CERTIFICATE OF LIABILITY INSURANCE (14)^H " 42A'30
r_I FAQrnMNll1
ACORDrrn CERTIFICATE OF LIABILITY INSURANCE 1DATE (MMIDONYrY)
1/04/2010
PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION
Gowrie Group ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
70 Essex Road ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Westbrook, CT 06498
860 399-5945 INSURERS AFFORDING COVERAGE NAIC #
INSURED INSURERa Federal Insurance Company 20281
Clearwater Community Sailing Assoc.,Inc INSURER B:
1001 Gulf Blvd. INSURER C:
Clearwater, FL 33767 INSURER D:
INSURER E:
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
ANY REQUIREMENT
,
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.
L INSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
A GENERAL LIABILITY 35823516 11/06110 11/06/11 EACH OCCURRENCE $1,000,000
X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
wcel S1,000,000
CLAIMS MADE 7 OCCUR MED EXP (Any one person) $10.000
PERSONAL & ADV INJURY $1,000,000
GENERAL AGGREGATE $2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $included
1 7 POLICY PRO- LOC
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
$
ANY AUTO (Ea accident)
ALL OWNED AUTOS BODILY INJURY
$
(Per person)
SCHEDULED AUTOS
HIRED AUTOS BODILY INJURY
$
(Per accident)
NON-OWNED AUTOS
PROPERTY DAMAGE
H
(Per accident) $
GARAGE LIABILITY AUTO ONLY-FA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESSIUMSRELLA LIABILITY EACH OCCURRENCE $
OCCUR F1 CLAIMS MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WC STATU-
COMPENSATION AND OR
EMPLOYERS' LIABILITY
E_L. EACH ACCIDENT
$
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $
If yes, describe under
SPECIAL PROVISIONS below
E.L. DISEASE - POLICY LIMIT
$
OTHER
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
The City of Clearwater is named as Additional Insured/Landlord on General
Liability Policy only ATIMA with respect to insured's use of holder
premises.
rcoTlclr%Arc unl 11C0 rANI'FI 1 ATIfIN
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
City of Clearwater DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL I0_ DAYS WRITTEN
25 Causeway Boulevard NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
Clearwater, FL 33767 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTAT VE
ACORD 25 (2001/08) 1 of 2 #S40947/M40946 IVIED 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.
A[:URD 25-5 (2009108) 2 of 2 #S40947(M40946