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CERTIFICATE OF LIABILITY INSURANCE (7) To: Chrystal From- Maria Crowelf 318/2013 11:44:35 AM (Page 2 of 2) DATE(FAMMYYYY) CERTIFICATE OF LIABILITY INSURANCE 3/08/13 I64.� 1 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 14OLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CER71FICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. IMPORTANT; If the certificate Ivoider Is an ADDITIONAL INSURED,the pollcyfies) rmist be endorsed. It SUBROGATION IS WAIVED, subject to the to 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 en6orsetnerd(s)_ C0NTxCT­_ PPMDVC*RAllied S ecialty Insurance, Inc .r .w.,,, 10451 Gu�'f Blv­2 PHONE 'r atm� -�-11�-���,-�-�.�-1-�'ll,���.��--�-­­­- - Treasure Isl ,and FL 33706 L 7 -3355 800/23 T.H.E. In,quIrlancle-1-Compamy 'R2866 PmReD Emerald Coast Bun gee, Inc. 1? Causeway Blvd. INSVREIR C: -Cearater Beach FL 33767 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; THIS IS To CERTIFY THAT THE POLICIES OF INSURANCE LISTED RELOW HAVE BEEN ISSUED TO THE INSLJR D NAMED ABOVE r-OR THE r-01ACY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,7 OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO W"CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE 1NS L4tkNCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EX"IONS AND CONDITIOUS OF SUCH POLICIES.UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, LTR TYPE OF INSURANC*-: INSR I VwVO I POLCY NUMMA 1#4Mn)oryyyyJ"F11 wVx GENERAL UABILITY EA04 OCCUR RENCE 5 1,000,000 A COMM5RCIALGENERALLIANLITY CPP0100575-03 D3111/13 03/11114 101,-()00 G"WMADr Ilk OCCUR PIMISIO N AL&,ADV INJkWY s 1,000,000 2,000,000 OCN1 A00ACOATE LIMIT APPLE-q PER- PROMICTS-OOMPIOPAGG 3 Pq,Q- r POUCY AUT01MOSILE LIAMLITY ANYAArG ALL OY� NED SCHMULM A UTQS AUTC;I-S HIRGO AUTO E AUTOS 3. UWWEILA LIAH occuR EACHA CURREN CE EXCESS LJAS CL 11�8 MADE AGGREOA7E Is L' D [�,REI'ENTION$ TQRY�WORK IER45 PENZAMN Ti, AND W4M_OYRR8'L*.ffiRJTY YiN ANY PR0PR1E7'O9fflARTKER)UXECU1TVE F L FkCH ACCIDOC_ S OFFICE"EMBER EXCLUDED? NIA (Moffl4aWffy 6-1 NH) -f-L-E!__�_�'EMOYE tf a,J&ttliba undm J D RIPTIONOFOPEIRATICM6wiew I E JffflL s ------------------------- DeStRIPTI•N Of OPERATfOWS 0 LOCATIONS I VENCLES(Aaadt ACORD 10,A44110ftl Ron ou Scwuw 0 more apace In, requftd) ADDITIONAL INSURED: CITY OF CLEARWATER AS RESPECT TO THE PRIMARY & NON-CONTRIBUTORY OPERATIONS OF THE NAMED INSURED ONLY- WAIVER OF STJBROGATION APPLIES TO GENERAL LIABILITY. RE: (2) FOUR STATION EURO BUNGEES #006 & EBVR1001 2012 MECHANICAL SHARY, ATTACK #GA3537 CERTIFICATE HOLDER CANCELLATION C6WY OF CI WATER SHOULD AN OF T44E ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1 MYRTLE AVENUE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CLEARWATER FL 33767 ACCORDANCE NTH THE POLICY PROVISION& AUT IVE &'7 Q 1988-2010 ACbR6-C-ORPORATION. All rights reserved. ACORD 25(2010106) The ACCIRD name and logo are registered marks of ACO RD t� f;. �. .. a • .. ..