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CERTIFICATE OF LIABILITY INSURANCE (4)DATE(MMIDD/VYYY) ,a►co ' CERTIFICATE OF LIABILITY INSURANCE 5/3112013 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 certlflcate holde� Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and condltlons of the policy, certain policies may require an endorsement. A statement on thls certiflcate does not confer rlghts to the certiflcate holder In Ileu of such endorsement(s). cowr�cT __ PRODUCER pHONE Kris Thompson ---- ---- ---- ------ r( . 1 813.639.7192 NA Commercial Lines -(813) 639-3000 . 813.639.3058 nic no :__ ____--- E-MAIL -----_..—_ _— Welis Fargo Insurance Services USA, Inc. poo�ss: kris.thompson(a�wellsfargo_com _ __ _.__._ ._ INSURER(5) AFFORDING COVERAGE ___ __ NAIC X_ 2502 N. Rocky Point Drive, Suite 400 _— 23620 Tampa, FL 33607 _ _ iNSURER A: Burlington Insurance Company ___ _ INSURED INSURER B : —' --- Ruth Eckerd Hall, II1C. INSURER C: ------ – 1111 McMullen Booth Road u+suRere o: ----- --------- -- - INSURER E : — ---- � '-- � Clearwater, FL 33759 INSURER F: COVERAGES CERTIFICATE NUMBER: 6117825 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. IIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ _ --- rsr-- POLICY EFF POLICY EXP, ��M�7g �sR T1/pE OF INSURANCE r�� A GENERAL LIABILITY 1648053802 %� COMMERCIAL GENERAL LIABIIITV CLAIMS-MADE � OCCUR X Soecial Events GEN'L AGGREGATE LIMIT AP�PLIES PER: � POLICY � PR� I� I LOC JECT AUTOMOBILE LIABILITY ANY AUTO ALL OWNED e SCHEDULED AUTOS AUTOS NON•OWNED HiRED AUTOS AUTOS UMBRELLA LIAB � OCCUR EXCESS LIAB CLAIMS-MADE WORKERS COMPENSATION AND EMVLOYERS' LIABILITY Y I N ANY PROPRIETORIPARTNER/EXECUTIVE ❑ N � A OFFICER/MEMBER EXCLUDEDT (Mandalory In NH) Ii ves. describe under _ _ _ _ _ . O9/28/2��2 I 09/28/2013 I-T,�CH OCCURRENCE snaa—"��R�NiE� .,. � ,� ar �s �'° „A` z r '�sa.��C�.. � .. _ . �. ., .. ..� _;;�, <, --,."- OESCRIPTION OF OPERATIONS I LOCATIONS I VEHIGLES (Attach ACORD 101, Atldltlond Remarks Schedule, N morc spaee Ia requlred) Ciry of Clearwater is named additional insured per written contract. Blast Friday 11-30-2012. Liquor Liability $1,000,000/$2,000,000. - Policy No C12629866, Mount Vernon Fire lnsurance Company City of Clearwater P O Box 4748 Cleanivater, FL 33758 MED EXP (My one person� _ PERSONAL 3 ADV INJURY _ GENERAL AGGREGATE __ oonn� irrc _ r.nIJProP AGG S S $ S E BOQILY INJURY (Per personj S BODILY INJURY (Per accident) S PROPERTY DAMAGE S (Per acddent) --_-- �- a EACM OCCURRENCE S AGGREGATE ? a WC STATU- OTH- E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S �� n�eencc _ D[)1 ICY LIMIT S 1,000.000 100,000 5,000 t_000,000 2.000,000 Included RECEIVED C►TY OF CLFA JUN 0 7 2013 RISK MANAGE:�`/�ENT 9173 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE D(PIRATION DATE THEREOF, NOTICE W��L BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATVE 9��,�.