CERTIFICATE OF LIABILITY INSURANCE (11) OP ID.SW
CERTIFICATE OF LIABILITY INSURANCE
DATE Lrt�arar3,r avvl
48118112
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 policyjiesj 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 727-461-6044 - NA NMEME::
Brown&Brown of Florida, Inc.
Park Place Blvd.,Ste 101 727-442-7695 A,C, Extll. _...n FAX_WAD
P.O. Box 2456(33757-2456) E IMAIL -- -
Clearwater,FL 33759 ADDRESS:
PRODUCER William r Hancock uUSTOuER ID CL AR17
"— _ _ INSURER( FFORDING COVERAGE
INSURED� Clear Clearwater olf Associates Inc Mutual
INSURER A.F VA Irisurari e pany 11—- - -_ 14385
dba The Landings INSURER S American Economy Ins.Co, 19694
---- ......
1675 Airport Drive INSURER
Cleo otter,FL 33765
INSURER CP;
INSURER E,'
INSURER F
COVERAGES CERTIFICATE NUMBER: � REVISION NUMBER,
THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTCI7 iELOVV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED Norm rHS`1-RNILI G ANY REQUIREMENT, TERM OR CONNTlON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT 1"ca 1uVHIC'H THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED FtEREIN IS SUBJECT TO ALL IHE °TERMS,
EXCLUSIONS AND CONDITIONS OF SUCI I POLICIE4.LIMITS SHOtirVN MAY HAVE BEEN REDUCED BY€AID GL AIMS.
_ .....
LT R fiYFE CE INSURANCE POLICY EEF POL ICY ECP
POLICY 7R ,...., ..,..
CPawoplYYYY 1�It91NL?tYl°!`Y � LIMITS
� GENERAL LIABILITY L-6,Ca-I 4Jc4tPRRENr C {w' 1,000,00
.5
rirnERCarL LNER a_Ll sii IIY X I 42C8437957894 06117112 06/17M 3 1 PREMISES 1,000,00
1-- OCCUR NIEL EX.r-LAny one pensanar --S 10,000
1,000, 0
PERSONAL, APIA INJURY`
Liquor Liablilty 02CE07957890 06117112 06117113 I
�ENEFtt+L�Ct aTCGA I F 2,130,110
CS0H...AGGRE.UATE L WIP APPI IES PER ( �F'R��LJiJL"'1°v f.Y�si�l�l4".(-AGG $� �„$� '�, �
... PRC"t- _...... ....------. ...; ...__._.._
Pr�LIC�� — LOC
Al OMOBILE LIABILITY 4,`3A4BINEL`a 51NCaI,.F LIMIT
4 1,000,000
I LL a accidarrtr
B Avy Aunt; 02CE079 57894 OS5i17f12 6611 ft13 - _ ,-.. 1 11 I'll
s
BODILY INJURY t er”� i _s,--- � ..— ..
ALL ULi?a�IL-C'wl�l tiJ';�* 1
3 ( i S06''311 Y IN I PrRY
t SCHEDULED AUTOS H I -
I PROPER"f Y OA.NI`GF
.` (NON GVvNEL 2,4t
L10.+➢BLtEkwl., 9..IAST `
JUCUk $
1�) E�XC53 LaA.B f I-- -------
t �L AIh1C MADI ( AGGREGATE g 5
DEDUCTIEL[-- I € E
RETEN-B'OF — ... ---
4✓f&R .ERS COMPENSATION J � � � 3 RA,STATU r C3T@H-)
AND E.KI PLOY ERS LI BILH'Y � ' (OWR1 L MTS
ER
A kNr R �ZiFrr �s r� xr I r t�� F-7 I ,t C84 016r`1 2012 03117112 03117/13 �L€ L��,a I N cIL L�� � 100,00
['GEIGER'P�EMECR L>ri,LliLtEC�? _... h1�A t — -- .._. _ ..
(Mandatory an N€8) �[ I r"7.SEl-�5C Ea._Y'gPLtCr EE $, 1CQr�11,D
9i yes,iSE�. I ILA LI'iF`6" ' r _
DESCF�IP's ietN uE U°ERta.Tltt+IS L.e(r:+n+
N e D€ [= L EEL :' Ltf i C ,
z
DESCROPTa'O OP`OPERATIONS;LOCATICN3 i VEHICLES (Att.,14 ACORD 101,ArddiRkinal Rernan's 6crieauie,if trade spac=e Is requiredji
City of Clearwater is listed as Additional Insured with regard to General
Liability,
CERTIFICATE HOLDER CANCELLATION
CITfF-8
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Clearwater THE EXPIRATION [SATE THEREOF, NOTICE WILL BE DELIVERED IN
Attn: 1` bbie Reid ACCORDANCE WITH THE POLICY PROWS IONS,
PO Box 4748
Clearwater,FL 33758 AUTHOPUZED REPRESENTATIVE
1988-2009 ACORD CORPORAT4OR', All rights—reserved,
ACC"RD 26(2012910,93) The AC ORD C"ragne avid logo are rr yi.r tefed I arks of ACCRt