�.,�.m.y.. _ . ALLI ED OEL-Ol March 8, 2013 CITY OF CLEARWATER 100 MYRTLE AVENUE CLEARWATER FL 33767 RE: Certificates of Insurance: Dear Sir/Madam; Enclosed is an original and/or duplicate Certificate of Insurance. Thank you for the opportunity to serve you. If you have any questions please feel free to contact me anytime. Sincerely, � Maria Crowell Account Representative Enclosure ALLIED SPECIALTY INSURANCE, INC. 10451 Gulf Boulevard, Treasure Island, Florida 33706 • 727 3b7-6900 • 1 800 237-3355 • FAX 727 367-5695/1407 85 N.E. Loop 410, Suite 600, San Antonio, Texas 78216 • 210 341-1321 • 1 800 235-8774 • FAX 210 341-2050 � � � DATE (MMJCIDIYYY`� A� � CERTIFICATE OF LIABILITY INSURANCE 3/0�3/13 THIS CERTIFIC��E IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFI�ATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAt3E AFFORDED BY THE PULICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER�S), AUTHqRIZED REPRESENTATNE 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). PROOUC� Allied Specialty Insurance, Inc NAME: - 10451 Gulf Blvd. a�"N ac No: _ Treasure Island, FL 33706 -Mn�� 800/237-3355 ADDRESS: - INSURER S AFFORDING COVERAOE NAIC # INSURERA : T. H. F'+ . Insurance C�IYI an 12 8 6 6 INSURED Emerald Coast 10 Causeway B1 Clearwater Bea e, Inc. �FL 33767 E: F: COVERAGES GERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERIIFY THAT THE POUCIES OF {NSURANCE 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 RESPECi TO WHICH 7HIS 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 POLIGES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A POLICY EFF POLICY EXP LIMITS L7R TYPE OF INSURANCE POLICY NUMBER MMIDD/Y MMIDD/Yri GENERAL LIABILITY EACH OCCURRENCE $ 1�() O O� O O O A COMMERCIALGENERALLIABILITY CPP0100575-03 03/11/13 03/11/14 pREMISESEaoccurrence $ �OO�OOO CLAIMS-MADE � OCCUR MED IXP (Any one person) $ PERSONAL & ADV INJURY $ 1� O O O� O O O GENERALAGGREGATE $ 2 � �OO� OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $ . POLICY PRa LOC $ AUTOMOBIIE LIABILITY Ea accident N LI I ANY AUTO BODILY INJURY (Per parson) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS " NON-OWNED PROPERTY DAMAGE $ Per accident HIRED AUTOS AUTOS $ ' UMBRELLA LIAB p�CUR °`� `�` EACH OCCURRENCE $ EXCESS IIAB CLAIMS-MADE AGGREGATE S _ DED RETENTION $ `� � f $ WORKERSCOMPENSATION WCSTATU- OTH- AND EMPLOYERS' LIABILITY Y/ N ANY PROPRIEfOR/PARTNER/EXECUTIVE ❑ N/ A �"�y��'� �� �, u:+`�� ���' � E.L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED9 (Mandatory in NH) y67• q� r-� c� ��.�� E.L. DISEASE - EA EMPLOYE $ _ DESCR PTION OF OPERATIONS below � � � ���, y � � �+ �� ��� � E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ADDITIONAL INSURED: CITY OF CLEARWATER AS RESPECT TO THE PRIMARY & NON-CONTRIBUTORY OPERATIONS OF THE NAMED INSURED ONLY. WAIVER OF SUBROGATION APPLIES TO GENERAL LIABILITY. RE: (2) FOUR STATION EURO BUNGEES #006 & EBVR1001 2012 MECHANICAL SHARK ATTACK #GA3537 CERTIFICATE HOLDER CANCELLATION _ CITY OF CLEARWATER 100 MYRTLE AVENUE CLEARWATER FL 33767 ACORD 25 (2010105) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIUERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI REPRESENT TIVE W • O 1988-2010 ACi The ACORD name and logo are regisbered marks of ACORD ��7'�'""C+Q> CORPORATION. All rights reserved.