� The ACORD nema and logo are reglstsred marks ot ACORD 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD25(2010/05) ��I��u��p�u��u�I��III��Ip��I�III�IIIUIIIIII�IIIU �Y�»„��.9"�,� _ I ____ 14795 DATE (MMMDIYYVY) �coR°' CERTIFICATE OF LIABILITY INSURANCE 5131l2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ON�Y 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 certlficate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and conditlons of the policy, certain policles may requlre an endorsement. A statement on thls certificate does not confer rights to the certiflcate holder In Ileu of such endorsement(s). ___.____ PRODUCER Commercial Lines - (813) 639-3000 Welis Fargo Insurance Services USA, Inc. 2502 N. Rocky Point Drive, Suite 400 Tampa, FL 33607 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Road Kris Thompson ,,. S 13.639.3058 A ; Burlington Insurance Company s: D: 813.635.7192 23620 Clearwater, FL 33759 INSURER F: COVERAGES CERTIFICATE NUMBER: 6��823 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INOICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. . A L SU POUCY EFF POUCY EXP L1M17S �� TYPE OF INSURANCE POLICY NUMBER MMID MM/DDMfYY EACH OCCURRENCE S 1,000,000 A GENERAI UABILITY 164B053802 09/28/2012 09128/2013 OA T R N ED PREMISES Ea occunence E _ 100,000 %� COMMERCIAL GENERAL L�ABILITY MED EXP (Any one person) S 5,000 CLAIMS-MADE � OCCUR PERSONAL 3 ADV INJURY S 1,000,000 X Special Events Q,000.000 GENERALAGGREGATE S ___. — _, � . ..-.� *.-,� �-.7 PRODUCTS - COMP/OP AGG S Included GEN'L AGGREGATE LIMIT APPLIES PER: i t�� I, �` s t �. � i� i POLICY PR� %� LOC �`°`� ��` COMBINED SINGLE LIMIT AUTOMOBILE LIABI�ITY Ea acciden► _ - _ � j r.A BODILY 1NJURY (Per person) S -- ANY AUTO ALL OWNED SCHEDULED '" ' A"," �` .""" BODILY INJURY (Per accident) S _ AUTOS AUTOS PROPERTY DAMAGE s NON-OWNED ��,P.��. r �, -� Peracddent -- HIREDAUTOS AUTOS �,", . ,..,� _ . S �`- � •`� - ` a EACH OCCURRENCE a __ _ UMBRELLA LIAB OCCUR AGGREGATE a .__— ----- D(CESS LIAB CLAIMS-MADE $ DED RETENTION $ WC STATU- OTH- WORKERS COMPENSATION � AND EMPLOYERS' LIABILITY Y 1 N E.L. EACH ACCIDENT S _, _ ANY PROPRIETORJPARTNER/EXECUTIVE ❑ N ! A OFFICERIMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE S_ ___ — (Ilsndatory in NH) It yes, describe under E.L. DISEASE • POLICY LIMIT S DESCRIPTION OF OPERATIONS below RE DESCRIPTON OF OPERATIONS / LOCATION5/ VEHICLES �Attach ACORD 107, AddlNonal Remarks 8chedule, N more space b rcqulrcd) C �TY O F C LE AR W AT E R City of Clearvvater is named as additional with respects to written contract. Liquor Liability 10-26-2012 to 10-28-2012, CL2629865, Mt. Memon Fire Insurance Company, $1,000,000/$2,OOO,000. ��N p� 2013 RISK MANAGEMENT 9113 �.roT�c��erc un� nFr� CANCELLATION City of Clearwater P O Box 4748 Clearvvater, FL 33758 SMOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WiTH THE POLICY PROVISION3. pUTHORIZED REPRESENTATIVE 9«�!�- The ACORD name and logo are registered marka oi ACORD � 1988-2070 ACORD CORPORATION. All rights reserved. ACORD25(201�0105) IIIII�IVIIiu��IiiNII�IIUiI��I��Illiiiliu�IUIiI��III�I�III�I�illll �rao,�+,��' �a�ao DATE (MMIDDM'VY) ,a►co a' CERTIFICATE OF LIABILITY 1NSURANCE 5/37/2013 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 ce�tiflcate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and condltlons of the poiicy, certain policies may requlre an endorsement. A statement on this certiflcate does not confer rights to the certlficate holder In Ileu of such endorsement(s). coNrn Kris Thompson _ — PRODUCER NAME: " Commercial Lines -(813) 639-3000 P�NE . 