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CERTIFICATE OF LIABILITY INSURANCE (9)ACORDTM CERTIFICATE OF LIABI PRODUCER Commercial Lines - (727) 796-6666 Wells Fargo Insurance Services USA, Inc. 311 Park Place Boulevard, Suite 400 Clearwater, FL 33759-3923 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Road Clearwater, FL 33759 14795 L ITY INSURANCE DATE (MM/DDfYYYY) 1 5/20/2010 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. INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Zurich Insurance Company 40142 INSURER B: Florida Hospitality Mutual INSURER C: INSURER D: INSURER E: PERIOD INDICATED. NOTWITHSTANDING 3 CERTIFICATE MAY BE ISSUED OR {CLUSIONS AND CONDITIONS OF SUCH LIMITS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED $ 100,000 MED EXP (Any one-person) S 10,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMPIOP AGG $ 2,000,000 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY $ (Per person) BODILY INJURY $ (Pereccldent) PROPERTY DAMAGE S (Per accident) AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC $ AUTO ONLY: AGG $ EACH OCCURRENCE S 10,000,000 AGGREGATE $ 10,000,000 $ $ X WC STATU- OTH- _ E,L- EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE S 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1.000.000 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THI MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, E POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR D• POLICY EFFECTIVE POLICY EXPIRATION LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE DNY DATE MMID Y A GENERAL LIABILITY CP0278060506 05/31/2011 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE Fx I OCCUR AY 2 4 2010 1E1'L AGGREGATE LIMIT APPLIES PER: INL POLICY j ;, X LOC OFFkND A AUTOMOBILE LIABILITY CP0278060506 /31/2011 X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS RECEIVED X HIRED AUTOS CI OF CLEARWATER X NON-OWNED AUTOS AY 2 12010 GARAGE LIABILITY 9173 I ANY AUTO A EXCESS/UMBRELLA LIABILITY UMB967294101 05131/2010 05/31/2011 X OCCUR F1 CLAIMS MADE DEDUCTIBLE X RETENTION $ B WORKERS COMPENSATION AND WC306-0020798-2010 01/01/2010 01/01/2011 EMPLOYERS' LIABILITY -- ANY PROPRIETOWPARTNER'/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CITY IS ADDITIONAL INSURED FOR INTEREST HELD IN PREMISES OF RUTH ECKERED HALL. TE CITY OF CLEARWATER ATTN: LEO SCHRADER, RISK MGMT P O BOX 4748 CLEARWATER FL 33758-4748 CANCELLATION en Day Notice for Non-Payment SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION 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 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. .-- AUTHORIZED REPRESENTATIVE L//C 1442292 © ACORD CORPORATION 1988 ACORD 25 (2001108) 1 of 2 ACORD. CERTIFICATE OF LIABI PRODUCER Commercial Lines - (727) 796-6666 Wells Fargo Insurance Services USA, Inc. 311 Park Place Boulevard, Suite 400 Clearwater, FL 33759-3923 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Road Clearwater, FL 33759 141,9D LITY INSURANCE DAT5/20/2010 5/20/2010 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. INSURERS AFFORDING COVERAGE NAIC # INSURER A: American Zurich Insurance Company 40142 INSURER e: Florida Hospitality Mutual INSURER C: 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 TERM OR CONDITION O ANY REQUIREMENT F ANY CONTRACT OR OTHER DOCUMENT WITH RESPE CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR , MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EX CLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS D' POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR NSR TYPE OF INSURANCE POLICY NUMBER PATE MM/DD DATE D GENERAL LIABILITY 6 05/31/2010 05131/2011 EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY CP027806050 DAMAGE TO RENTED orcurrencq) REMISES (Fa $ 700,000 CLAIMS MADE 7 OCCUR MED --XP (Any one ucrson) 10,001 PERSONAL a ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 POLICY PRO• X JECT A AUTOMOBILE LIABILITY CP0278060506 05131/2010 05/31/2011 COMBINED SINGLE LIMIT $ 1,000,000 X ANY AUTO l (Ea accident) ++????^ ALL OWNED AUTOS D ? /// C? E BODILY INJURY $ SCHEDULED AUTOS R YYY (Per person) X HIRED AUTOS BODILY $ X NON-OWNED AUTOS J ??10 A 16 (Per accident) . PROPERTY DAMAGE $ ANC /'? (Per accident) GARAGE LIABILITY y`/r C ?'?"?`5 DEFT AUTO ONLY - EA ACCIDENT $ EG1SI 1 A AV E `I G 3 ANY AUTO , OTHER THAN EA AGG S AUTO ONLY: AGG $ A EX CESSIUMBRELLA LIABILITY UMB967294101 05/31/2010 05131/2011 EACH OCCURRENCE $ 10,000,000 X OCCUR F1 CLAIMS MADE AGGREGATE $ 10,000,000 DEDUCTIBLE $ X RETENTION $ ? $ COMPENSATION AND 01/01/2011 X WC I Imil OTH- B WORKERS W(;3UEi-0020798-2010 01/0112010 EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 1,000,000 ANY PROPRIETORIPARTNCR/EXECL'T!VE OFFICERIMEMSER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S 1,000,000 If yes, describe under 7,000,000 E.L. DISEASE - POLICY LIMIT $ SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS PROOF OF GENERAL LIABILITY CANCELLATION Ten Day Notice for Non-Payment CERTIFICATE HOLDER 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, PARKS & NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL RECREATION ATTN: DEBBIE REID IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 100 S. MYRTLE AVE REPRESENTATIVES. CLEARWATER FL 33758 AUTHORIZED REPRESENTATIVE ACORD 25 (2001108) 1 of 2 1442278 0 ACORD CORPORATION 1988 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 #S915260/M915043