CERTIFICATE OF LIABILITY INSURANCE (2) OP I[)- BK
DATTI E I M MI DD?YYY'Y)
'D"Yy
CERTIFICATE OF LIABILITY INSURANCE 01129113yy)
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 policy(ies) must be endorsed, If SUBROGATION IS WAIVED, SLAbject to
the terms and conditions of the policy,certain policies may require an endorsement, A statement on this certificatte does Not confer rIghts to the
Certificate,holder in lieu of such endorsement(s).
PRODUCER CONTACT
727-44T-6481 NAME:
Bouchard-Clearwater -Ni ONE FAX
101 Starc rest Drive 727449-1267 (A,C,No,Ex* ac ray}:
P 0 Box 6090 E-MAIL
Clearwater,FL 33758-6090 _ADDRESS� - --------------------------- ......
PRODUCER
Josh Bouchard,AAI CUSTOMCR0# CLEA-37
.................................
INS URERIS)AFFORDING COVERAGE NAIC rF
INSIRED Clearwater Marine Aquarium Insurance Company
Mr, David Yates
INS U krp-
249 Windward Passage WSURFIR c Aspen Specialty Insurance CO 10717
Clearwater,FIL 33767
INSURFIR D;
INSURER F:
C OV I-P A GP S CERTIFICATE NUMPIEW REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED'ro,rHE INSURED NAMED ABOVE FOR THE'- POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REOUIREMENT, I ERIN OR CONDITION OF ANY CC)NTRAICT OR OTHER DOCUMENT VATH RESPE'C'T TO Iv'MICH THIS'
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, FHIF INSURANCE AFFORDED BY 'rj1E POLICIES DESCRIBED HEREIN IS SUBJECT K, ALL 1HE IrERMS,
EXCLUSIONS,Ali[)CONDITIONS DFSUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
—----------------------------------------------------
ILITS"R 5,Epp-
111E.1 POLICY EFF POLIC'
POLICY NUMBER
CENERAL LIABILIFfY EACHQGO�IRRENCE
Is
A X COMMER,0AL GENERAI,'UNIBILIFY CPS1642892 10101112 10101113 PREMI, S(Ea accurrenco� 100,000
AIMS-w"LL, OCICURI MED EXP(An�e ane,per,,cm;, f
_X I
PERSONALAADVIINAJRV $
2,000,000
G E NE FUL AGO R LG,
A(3(3RE(3ATi1,-,,1,Will' APPLU-3 PFR'
C',0IdPX aI'-1P Ae 2,DOO,000
X POLICY
AUTOMOMLE LIABILITY CC)PAPINEDSINGI-17,I A&I
ANY 4.11T
SOCILY ENJURY N'r N9r-,1`1ffl
ALL
RODILY 441URy;Pei acude,1s 0 $
SCHEDLILEO,'�U[OS
PROPERTY D.,f,4AGF
H I R E D AJ T C'S (Pela4 idenI)
NON CWdNEL)
UMBRELLA LIAR X l:,Ii i�,err c,L 1$ 9,0()0,000
00 CUR L. I
X EXCE55LIAB C�LJMS-MADE AC-;CREGATE 9,000,000
C CXA611 QY1 2 '10101112 10101113
j DEDUCTIBLF�
RFJFNTIQN S NONE
WORKERS COMPENSATION
R
AND EMPLOYERS'LIABILITY YIN
--------------------
ANY PROPRIETOWPAR`fr`PR' E EACH ACC. NFI- 15
A
0FFICF.R;MEM8,ER EACU)DEI_�Y! L.-A
(Mandatory in NH,
1-DISEASE,,-FA[,,AIPL',,1YCr, z
If yP,,,,.jewrjbc inder
IDESCRiPTION OF CPERI,,TIONS I)eic-vo
1 E I, F01j_Y Ljn1T
DESCRIPTIoN OF OPERATIONS,'LO CATIONS;VEHI-CLES jAnach ACORD 101 Additional Remarks Sch d I -f Me�S roqujred��
RE- RENTAL SPACE AT HARBORVIEW CENTER,321)CEEVELAND STREFT,uClIe ATER,
FL6RIDA-CITY OF CLEARWATER IS ADDITIONAL INSURED ON GENERAL LIABILITY„
ONLUY IF REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO TERMS,CONDITIONS AND
LIMITS AS SPECIFIED IN THE POLICY-
CERTIFICATE HOLDER CANCELLATION
CITY OF
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
CITY OF CLEARWATER THE EXPIRATION DATE THEREOF, NOTICE 'NILL BE DELIVERED IN
112$.OSCEOLA AVE ACCORDANCE WITH THE POLICY PROVISION$-
CLEARWATER,FL 33756
AIJTHOMZED RrPkFSEWrAU)YF
1988-2009 ACORD CORPORATION, All rights reserved,
ACCORD 75(2003x09) Tffe ACORD name and 16,go are regIslen;.�d rnarks of AGORED