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t <br />I- <br />S.' <br />r,. <br />f-' <br />S . Insurance Coverage - The ^‘ointly used doclc is insured hy one of the folloving: <br />property ovner's nosecvner's policy, <br />eparate group/association owned policy. <br />list the following ini’omaticn: <br />nam» of iDSUTed *0 <br />rmtiM* of insurance carrier __ <br />nmwm of insurance agency ( <br />policy no. ~ ^— <br />.. \sf <br />effective date of coverage *T " (^P* <br />amount of coverage; Public liability, per person, per occurence <br />Public liability, per occurence <br />0-Security and policing of the Jointly used dock and property is provided by <br />(check applicable items): <br />fencing. security lighting. ^<Cproperty owner's presence. <br />contract security service, other (specify) <br />COCK I5F0BMATI0N <br />11.List Dock Ifee Area Specifications: <br />(c^ <br />ft. and ft. <br />12* Dock Construction (check applicable items): <br />seasonal dock (relocated or replaced each year). <br />permanent piling with seascual reck. iS^peimaaent piling and decking <br />wooden decking.metal deck .ng. <br />13. List Dock Accessories: <br />Humber of fire extinguishers available at the dock <br />Humber of life preservers available at the dock _ <br />14. List nuoiber of slips in each category ("slips" includes boat lifts): <br />Transient (day use only) slips . Transient (day iwe) off-shore bwys <br />Permiient ocorage slips (C-. Permanent moorage off-shore buoys ^ <br />Dry storage (rack) slips____________.Maximum nuniber of boa*t8 the dock c. <br />15.List number of off-street parking spaces available for users of the Joint use <br />dock. Parking, if provided must not be separated from the dock by any public <br />road. spaces. <br />3 of 5