terms and conditions apply.
Page 1 of
Agency Code 12-0055-00 Policy Number 964682-72537666
1. •
IMPORTANT INFORMATION REGARDING TERRORISM RISK
INSURANCE COVERAGE
The Terrorism Risk Insurance Act of 2002 was signed into law on November 26, 2002 The Act (including ensuing
Congressional actions pursuant to the Act) defines an act of terrorism, to mean any act that is certified by the Sec-
retary of the Treasury, in concurrence with the Secretary of State and the Attorney General of the United States to
be (i) an act of terrorism, (ii) to be a violent act or an act that is dangerous to human life, property or infrastructure,
(iii) to have resulted in damage within the-United States or outside the United States in the case of certain air carri-
ers or vessels or the premises of a United States mission, and (iv) to have been committed by an individual or indi-
viduals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect
the conduct of the United States government by coercion.
Subject to the policy terms and conditions, this policy provides insurance coverage for acts of terrorism as defined
in the Act.
Any coverage for certain commercial lines of property and casualty insurance provided by your policy for losses
caused by certified acts of terrorism are partially paid by the federal government under a formula established by
federal law Under this formula, the government will reimburse us for 85% of such covered losses that exceed the
statutory deductible paid by us You should also know that in the event aggregate insured losses exceed $100 billion
during any year the Act is in effect, then the federal government and participating United States insurers that have
met their insurer deductible shall not be liable for the payment of any portion of that amount of the loss that exceeds
$100 billion. In the event that aggregate insured losses exceed $100 billion annually, no additional claims will be
paid by the federal government or insurers. This formula is currently effective through December 31, 2014
The premium charge, if any, for this coverage is shown separately on the attached Declarations page. In the event
of a certified act of terrorism, future policies also may include a government assessed terrorism loss risk-spreading
premium in accordance with the provisions of the Act.
Please contact us if you would like to reject coverage for certified acts of terrorism
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