813.639.3058 —� j,� � N,�: 813.639.7192 Wells Fargo Insurance Services USA, Inc. E'M^�� kris.thompson(a�wellsfargo.com _ ______. ADDRESS: 2502 N. Rocky Point Drive, SUIt6 40O INSURER 5 APFOROING COVERAGE __ NAICN_ Burlin ton Insurance Company 23620 Tampa, FL 33607 ___ _ iNSURER a: 9 --- -------- INSURED INSURER B : . ---- --- '----��-- Ruth Eckerd Hall, I(iC. INSURER C: —_— -- —'— - 1111 McMullen Booth Road INSURER D: -- -- - Clearwater, FL 33759 INSURER F: COVERAGES CERTIFICATE NUMBER: 6� � �822 REVISION NUMBER: See belowv THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 RESPECT TO WHICH THIS 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. ___— IN8R A DL S B POLICY EFF POLICY D(P LIMITS �� TYPE OF INSURANCE POLICY NUMBER MM/DO/YYYY MMIDD/YYYY EACH OCCURRENCE � _ 1.000.000 A 6ENERALLIABILITY 1648053802 �9i28��2 09/28l2013 qMAG T R N D x PREMISES Ea occurrence S__ 100,000 COMMERCIAL GENERAL LIABILITY MED EXP (My one Personl S 5,000 CLAIMS-MADE � OCCUR PERSONAL 3 ADV INJURY S _! 1.000,000 X Special Events GENERAL AGGREGATE S ____ 2,000,000 ----- �?'� � � � � PRODUCTS - COMP/OP AGG S __ Included GEN'L AGGREGATE LIMIT APPLIES PER: `� ' F�.:- � ��': �� a POIICY PR� X LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accideM ---- . . _, } ; ':=� BODiCYINJURYjPe►person) S ANY AUTO �E ., . . 3 �' " ALL OWNED SCHEDULED BODILY INJURY (Per accidenl) S ___ __ AUTOS AUTOS PROPERTV DAMAGE a NON-OWNED �° ,- ,�y�; Per accident --� -- HIRED AUTOS AUTOS ' � c S I ?S„�` UMBRELLA LIAB OCCUR EACH OCCURRENCE S _____ AGGREGATE S __. __ EXCE55 LIAB CLAIMS-MADE S DED RETENTION WC STATU- OTH- WORKERS COMPENSATION - - '--�-- — AND EMPLOYERS' LIABILITY Y 1 N E.L EACH ACCtDENT _ E_____ __�_ ANV PROPRIETOR/PARTNER/EXECUTIVE ❑ N � A - OFFICER/MEMBER EXCIUDED? E.L. DISEASE - EA EMPLOYEE S __.__ __ (Manddory in NH) Ityes describe under E.L. DISEASE • POLICY LIMIT S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS 1 LOCATONS/ VENICLES (Attach ACORD 701, Addltlonal Remarks Schedule, N moro space Is roquimE) REC EI V ED Certificate holder is named as additional insured per written contract for Blast Fnday 09-28-2012. Liquor Liability CITY OF C�EARW�TER $1,000,000/$2,000,000 Mt. Vemon Fire Insurance Company Policy Number CL 2629864. JUN o 7 2013 RISK MANAGEMI_NT CERTIFICATE HOLDER CANCELLATION Gity of Clearwater P O Box 4748 Clearwater, FL 33758 SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE DCPiRATION DATE THEREOF, NOTICE WILL BE D6LIVERED IN ACCORDANCE WITN TNE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9«�/�- The ACORD neme and logo ere registered marks of ACORD � 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (201�0105) I IIII�I) III I'lll'I �� I'I� �II� (III �II ulqp �� I� �III ��'I �I� �III �I� �I NII •creo��v000iaemzAZAraau' �u �m� N II U u u 74795 CERTIFICATE OF LIABILITY INSURANCE �"�`��"'��' .