CERTIFICATE OF LIABILITY INSURANCE (246)Al!'�� � DATE (MM/1DD/YYYY)
� CERTIFICATE OF LIABILITY INSURANCE 3�4�2013
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDE:R. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PiDLICIES
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 righks to the
certificate holder in lieu of such endorsement(s�.
PRODUCER CONTACT
NAME: .
COl[l@�3 Insurance Corner PHONE (']2']� 521-2100 FAX No; (727)528-0526
One Beach Drive S. E. Ste. 230
Saint Petersburg FL 33701
INSURED
Reuben Clarson Consulting, Inc.
972 31st Avenue NE
St.
FL 33704
National Ins Co of
COVERAGES CERTlFlCATE NUMBER:13/14 GL REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIC`f' PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WFIICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE:. TERMS,
EXCLUSIONS AND CO NDITIONS OF SUCH POLI CIES. LIMITS SHOWN MAY HAVE BEEN REDU CED BY PAID CLAIMS.
INSR TypE OF INSURANCE POLICY NUMBER MM/DDY� MM OD/WYY UMITS
LTR
GENERA� LIABWTY EACH OCCURRENCE $ 1,, OOO � OOO
X COMMERCIALGENERALLIABII.ITY PREMIS Eaoccurrence S .200,000
.aa CLAIMS-MADE �X OCCUR SCC29986540 /31/2013 /31/2014 MEDEXP(Anyoneperson) $ 10,000
PERSONAL & ADV INJURY $ 1,� OOO � OOO
GENERAL AGGREGAiE $ 2;, 000 � 000
GEN'LAGGREGATE LIMIT APPUES PER: PRODUCTS -COMP/OPAGG $ 2,, OOO � O00
X POLICY P�� LOC $
AUTOMOBILE LIABILITY — OMBINED INGL LIMIT
Ea accident .
ANYAUTO BODILYINJURY(Perperson) $
ALLOWNED SCHEDULED 4� �! � ,� ,;
AUTOS AUTOS �s �as� � r �,� BODILY INJURY (Peraccidenl) $
NON-0WNED PROPERTY DAMAGE $
HIREDAUTOS AUTOS Peraccid nt _
..�.��,::: � ,� r.... $
UMBRELLA LIAB OCCUR �'G�Q*y r` F''. �, r j�+,� Y.,�.- EACH OCCURRENCE $
EXCESS LIAB �� � �� a` "
CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY '
ANY PROPRIETOR/PARiNEWEXECUTIVE Y/ N E.L. EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? � N � A �
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $
If yes,desaibeunder
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
DESCRIP710N OF OPERAiIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additionai Remarks Schedule, if more space is requlred)
Certificate holder is included as additional insured on a primary � non-contri.butory basis with re�spects
to General Liability. Waiver of Subrogation applies.
TE
City of Clearwater
Attention: City Clerk
P.O. Box 4748
Clearwater, FL 33758-4748
Paul Smet/JESSIC ��'�`"G ��
O 1988-2010 ACORD CORPORATION, All rights reserved.
Tho Af:(1Ri1 n�mo anrl innn �ro ronicfArorl marlrc nf A(:(1RI1
ACORD 25 (2010/05)
I NS025 r�m nnsi m
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLEU BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE