CERTIFICATE OF LIABILITY INSURANCE (15)Client#: 13438 CLEARCOMMU
DATE (MM/DD/YYYY)
ACORDTM CERTIFICATE OF LIABILITY INSURANCE 11/21/2011
THIS CERTIFICATE IS 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 policy(ies) 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).
PRODUCER NAME:
Gowrie Group ac"N EXs : 860 399-5945 ac, N, : 8603993615
70 Essex Road E-MAIL
ADDRESS:
Westbrook, CT 06498 INSURER(S) AFFORDING COVERAGE NAIC #
860 399-5945 iNSURERA: Federal Insurance Company 20281
INSURED INSURER B :
Clearwater Community Sailing Assoc.,lnc
INSURER C :
1001 Gulf Blvd.
INSURER D :
Clearwater, FL 33767
INSURER E :
COVERAGES CERTIFICATE NUMBER: Kev�s�vN num�strc:
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,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
�NTRR TYPE OF INSURANCE j�� R� yjryp POLICY NUMBER MM/DDY� MM/DDY� LIMITS
A GENERALLIABILITY 35823516 11/06/2011 11/06/201 EACHOCCURRENCE $�,0��,��0
X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence s 1 OOO OOO
CLAIMS-MADE � OCCUR MED EXP (Any one person) $ � � ���
PERSONAL & ADV INJURY $ � �OOO�OOO
GENERALAGGREGATE $Z,OOO,OOO
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG s included
POLICY PR7 LOC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
Ea accidenU _
ANY AUTO
BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS Per accident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY " `
ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED7 � N/A
(Mandatory in NH) E.L. DISEASE - EA EMPIOYEE $
If yes, describe undar
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Atlach ACORD 107, Additional Remarks Schedule, if more space is required)
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.
City of Clearwater
25 Causeway Boulevard
Clearwater, FL 33767
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATNE
O 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
#S49370/M49369 M ED