� � 5/31/2013 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), AU'fHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certlficate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditlons of the pollcy, certain pollcles may requi�e an endorsement. A statement on thls certlflcate does not confer rights to the certlflcate holder In Ileu of such endorsement(s). PRODUCER Commercial Lines - (813) 639-3000 Wells Fargo Insurance Services USA, Inc. 2502 N. Rocky Point Drive, Suite 400 Tampa, FL 33607 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Road Kris Thompson _��. 813.639.3058 kris.thompson@wells6 INSURER(S) AFFORDI A ; Burlington Insurance s: c: 813.639.7192 23620 INSURER E : Clearwater FL 33759 INSURER F COVERAGES CERTIFICATE NUMBER: 6117821 REVISION NUMBER. See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BEIOW 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 RESPECT TO WHICH THIS 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. __ __ INSR A DL SU R POLICY EPF POLICY EXP LIMITS �� TYPE OF INSURANCE POLICY NUMBER MIDD/YYYY MMlDD/YYYY 6ENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 q 1648053802 09/28/2012 09/28l2013 p REN ED — x COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S______ 100.000 CLAIMS-MADE � OCCUR MEO EXP (My one person) S _.__ 5,000 X Special Events PERSONAL d ADV INJURY S 1.000,000 GENERALAGGREGATE S 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: �' �'�y °' �� PRODUCTS - COMP/0P AGG S ___ Includea PRO- � �: l t ._.. s — POLICY X LOC COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea acddent _ -'------- ANY AUTO _ °• `,� _ BODILY INJURY �Par perom) S ALL OWNED SCHEDULED "' '"' °' r .. vj gODILY INJURY (PeraccidenQ S _. AUTOS NON�OWNED PROPERTY DAMAGE y _ � °m�� . , , Peraccadent - --- — HIRED AUTOS AUTOS . , . s ,,,��: UMBRELLAI.IAB RJ""�� - ; � �f`� ~" .. � EACMOCCURRENCE 5 ___ __ OCCUR DfCESS LIAB CLAIMS-MADE AGGREGATE 5 _ ___ $ DEO RETENTION S WC STATU- OTH- WORKERS COMPENSATION _ _ —�- AND EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE Y' N E.L. EACH ACCIDENT S ,. _, OFFICER/MEMBER EXCLUDED? � N / A _ (Mandatory In NH) E.L. DtSEASE • EA EMPLOYEE S _____ __ Ifyes, describe under E.L. DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHIC�ES (Attach ACORD 107, Addlllaaal Ramarks Schedule, H more space Ia requlred) C�TY O F C L E A R w A 1��, City of Clearwater is named as additional insured. Clearvvater powntown Events, Inc. is named as additional insured with respects to liquor liability. ry Liquor Liability a1,000,000. Founders Insurance Company. ��N �/ ZQ�� 04-27-2012 Blast Friday RISK MANAGEMtiv ; 9173 City oi Clearwater P O Box 4748 Clearvvater, FL 33758 oo,o�a ACORD 25 (2010/05) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TME EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVEREO IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE p 9«�/�- � t �C �°- �--.��2K� ; 1 ��-2k5 i 2 The ACORD name and iogo are registerod marks ot ACORD � 1988-2010 ACORD CORPORATION. All ri$hts reserved. II�IIII III INII�I IIII NI� (IIIII i�ll �II IN� INII �IN �IIII �N�I (�� I�III �IIII NII II�I •creo»�moae�AZio¢�oiwao' 14785 DATE �MM/DDIVYYYI ,a►coRa' CERTIFICATE OF LIABILITY INSURANCE 5I31/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS BELOW CATHIS CERT F CATE�OFN NSURANCE DOES NOT CONST TUTE A CONTRACT BETWEENT HE SSUING NSURER(S)TAU7 OR