CERTIFICATE OF LIABILITY INSURANCE DATIE�MWODYYY
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CERTIFICATE OF LIABILITY INSURANCE 0 Ulily
THIS CERTIFICATE IS ISSUED A$ A MATTER OF INFORMATION ONLY AND CORFERS 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 iNSURER4S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the P0IiCy(ieS)MUst be endorsed. If SUBROGATION IS WAIVED,Subject to the
terms and conditions of the policy, certajn policies inay require an endorsement A statement on this certificate does not confer rights to the
certificate hoider in lieu of such andorsement(s),
7R_wucs�
MHBT Inc, NO�,NNE T F A`X
LAKCo,Extj� -77LI-I U rj 16,919,
8144 Walnut KII Lane,16th Roor e-MAII,
A PSDORo,
Daffas,TX 75231 NAIC 4
a
INSURER A ('Ad RpqL?Liblic rria_uk ance 2,11-47
_,3ut_,s of A
Nsukek 6
All uf J"ric"I'uding
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West Cerrta0 F[orida Council, Inc, INS UREA 0
l 1046 Johnson B lvd
Seminole, FL 33772
...... �IN`u REP F
COVERAGES CERTIFICATE NUMBER. REVISION NUMBER.
I-His Is to UER I It-TT HAI I L a LICIES OF JNSURA EFLISTE170.7F HAVE BEEN ISSUED TO THE iNSURED NAMED ABOVE FOR THE POLICY PERt
INDICATED NOTWITHSTANDINo,ANY REQUIREMENT-TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VWjCli Tills
CERTIFICATE MAY BE ISSUED OR MAY PkERFA[Ii, THE INSURA14CE AFFORDED By IHF POLCILS DIESCRIBPEI HEREIN IS SUBJECT TO ALL THE TFRISlS,
EXCLUSIONS AND CONDn[ONS OF SUCH POLICIES-LIMOS Sl,,iO'YVN MAY HAVE SEEN REDUCED BY RAID CLAIMS,
IV"s APO Q a POLICYEFF Poucytxp
INS
1,FIR TYPE Of INSURANCF (MMITAVYYYY ri"�Y, UMITS
GENERAL LABilLNY
EACH OCCURRENCE
A COMMfhUIAI CeNILXAL t 'KIL I Emil E
R MfD ESP�Arqx-,,pbmr,�
r RAIMS MADL OCCO'
PERSONAL&ADV 04JURY 1
(,;FNE RA F6 AI
UTERI AGGRFOATE UNI Y AiPHPSIr,t 6 Iz6D?.)(,T S
FF
POUCY PO_ I I
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AUTOMOBILE LABILWY
Ea acciderr)
ANY AuTO I I BOU LY[NJ U RY tPer perform $
ALLOWNED I SCHEDULED
AoTOG BODILY If ;Per aaAW) S
AUTOS
•HIRED RED AUTOS All'
UMBRELLA LIAL CXCUR 7F
J
EXCESS UAB
_ GLAIMS,NIADE s ACOREGATE
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I'AT 6
WORKERS COMPENSATION
AND F M PLOYERV LIABILITY Yrw
ANY
OFRCEdMEMBER)EXOLUDED'b
fM_4.i.,y to NF
9 yes,desai"a undef
tr�rpl? lz op npER�grkjo�, , EL.DISEASE-ROLICY[AlArT $
F F
DESCRIPTIONCIF OPERATIONS!L,VLA HUNS I VIt_'HK;LES (AO.AchACORDIDII,,AddiV�onaiRe-,Y?prk,.Isd)ddd4t,ifwofesp&c6i.g-tet,�ie,,d�
Certificate holder is narned as an additionaI insured by virlue of a wirittun&oraI contract or by the of a peprnit Sr certificate of insurance,bbl
only with respect to operations by or on behalf of the insured,or to fa nitres M,or facilities used by thn,Insured and then oMy for the linift of faltiffity cpecifled in
sucti contract for the event speciflea nor(ar,
GeneraI liability coverage is p avided in accDrdancr- with WesC�.ntraf Florida Coul-rcil a License Agreement lo rraintain Sign age and
Fenc and PnIrlic,ArcR�:w- I irp.nvpt Agr�,�rnv.nt vAth flllf,. ClIty cf Fkiridoi I el 09 I.1-4,Vsk-'al
addfe-ss is-,G S ECON D S1 E CLEARWATER 337 59
CERTIFICATE HOLDER CANCELLATION
The City of Clearviater SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANC&LED BEFORE
100 S I' yrtit Ave, THE EXPIRATON DATE THEREOF, NOTICE WILL BE DELIVERED IN
Clearwater, FL 33756 ACCORDANCE Wtth'THE POLICY PR0Vs,9[ONS_
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tc)Ig,qR-201OAr,OPF)r()PPOR-ATI.O 4 Afl right sr&s-erved,
ACORD 25(201DIDS) The ACORD nine arid 10W)are registered marks of ACORD