CERTIFICATE OF LIABILITY INSURANCE (145)�
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OEL-01
March 13, 2013
CITY OF CLEARWATER
112 S. OSCEOLA AVE.
CLEARWATER FL 33756
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ALLI ED
RE: Certificates of Insur�nce:
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,
��2�2�
Maria Crowell
Account Representative
Enclosure
RECEIV� W ATER
C�1Y pF CLEf,R
MAR 1 � 2013
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RISK N` ��-j3
ALLIED SPECIALTY INSURANCE, INC.
10451 Gulf Boulevard, Treasure Island, Florida 33706 • 727 367-6900 • 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
� � 1 � DATE(MMIDD/YYYY)
coRO CERTIFICATE OF LIABILITY INSURANCE 3/1:3/13
THIS CERTIFICATE IS ISSUE� AS A MATfER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEf3ATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE PQLICIES
BELQW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTQNT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, sub�ect to
the terms and conditions of the policy, certain policies may requi�e an endorsement. A statement on this certificate does not confer rights to the
certificate holder in lieu of such endorsement�s�.
PRODUCER AlIlGC� Specialty Insurance, Inc NAME -
10451 Gulf Blvd. PHONE FAx
Treasure Island, FL 33706 E-MAIL� �� AIC No: .
800/237-3355 ADDRESS: -
T.H.E. Insurance Company �1286
INSURED Christopher J. Biery
DBA: Top of the Line Parasail
7 Rockaway Street
Clearwater FL 33767
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWfTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHRCH THlS
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.
INS�— POLICY EFF POLICY EXP � LIMITS
LTR TYPE OF INSURANCE -. POLICY NUMBER MMIDO/YYYY MMIDD/YYYY
OENERAL LIABILITY � EACH OCCURRENCE g 1,�� O O� O O O
A COMMERCIALGENERALLIABILITY CPP0102828-01 03/18/13 03/18/14 pREMiSES Eaoccurrence S L�O� ���
CLAIMS-MADE � OCCUR MED IXP (Any one parson) $
� PERSONAI & ADV INJURY $ 1 r O O O� O O O
I GENERAL AGGREGATE g 2� O O O, O O O
GEN'� AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP/OP AGG $ Z,_O O O, O O O
POLICY PR� LOC I $
AUTOMOBILE LIABIUTY Ea aocident IN L IMI $
� ANY AUTO BODILY INJURY (Per person) S
AI.L OWNED SCHEDULED I BODILY INJURY (Par accident) 8
I__� J AUTOS NO OWNED PROPERTY DAMAGE $
�� Per accident
HIRED AUTOS AUTOS � $ —
UMBRELLA LIAB OCCUR EACH OCCURRENCE _ S __
EXCESSl1AB CLAIMS•MADE ����� �� AGGREGATE 5
4�..�� F.. > $
DED RETENTION 3
WORKERS COMPENSATION VVC STATU• OTH-
AND EMPLOYERS' LIABILITY
ANV PROPRIETOR/PARTNER/EXECUTIVE Y/ N �,. fi'�Q� � i�Y ,�� � E.L. EACH ACCIDENT S
OFFICER/MEMBEREXCLUOED? � NlAi '
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE 8
If yes, describe under
DESCRIPTION OF OPERATIONS below �"° :";.° r" ': i `"� s"` '�.!+ .q' ° E.L. DISEASE - POLICY LIMIT S
w�rr�n
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DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, rf more space is requiredJ
Additional Insured: CITY OF CLEARWATER AS RESPECTS TO THE GENERAL LIABILITY
OPERATIONS OF THE NAMED INSURED ONLY.
CITY OF CLEARWATER
112 S. OSCEOLA AVE.
CLEARWATER FL 33756
RECEIVED
CITY OF CLEARWATER
MAR 19 2013
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEIIVERED IN
ACCORDANCE WITH TNE POLICY PROVISIONS.
AUTHORI REPRESENT TIVE
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NT O 1988-2010 ACbRD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACOR� }�$►e and logo are registered marks of ACORD