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CERTIFICATE OF LIABILITY INSURANCE (82)
CERTIFICATE OF LIABILITY INSURANCE 5DATE /15/2009) PRODUCER (727) 391-9791 FAX: (727 3 ?g3 ,,d 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stahl & Associates Insurance, Ingbg VC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 110 Carillon Parkway MAY 18 2009 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. - St_ Petersburg FL 33">B' ManaQer's office INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A' AmerlSUra Mutual Ins Co JMC Development Corp. INSURERBAmerlsure Insurance Co JMC Design & Development Inc. INSURER C 2201 4th St' Nr Suite 200 INSURER D: St P$tersburcr FL 33704 WRI IR FR F' nnVFRAnFC 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 OFSUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L POLICY NUMBER E INSURANCE EFFECTIVE' DATEPOLICYM M/DD/YYYY POLICY EXPIRATION DATE MM/DD/YYYY ^-----..L.IMIT----- ITS __GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES LEa occurrence) S300,000 .A CLAIMS MADE Y OCCUR L2027887 5/1/2009 5/1/2010 MED EXP (Any one person) S 5,000 X j Blanket Add Insured PERSONAL&A _--DV INJURY $ 1,000 000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S 1,000,000 POLICY X PRO- LOG AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT ? X ANY AUTO (Ea accident) $ 1,000,000 A ALL OWNED AUTOS 027550 5/1/2009 5/1/2010 BODILY INJURY SCHEDULED AUTOS (Per person) $ -- HIRED AUTOS BODILY INJURY P id t $ NON-OWNED AUTOS er acc en ) ( PROPERTY DAMAGE $ (Per accident) G_A_ RAGE LIABILITY ) AUTO ONLY - EA ACCIDENT $ - ANY AUTO MAY ` O EA ACC OTHER THAN $ AUTO ONLY: AGG $ EXCESS/ UMBRELLA LIABILITY . EACH OCCURRENCE $ I I OCCUR CLAIMS MADE i ( AGGREGATE - $ --- $ DEDUCTIBLE $ RETENTION WORKERS COMPENSATION X TU- OTH_ TORY I MIT$ _ _E R Y ____ _ J ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT S 500,_0. 00 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) C1385656 5/1/2009 5/1/2010 E. L. DISEASE - EA EMPLOYE $ ,]00,000 IF yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER i DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Re: Marquesas, LLC. Certificate Holder is listed as additional insured with respects to General Liability ATIMA CERTIFICATE HOLDER CANCELLATION City Of Clearwater Attn: City Manager PO Sox 4748 Clearwater, FL 33758-4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Kelly Petzold/GREEN ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200901) The ACORD name and logo are registered marks of ACORD 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- This Certificate of Insurance 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 (2009/01) NS025 (200901