CERTIFICATE OF LIABILITY INSURANCE (12)J
Client#• 13438
CLEARCO MU
ACORDr. CERTIFICATE OF LIABILITY INSURANCE
DATE
1117/08 (MMIDDIY ')
1
PRODUCER
Gowrie, Barden & Brett, Inc.
70 Essex Road THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Westbrook, CT 06498
860 399-5945
INSURERS AFFORDING COVERAGE
NAIC #
INSURED INSURER A: Federal Insurance Company 20281
Clearwater Community Sailing Assoc.,lnc INSURER B:
1001 Gulf Blvd.
INSURER C:
Clearwater, FL 33767 INSURER D:
INSURER E:
COVERAGPS
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.
LTR NSR TYPE OF INSURANCE POLICY NUMBER DALTEYMM/DD EFFECTIVE POLICY MMIDD/Y
YI
LIMITS
A GENERAL LIABILITY 35823516 11/06108 11106109 EACH OCCURRENCE $1.000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
R occurrence)
$1,000,000
CLAIMS MADE FRI OCCUR MED EXP (Any one person) $10,000
PERSONAL & ADV INJURY $110001000
GENERAL AGGREGATE s2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $included
POLICY PRO LOC
JECT
AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT
$
(Ea accident)
ANY AUTO
ALL OWNED AUTOS BODILY INJURY
$
(Per person)
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
$
(Per accident)
NON-OWNED AUTOS
PROPERTY DAMAGE
(Per accident) $
GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC. $
F AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
OCCUR F_] CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WC STATU- OTH-
WORKERS COMPENSATION AND TORY
EMPLOYERS' LIABILITY
E.L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
The City of Clearwater is named as Additional Insured/Landlord on General
Liability Policy only ATIMA with respect to insured's use of holder
premises.
TE HOLDER
City of Clearwater
25 Causeway Boulevard
Clearwater, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1Q DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
ACORD 25 (2001/08) 1 Of 2 #S27453/M27452 MED O ACORD CORPORATION 1933
i,.
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 WAIVED, 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-S (2001/08) 2 of 2 #S27453/M27452