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CERTIFICATE OF INSURANCE (10)Date: 4/1/2010 Time: 1:12 PM TO: @ 9,17274626957 = Page: 002 CERTIFICATE OF INSURANCE UATE M = 04/01/2010 PR6OUCtR LEE-S, AND MEO I ED THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND E$ CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE OF INSURANCE DOES NOT AFFIRMATIVELY OR 8722 S. Harrison St. NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED Sandy, UT 84070 BY THE INSURANCE POLICIES BELOW. (801) 304-5500 INSURERS AFFORDING COVERAGE INSURED INSURER A: Wavejammerz, Inc. INSURER B. Prime Insurance Company . INSURER C: 25 Causeway Bd INSURER D: Clearwater Beall, FL 33767 "LIMITS SHOWN ARE THOSE IN COVERAGES EFFECT AS OF POLICY INCEPTION" The policies of insurance listed below have been issued to the insured named above far the policy indicated. Notwithstanding any requirement berm 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 boon reduced by paid cleims- TYPE OF INSURANCE POLICY EFFEcnvE POWCY EXPIRATION POLICY NUMBER D.etE (MMIDo" DATE (6 kMI)ITY) LIMITS W C I I SC1003585 4/1/2010 4/12011 $100,000 Per Person Q $500,000 Per Accident Claims Made F-1 PRODUCTS $1,000,000 PdicyAggregete © Exuding Products and Complete ? Cmmerclal do L Any Auto AJI Owned Autos Scheduled Autos Hired Autos Ncn-Owned Autos O.T.R.P.D. ? Garage Coverage G. K. L. L. Drive Away D.O-C- Cargo On Hook Contractual Liability Wrongful Repossession Excels Llabillty ? Claims Made LIMITATION OF COVERAGE FOR ADDITIONAL INSURED Liability Coverage is only provided to the Additional Insured with respect to Accidents otherwise covered under the Policy/Coverage Contract where the Insured is found directly liable and not where the Additional Insured is found independently negligent of the Insured. DESCRIPTION OF OPERA'nONILOCATIONSNEHICLES!EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISION Coverage is limited to only insured activities or operations identified in the Policy. Rental - Personal Watercraft & Jet-Skis - receipts, Rental - Bananaboat Boats - units., Rental - Personal Watercraft Bd. Jet-Skis - units. LJ?CIERTIFICATE HOLDER ADDITIONAL INSURED i LOSS PAYEE ILI City of Clearwater - City Marina SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. 25 Causeway Blvd Clearwater Beach, FL 33767 Catherine Yellin AUTHORIZED REPRESENTATIRE DA-F-030 ? 4..7r;?.q-fIa 7.i,Ye r„?3', ? '-w??• Y/ ?LUIV 111114: 1:1L NM TO @ 9,17274626957 Page: 003 ADDITIONAL NAMED INSURED ENDORSEMENT FOR STATE OR POLITICAL SUBDIVISIONS AND U.S. GOVERNMENT AGENCIES RCL-99-13 This Endorsement changes the terms and conditions of the Coverage Contract issued. Please read it carefully! The "Who is a Participating Member7' provision of this Coverage Contract shall include as an additional Named Insured under the Coverage Contract issued, any state, political subdivision, or U.S. government agency so designated in the schedule below ("Additional Named Insured"), subject to the following additional provisions: 1. Coverage applies only to operations performed by or on behalf of the Participating Member for which an Additional Named Insured has issued a permit to the Participating Member, and only with respect to liability arising from the operations of the Participating Member shown on the Participating Member's Declarations Page. 2. No coverage exists for Bodily Injury or Property Damage arising out of operations for which a permit was not issued by an Additional Named Insured. 3. Liability coverage is provided to, and the Insurer has the duty to defend, any Additional Named Insured listed below only with respect to injury, loss, or damage associated with the Participating Member's use and occupancy of State or Federal lands covered by this Coverage Contract. 4. If the Participating Member fails to conduct special permit activities in full compliance with the special representations that are a part of this Coverage Contract, then the Coverage Contract shall nevertheless apply; however, special use permit activities that are not conducted in full compliance with the special representations are subject to an automatic and immediate $5,000 increase of the Participating Members Self-Insured Retention- 5. No Endorsements issued after the initial Coverage Contract shall be added to the Coverage contract without the approval of the Additional Named Insured. 6. The Participating Member may use a participant agreement form approved by the Additional Named Insured. This participating agreement provision supersedes any contrary provision contained in the Policy or any other Endorsement. 7. Should this Coverage Contract be cancelled before the end of its stated term, the Insurer shall give any Additional Named Insured 30 day's prior written notice of such cancellation. If notice to any Additional Named Insured is not provided for any reason, the Participating Member's Coverage Contract will cancel; however, coverage will be provided to any Additional Named Insured through the stated term or until proper notice is delivered. Master Coverage Contract # Certificate # Participating Member: Wavejammerz, Inc. Effective Date: 4/1/2010 Date Issued: 4/1/2010 Additional Named Insured -Designation of State, Political Subdivision, or U-S. Government Agency: City of Clearwater - City Marina Attention: Catherine Yellin 25 Causeway Blvd Clearwater Beach, FL 33767 Endorsement # 1 RCL-99-13 21APR2004 Page 1 of 1