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, <br />nPt.nl'ete n'A 0' ic;; . <br />ii! t!tc followi'�� informhtiori: <br />riau:e of insured <br />acme of irisurar ce carrier <br />name cf insurnnce aj;erx <br />policy no. Q_1JL effective dote of coverageJ:iCQ <br />aunt of coverstLe; Public lieLility, per person, per ocrur•nce <br />Public ':ability, per occurenc.e 10�boo <br />10. Seciu-i'..y and rolicine of the Jointly user dz­�k e.rd property is ).,rovided by <br />(check er:p)iceble items): <br />_..__ Pe acing. securit ) ighting. property cwcber's prersence. <br />contra^t security eer 'ce. other {$peciPyl <br />IrCK IPII'OFW,TTON <br />11. List Dock Uee Area Specific !uns: <br />W-3th of shoreline; I _ ft. I&%gtt, of me.{rr dock frrri chore; 5_ ft. <br />Dock settacks frog, side *_,mpe:-ty lines at shore; L_ ft. and 35ft. <br />12. DDck Construction (check al piiceble items): <br />_L_ seasonal deck (relocpted r r rep)a :^! i each year) . <br />— renranent pili.nf; wlt�i seasonal deck. permanent piling and decking. <br />__._. w«oden decking. _.._ metal decking. <br />13. Lint Dock A.ccesrories: <br />Number of fire extinguishers evailer_.e at the do,�K 1 <br />Number of life preservers available at thu dock Q <br />14• List number of slips in tech category ("flips" inc ules boot sifts): <br />Transient (day use on)y) slits . Transient (de; use) off-sho. joys <br />Permanent naoraye slips , ?ersene-+t wx raeo oft-sh-re buoys C,_. <br />Dry storage ( rack) s11j,s D.Wiximire nusrber of ''boats at the dock _. <br />I$. List number of off-street lsrrcirs Ppacas avallable for users of the joint u e <br />bock. IvAing, 4f ) rr`vided must not l.P se,Mreted fmir the dock by wny public <br />rood. s;eces . <br />3 � r ►, <br />