CERTIFICATE OF LIABILITY INSURANCE (3)
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iaD~A. CERTIFICATE O'F LIABILITY INSURANCE 3/12 08
~lIcERAll1ed Specla ty Insurance, Inc THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
10451 Gulf Blvd. ~t~t:~~gN[~:T1F~c?A~~~~~~l':,~~5~~~bEOR
Treasure Island, FL 33706 '
800/237-3355
INSURED Emerald Coast Bungee, Inc,
915 Lantana Avenue
Clearwater FL 33767
INSURERS AFFORDING COVERAGE
INSU'lEA A' T. H. E. Insurance
~Fl8:
THE POlICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO 1HE INSURED NMtED ABOVE FOR THE POUCY ~R10D INDlCAlED. NCJ'T\II4THSTANDlNG
ANY REQUIREMENT, TERM OR CONDITION OF AHV CONTftACT OR OTHER DOCUMENT'MI1i RESPECT 10 WHICH nns CERTlF1CATE MAY BE IssueD OR
MAY PERTAIN. THE INSURANCEAFFOUJED BY THE POUCIES DESCRIBED HERSN IS SUBJECT TO ALl THE TERMS, EXCLUSIONS AND CONDITlONS OF SUCH
POL.ICIES. AGGREGATE UMIlS SHOM MAY HAVE BEEN REDUCED BY PAID ClAIMS..
I!'l.!!l ~P..'r! POLICY 1(1- POLICY EFFEC1lVE POLleY ElCPlRAllON I.MTS
~ ERAL UAIIIUTV EACH OCClJRREtlCE $ 1,000,000
11 X COMMERCLM. SENEmL/TY M8LF6960 03/11/08 03/11/00 DAMAaETORaIIl'eD 50,000
I
I ClAIMS MADE X ~ MI!D_,AIhr___l .
i-- & ADV IN,lURV $ 1.,000,000
:-- GENERAL~T1! . 2,000,000
~~AGGf&iUMlT APflPER: - COUFYQP AGO s 1,000,000
PO.JCY ~ tOe
:j::a;~ COMBINED SJlGLE UNIT $
tea_elM"
, ALL Ol/IINED AUTOS BODIt. Y ttlURY' $
_ SCHEDULED AUTOS ll"er plllSOl1)
- HIRl:DAUTOS BODILY INJURY'
(Pw~ $
- NON-OWNED AUTOS
PROPERTY DlWAGE S
(Par MXIClC1\)
~GlE LlABIUTY .wro OfolLY. eA ACCIDENT S
AH't AUTO OTHER'T1-WI EA ACe s
AUltl otlL'I': AGO S .
EXCE8SIUM8REUA UABUlY EACH OCCURI'lENCE S
o CX:CUR 0 CUlIIIIS MACe AGGREGATE s
s
R DEDUCTIBL.E .
ReTENT10N . I
WORKERI COMPENSA11OIf AHO I ~rovsr~ I I~
eMPUWERr I.IABIU1Y E) "ArM ~IOEiIIT S
ANY PROPRIETClM"ARTNERIEXECUTIVe
OFFICER/MEIlISER exCLUDED? U. DISEASE- EA EMPLO'tEE I
~L~.<<!'1CItbe under SoL. DtSEASl!!- POUCY LIMIT '"
011lER
DESCRIP110N OF OPERATlCNSI LOCA'J1Ol'flI' \lElt1CLe81 EllCWSlONS ADDID In' BfIlORSl!MEIIT' SPECIAL PROVI8lOfIS
ADDITIONAL INSURED: CITY OF CLEARWATER AS RESPECTS TO THE OPERATION OF THE
NAMED INSURED ONLY,
CITY OF CLEARWATER
100 MYRTLE AVENUE
CLEARWATER FL 33767
SHOULD ANY OF 1HIi ABOVE! DESCflIIIED POUCIES Be CAllCEU.EO BEFOIU! 'n41l ElIPIRAnoN
DATE TMEREOF, THE ISSIMlG ....S\IRER WLL eNDEAVOR TO MAL -1Q... DAYS WRJTnN
NOnCE TO ne Cl!R11F1CATE! HolDeR NAMED TO llCE UFT, BUT FAILURe TO DO so SHALL
IIIW08B NOOBUGA11ON DR UAEIIUTVOF ANVNNOUPOilllHe lNSUflER, ITS AGEIiITSOR
AU
ACORD 26 (2001108)