Z'ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certiflcate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and condltlons of the policy, certain pollcles may requlre an endorsement. A statement on this certlflcate does not confer rlghts to the certiflcate holder In Ileu of such endorsement(s). C NTA T Kris Thompson _— PRODUCER NAME: ------- Commercial Lines -(813) 639-3000 PHONE , g13.639.3058 ��ac Nor 813.639.7192 _ Wells Fargo Insurance Services USA, Inc. E'MA�� kris.thom son ellsfar o.com _ __ ADORE55: P � 9 2502 N. Rocky Point Drive, SUItB 4OO __ INSURER(S) AFFORDING COVERAGE N� �!__- Tampa, FL 33607 __ _ iNSURER�: American Guarantee and Liability Insurance Com 26247 __ INSURED u+suReR s: FHM insurance Company ___ _ 10699 ,, Ruth Eckerd Hall, If1C. INSURER C: — — - 1111 McMullen Booth Road iNSURER o: ___--------- ----- Clearwater, FL 33759 INSURER F: COVERAGES CERTIFICATE NUMBER: 6117805 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 RESPECT TO VVHICH THiS 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. ______ INSR ADDL S POUCY EFF POUCY D(P LIMITS �� TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDDlYYYY GENERAL UABILITY EACH OCCURRENCE S 1.000,000 q CP0278060508 05/31/2013 05/31/2014 A� p N �oo,000 x COMMERCIAL GENERAL LIABILITY PREMISES Ee occurtence $ _. --- r-.�•^��°a^�'�^� i '�'?� 10.000 CLAIMS-MADE � OCCUR F '-� � E E! t;� MED EXP (My one person) S _____ __ �° °•-� '" '� PERSONAL 8 ADV INJURY S __ 1 C00,000 GENERAL AGGREGATE 3 _ 2.000,000 'q --. � �",; PRODUCTS - COMP/OP AGG S 2,000,000 GEN'L AGGREGATE LIMIT APPUES PER: �- v�- "' '` S POIICY PR� X LOC _,'_ i'3� �05/31/2014 COMBINED SINGLE LIMIT 7,000,000 q nurorosi�e �usiun CP02780605�'� O��?� Ea accidenp ---- x ANY AUTO &�( , .. �• ' ' BODILY INJURY jPer person) 5 i.�Z.. ...� �,. , .. r �.� �. _ � - ALL OWNED SCHEDULED BODILY INJURV (Per accidenl) E AUTOS AUTOS PROPERTY DAMAGE s NON-OWNED Per accidenl --- x HIRED AUTOS X AUTOS s A UMBRElLAL1AB X OCCUR AUC967294105 05/31/2013 05131/2014 �CHOCCURRENCE $ 10,000,000 D(CESS LIAB AGGREGATE _ S ____ �0,000,000 CLAIMS-MADE — E DED x RETENTION i � X WC STATU- OTH- YYORKERSCOMPENSATON WC30600207982012 1/1/2013 1!1/2014 - ---- B AND EMPLOYERS' LIABILITY 1.000.000 ANV PROPRIETOR/PARTNERlEJ(ECUTIVE Y� E.L. EACH ACCIDENT _ S ._ — OFFICEWMEMBERD(CLUDED? N�A 1.000,000 (Mandatory in NH) E.L. DfSEASE - EA EMPLOVEE $__ Ifyes describe undar E.L. DISEASE - POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATION5/ VEHICLES (Attach ACORD 101, Addltional Remarks S�hedule, It more spa�e 1s requirod) C ITY O F C L EA R W ATE R CITY IS ADDITIONAL INSURED FOR INTEREST HELD IN PREMISES OF RUTH ECKERED HALL. JUN 0'7 2013 RISK MANAGtMEN1 9173 CERTIFICATE HOLDER _ CANCELLATION CITY OF CLEARWATER SNOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ATTN: , RISK MGMT ACCORDANCE WITH THE POLICY PROVISION3. P O BOX 4748 CLEARWATER FL 33758-4748 AUTHORIZED REPRESENTATIVE C �-� C� L�2-[� ��-2K5 � ��. 