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CLEARWATER COMMUNITY SAILING CENTER EXPANSION - 07-0040-MA - CERTIFICATE OF LIABILITY INSURANCE (2)A CORD C E RT I F I CAT E O F L IAB I L I TY I N S U RAN C E DATE (MMIDDIYYYY) 18 08 08 TM / / PRODUCER 1-813-229-8021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION M. E. Wilson Co., Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 300 w. Platt St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ste 200 Tampa, FL 33606 INSURERS AFFORDING COVERAGE NAIC # INSURED i INSURERA: Amerisure Mut Ins Co 23396 R. Krueger Construct on, Inc. INSURERB:Amerisure Ins Co 19488 141 Stevens Avenue, Suite 3 INSURER C: Oldsmar, FL 34677 INSURER D: INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR ADD' INSRD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MMIDDIYY POLICY EXPIRATION DATE MMIDDIYY LIMITS A GENERAL LIABILITY GL2047731 08/15/08 08/15/09 EACH OCCURRENCE $1, 000, 000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurence 100,000 $ CLAIMS MADE ? OCCUR MED EXP (Any one person) $10, 0 0 0 PERSONAL&ADVINJURY $ 1, 000, 000 GENERAL AGGREGATE $ 2, 000, 000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2 , 0 0 0 , 0 0 0 POLICY X JE ? LOC B AUT OMOBILE LIABILITY CA2047732 08/15/08 08/15/09 COMBINED SINGLE LIMIT X ANY AUTO (Ea accident) $1, 000, 000 ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ X HIREDAUTOS BODILY INJURY X NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per accident) $ GA RAGE LIABILITY AUTOONLY-EA ACCIDENT $ ANY AUTO EA ACC OTHER THAN $ AUTOONLY: AGG $ EXCESSIUMBRELLALZABILITY EACH OCCURRENCE $ OCCUR ? CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATIONAND wC2047728 08/15/08 08/15/09 X ORYLAMITS OER EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE E.L. EACH ACCIDENT $ 500, 000 OFFICERIMEMBEREXCLUDED? E.L. DISEASE-EA EMPLOYEE $500,000 If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE-POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS Certificate holder is included as an additional insured as respects general liability when required by written contract Clearwater Community Sailing Center Project CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 410 N. Myrtle Avenue IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Clearwater, FL 33755 USA AUTHORIZED REPRESENTATIVE . '? - y ? ACORD 25 (2001108) DDoo2 9561562 ©ACORD CORPORATION 1988 Certificate Delivery by CertificatesNow - www.ConfirmNet.com - 877.669.8600 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS U1IAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001108)