CERTIFICATE OF LIABILITY INSURANCE (8)3/Z4/2C11 4:05 PM FROM.: 'vermos' Vermo4t TO: 727-4621-6957 PAGE: OF 00:
,
R CERTIFICATE OF LIABILITY INSURANCE GATE (MM 'DD; YYY)
l`, 03124/20„
THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: if the certificate holder is an ADDITIONAL INSURED, the policypes) must be endorsed. 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).
PPODUCEP Pnnne (727) 74E-2886 Fax (727) $2-1991 d'jN7^c7 Vermost & Associates, LLC
NAME'
VERMOST & ASSOCIATES, LLC (727) 577-4991
h a"
(727) 748
2886
-
a
N
CNa EK
14100 U S HWY 19 N SUITE 105 E-MAIL
CLEARWATER FL 33764 P
-
PRCD UC UCEP 12757
CUSTOMER ID
INSURER(S) AFFORDING COVERAGE NAIC i
NsuRED
BRUCE LITTLER INC INSURER A Auto-Owners Insurance Company 18988
25 CAUSEWAY BLVD NSUREPB
CLEARWATER FL 33767-2064 INSUitERC
INSURER 0
INSURER E
NSURER F
I_UVtKAI I=.j II IIFIUAI In NUM6ER! T/y11i RFVISIr)N NfIMRFR•
THIS IS TO CERTIFY THAT 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,
LUSIONS AN"NQITIONS OF SUCH S. LIMITS §H= MAY HAVE BEEN REDUCE
INSR TYPE OF INSURANCE ADO'L SUER POLICY NUMBER POLICY E" POLICY EXP LIMITS
TR IN R DnYYY
A GENERAL LIABILITY 9113016800 04101111 04/01/12 EACH OCCURRENCE $
X COMMERCIAL GENERAL LIAHILIT" DAMAGE TO RENTED
51
0011
PREMISES Ea octurence) ,
CLAIMS
R
MADE I X l OCC P
D
E 5
000
-
U ;Any one person)
ME
.
X $
,
I
PERSONAL & ADV INJURY
$ EXCLUDED
GENERAL AGGREGATE g 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMB/0P AGG $
X POLICY ?'J
RO LOC. FCT
P 17
AUT OMOBILE LIAEILITY COMBINED SINGLE LIMIT
ANY AUTO
(Ea accident) $
BODILY INJURY (Per person) $
ALL OWNED AUTOS
SCHEDULED AL"CS
BODILY INJURt (Per accident)
$
PROPERTY DAMAGE
HIRED AUTOS (Per accident) $
NON-OWNED AUTOS $
$
w. UMBRELLA 11 1 -1 OCCUR EACH OCCURRENCE $
EXCESS LIAR CLAIMS-MADE AGGREGATE $
DEDUCTIBLE $
RETENTION $ $
WORKERS COMPENSATION 'd? R TACT GTH $
AND EMPLOYERS' LIABILITY , '-'"
Y / N
ANY PROPRIETOR/PARTNERIEXecLnWE
E L EACH ACC!DEFtT -
$
OFFICERIMEMBER EXCLUDED?
(Mandatory In NH) N!A
E L DISEASE-EA EMPLOYEE
,$
If yes, deserg under
DESCRIPTION OF OPERATIONS nelow
E.L DISEASE-PCLICr LIMIT
$
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required)
GIFT SHOP, INCLUDING ALL ROOMS
THE CITY OF CLEARWATER, FL IS NAMED AS ADDITIONAL INSURED
lr-m4irILAlr nVLIJCK GANGtLLAIIVN
CITY OF CLEARWATER FL
25 CAUSEWAY BLVD
CLEARWATER, FL 33767-2604
Attention: HARBORMASTER 727-462-6957
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AV7110RZED PEPRESENTATVE
John Gay, Vice Presi t
25(2009/09) p
The ACORD name and loco are reDistered marks c