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CERTIFICATE OF LIABILITY INSURANCE (140)ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDUNYYYI 5/11/2010 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF (NFORMA71ON Willis of Illinois, Inc. 233 S. Wacker Dr ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Ste 2000 Chicago IL 60606 INSURERS AFFORDING COVERAGE NAIL INSURED IN5URERA:Lexin on Insurance Company. 9437 H.W. Lachnerr TaC. INSURERB: Mr. Paul Blackowicz 20 N Wacker Drive Suite 1200 INSURERC: . , Chicago IL 60606 INSURERD: INSURER E: COVERAGES 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 HE 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. _ INSR. LTR DD' N SR TYPFOFINSURANCE POLICYNIIMBER POLICYEFFFCTNE D POL3GYE7LPIRATLON ---- LIMBS GENERALLWBILLTY EACH OCCURRENCE $ ' COMMERCIAL GENERAL. LIABILITY DAMAGE TO RENTED PREMISES Eao=wm $ CLAIMS MADE 17 OCCUR MEDEXPIAnywaDmon) $ PERSONAL &ADV INJURY GENERAL AGGREGATE $ _ GEN'L AGGREGATE U MIT APPLIES PER: PRODUCTS-COMPIOPAGG, $ POLICY IRI LOC AUT OMOBILE LIABILITY COMBINED SINGLE LIMfi ANYAUTO (Ea accldenl) S ALLOWNEDAUTOi BODILY INJURY SCHEDULEDAUTOS (Parperwn) $ HIRED AUTOS BODILY INJURY NON-OWNEDAUTOS (Perneddenl) $ - - PROPERTYDAMAGE -•--- - - ; (Pelecridenl) GARAGEL.IABILITY AUTO ONLY -EA ACCIDENT $ ANY AUTO OTLIERTHAN EAAGC S AUTOONLY: AGG $ EXCrSSIUMBRELLA LIABILITY EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE. 5 DEDUCTIBLE _ $ , I RETPNTI06N X WORKERS COMPENSATION AND WCSTATU• OTH- [TOR I]Ti Es EMPLOYERS LWB[EJTY ANY PRE)PR[ETORfPARTNERlEXECIIT]V!s E.L. EACH ACCIDENT - $ OFFICERIMEMBEREXCLUDED? - EL.DISEASE -EAEMPLOYEE $ If yes,. de_vrn be valor SPECIAL PROVISIONShelow , E.L. DISEASE - POLICY LIMIT $ A OTHER 044177432 6/1/2010 5/1/2011 $1,00(),0©0 Per Claim Professional Liability $1,000,000 Aggregate DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY EN DORSEMENTI SPECIAL PROVISIONS *Except for Non-Payment, 10 Days. I L rILjL jr-K City of Clearwater Attention: City Clerk P.O. Box 4748 Clearwater FL 33758.4748 ACORD 25 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELL&I] BEFORE THS EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO T14E LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. TIOW 1ARR