CERTIFICATE OF LIABILITY INSURANCE (6)Wells Fargo 1/23/2008 2:21:Ub PM YAUt G/UU:j tax berver
ACORDY CERTIFICATE OF LIABILITY INSURANCE DATE (MM/OD/YYYY)
1/23/2009
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
wells Fargo ins services Southeast, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
P o sox 31666 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Tampa FL 33631-3666 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
(727) 796-6666
INSURERS AFFORDING COVERAGE NAIL #
INSURED INSURERA: markel International Ins CO Li
Field's, Inc- DHA INSURER 8:
Barefoot Beach House
P.O. Sox 3337 INSURER C:
Clearwater Beach FL 33767 INSURER D:
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE PO
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W
MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TER
POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 7
.?.. ..___ ?...,?..?..,...,....,..? POLICY NUMBER P?°TEYAAhVOD1YlYE PDATE6XWDD1Y0N
I GENERAL LIABILITY
A X COMMERCIAL GENERAL LIABILITY O9.C52263
CLAIMS MADE XX OCCUR
GENT AGGREGATE LIMIT APPLIES PER
7 POLICY F] JFr.T F7 PRO LOC
AUTOMOBILE UABWTY
ANY AUTO
ALL OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
1/14/2009 1 1/14/2010
I L.'
I
JA 2 7 A
%GE UABIUTY
ANY AUTO
EXCESS/UMBRELLA LIABILITY
OCCUR 71 CLAIMS MADE
DEDUCTIBLE
RETENTION S
WORKERS COMPENSATION AND
EMPLOYERS' LI ABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE
OFFICERIMEMBER EXCLUDED?
H yes, desarihe Under
SPECIAL PROVISIONS below
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES) EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
Florida statute mandates 10 day cancellation notice fox nonpayment of premi
Re: 332 south Gulf Blvd, Clearwater, FL 33767
Rental of Beach Chaise, umbrellas and cabanas.
The City of Clearwater is additional insured as respects General Liability.
.ICY PERIOD INDICATED. NOTWITHSTANDING
iICH THIS CERTIFICATE MAY BE ISSUED OR
05, EXCLUSIONS AND CONDITIONS OF SUCH
LIMITS
EACH OCCURRENCE S 000 00
DAMAGE TO RENTED 50
000
PREMISES Eaomurenoe $
,
MED EXP An one rsen $ 2,000
PERSONALS ADV INJURY S 1,000,000
GENERAL AGGREGATE $ 2,000,000
PRODUCTS - COMP/OP AGO $ 1,000,000
COMBINED SINGLE LIMIT $
(Ea maidens)
BODILY INJURY $
(Per Person)
BODILY INJURY $
(Per waidenl)
PROPERTY DAMAGE $
(Per xadder")
AUTO ONLY - EA ACCIDENT $
OTHERTHAN EA ACC $
AUTO ONLY; AGO S
EACH OCCURRENCE $
AGGREGATE S
S
WC STATU• OTH-
E.L. EACH ACCIDENT $
E.L. DISEASE - EA EMPLOYE $
E.L. DISEASE - POLICY LIMIT $
um.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN
city of Clearwater
A DDunicipal Corporation NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
25 Causeway Blvd IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
Clearwater FL 33767 AUTHORIZED REPRESENTATIVE
ii
ACORD 25 (2001/08) CQ ACORD CORPORATION 1988
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wells f'argo 1/"L3/ ZUUU G : L1 : U0 rri rHun Of vva r4LA Oux vc.L
1/23/2009
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 (2001/0)
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