9«�/�- The ACORD name and logo are registered marks oi ACORD � 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) I II'II'I III IIIIIII I�II III� IIII� II� III� II'� "III III� �III III� I'III �II IIII' IIII IIII •creo+�av000auo2,ozioroiao" N11 �M� HI Ntu� N U n�� 14795 �� DATE(MMlDD/YYYV) ACORO CERTIFICATE OF LIABILITY INSURANCE 5/31/2013 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 certlflcate holder Is an ADDITIONAL INSUREO, the policy�les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and condltions of the pollcy, certaln pollcles may requlre an endorsement. A statement on this certlflcate does not confer rlghts to the certiflcate holder In Iieu of such endorsement(s). PRODUCER NAMEA T KfIS Tf10(11pS011 ___,_____ Commeraal Lines -(813) 639-3000 P�NE , 813.639.3058 ac No): a13.639:7192 Welis Fargo insurance Services USA, Inc. �ooRess: kris.thompson�wellsfargo.com __ _ 2502 N. Rocky Point Drive, SUIt6 40� INSURER(S) AFFORDING COVERAGE _ �C �_ Tampa, FL 33607 iNSUReR n: American Guarantee and Liability Insurance Com 26247 INSURED iNSUReR e: FHM Insurance Company _ 10699 _ Ruth Eckerd Hall, If1C. INSURER C: __ - 1111 McMullen Booth Road INSURER D: - ---- INSORER E : ____ — - — Clearwater, FL 33759 :OVERAGES CERTIFICATE NUMBER: 6117810 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE 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 RESPECT TO WHICH THIS 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. _ _._ ISR AD l SU POUCY EFF POLICY EI(P LIMITS � TYPE OF INSURANCE POLICY NUMBER MM/D MM/DDM/YY 6ENERAL LIABIUTY EACH OCCURRENCE $ 1,000,000 A CP0278060508 05/�/ 013 05/31/2014 q�q R N E x COMMERCIAL GENERAL LIABILITV �'1.�,'�Cl�, ��i� PREMISES Ea occurtence 5 100.000 CLAIMS-MADE � OCCUR � `- `� E �vl �`uJ� MED EXP (Any one person) S 10,000 PERSONAL 6 ADV INJURY S J ,�;� GENERALAGGREGATE 5 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG S PRO- ., �:.., '-��. S POLICV %� lOC . . "� ' .� � ` = �. � A AUTOMOBILE LIABILI7Y CP02780605 8 � r,�;, „ 45/3'F�E,�Q4�` Q5/31/2014 COMBINED SINGLE LIMIT � J Ea accident �s ti `. � r�. ��.- _. . X ANY AUTO� . .. _.. -.... ..... ... ... .... __ . . . __ . . _ _ . . . . BODIL-l! INJU}iY�(Rer�person) � S ALL OYVNED SCHEDULED BODILY INJURY (Per accident) E AUTOS NON-OWNED PROPERTY DAMAGE $ X HIREDAUTOS x AUTOS Peraccident $ A UYBRELLA LIAB x�cua AUC967294105 05/31/2013 05/31/2014 �CH OCCURRENCE S D(CESS LWB ri aiuc_n�snF AGGREGATE _ S DEO x RETENTION S � VYORKERS COMPENSATION B AND EMPL01/ER5' LIABILITY Y/ N ANY PROPRIETORIPARTNERlF�(ECUTIVE � N / A OFFICER/MEMBER EXCLUDED7 (Mandritxy In NM) If ves, describe under WC30600207982012 � 1/1/2013 � 1/1/2014 E.L. EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE S E.L. DISEASE - POLICY LIMIT i DESCRIPTION OF OPERATIONS 1 LOCATIONS l VEHICLES (Apach ACORD 107, AddlNonal Remarks Schedule, i( more space Is requlred) for your information only HOLDER City of Clearwater P O Box 4748 Clearwater FL 33756 N 1,000,000 2,000,000 2,000,000 i_oao.000 70,000,000 �o,000,000 i,000,000 1,000,000 1,000.000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TNE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9��,��. ��: The ACORD name and logo are registered marks of ACORD 01988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/OS) I I�IIHI III II��I I�� I�II IIIIII I�II IIIII (IIII III� I�I� Illq IIIII INII IIIU IIII� IIII I'll �creo+�+r000as�ar�aaoA- 14795 �� DATE (NMlDD1YYYY) ACORU CERTIFICATE OF LIABILITY INSURANCE 5/31l2013 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 AITER 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 certiflcate holder Is an ADDITIONAL INSURED, the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subJect to the terms and condltlons of the pollcy, certaln pollcies may requlre an endorsement. A statement on thls certificate does not confer rlghts to the certiflcate holder In Ileu of such endorsement(s). PRODUCER N�E CT Kris Thompson __ _ Commeroial Lines -(813) 639-3000 P�NE 813.639.3058 1�, N,�; 813.639.7192 (A/C No Eztl: Welis Fargo Insurance Services USA, Inc. nonR�ESS: kris.thompson�welisfargo.com _____ 2502 N. Rocky Point Drive, Suite 400 INSURER S AFFORDING COVERAGE �� Tampa, FL 33607 iwsuaER �: American Guarantee and Liability Insurance Com 26247 _ INSURED iNSURER e: FHM Insurance Company _ 10699 _ Ruth Eckerd Hall, If1C. INSURER C: --- 1111 McMullen Booth Road iNSUReR o: ___ --- Clearwater, Fl 33759 COVERAGES CERTIFICATE NUMBER: 6117818 REVISION NUMBER: See below THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEO HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ INSR TypE OF INSURANCE A DL SU pOLICY NUMBER MIUODYNYYY MM/ODNYYY UMITS LTR (iENERAL LIABILITY EACH OCCURRENCE S 1,000,000 A CP0278060508 '�/2fi. ,, 05/31/2014 oA�a��b�t N D -- X COMMERCIAL GENERAL LIABILITY r"^,'�' y �� PREMISES Ea occurrence E 100_000 �, ..: CIAIMS-MADE � OCCUR �<� 3`� '� MED EXP (My one person) S __ 1Q000 PERSONAL 8 ADV INJURY S ._ 1.000,000 �� 2.000.000 b GENERALAGGREGATE S _ GEN'L AGGREGATE LIMIT APPLIES PER: L PRODUCTS - COMP/OP AGG S ___ z,000,000 POLICY PRO- X LOC k,. ,m y� .��,: r'r �._ ��,, S A AUTOMOBILELIABILITY CP0278060508 � p�t3'kf,��"'�> � B/�1/2014 �a��SINGLEUMIT _ �,000,000 .. . . . . ._ ..._ {�.,,,:�;,.w`�:.a`'` ..,... BODIL��{NJ1lRV(Perpetson) S. . . ... ._. X ANY AUTO - ALL OWNED SCHEDULED BODILY INJURY (Per accident) S AUTOS NON�OWNED PROPERTY DAMAGE s x HIRED AUTOS X AUTOS Per accidenl __ s ___ - A UMBRELIALiAB X OCCUR AUC967294105 05/31/2013 05/31/2014 EACHOCCURRENCE 3__ 10,000,000 EXCESS LU18 CLAIMS-AAADE AGGREGATE _ S _ 10,000,000 DED X RETENTION S � a WORKERS COMPENSATION X WC STATU- OTH- B ANDEMPLOYERS'LIABILITY WC30600207982012 1/1l2013 1/1/2014 -� Y / N 1.000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L EACH ACCIDENT $____ __ OFFICER/MEMBER EXCLUDED? N� A 1,000,000 (Mandatory In NH) E.L. OISEASE - EA EMPLOYEE S If yes, describe under 1,000,000 DESCRIPTION OF OPERATIONS below E.L. DISEASE • POLICY LIMIT i DESCRtPT10N OF OPERATIONS 1 LOCATION51 VEHICLES (AltacA ACORD 101, AddRlonal Remarks Sehsdule, N nwre space Is requlred) Event: Friends of Music . RECEIVED Date: SundayApril 1st, 20�2 CITY OF CLEARWATER JUN 07 2013 k��r, iv�HNAGEMENT CFRTIFICATF MA1 1]FR CANCELLATION _ City of Clearvvater P O Box 4748 Clearwater, FL 33758 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TME POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 9��,�,� oo�m. The ACORD name and logo are ragistered marks of ACORD � 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) ( IIIIIII II' I'lllll III) IIIII �IIII IIII III� �� III ��II IIIII I111I IIIII �� I'lll III� II'I -creo+�vaowes�ozzmxaorop' N u� r �n �� N u� U u