CERTIFICATE OF LIABILITY INSURANCE (262)� � DATE (MM/D0/YYYY)
'4� ° CERTIFICATE OF LIABILITY INSURANCE 6/4/2013
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 certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
the tertns 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).
PRODUCER CONTACT JOdII RSACi01 tl
NAME: P
Lassiter-Plare Insurance Of '1'dIIlpd Bay PHONE .(g00) 845-8437 �C No: (888)883-8680
4401 West Keanedy Blvd E-MAIL
S111t8 i OO INSURER 5 AFFORDING COVERAGE NAIC #
Tampa FL 33609 iNSUReRa:Certain IInderwriters at Llo ds
INSURED �uc��oco o •
Reuben Clarson Consulting� =AC. INSURERC:
972 31st Avenue N.F.. INSURERD:
St. Petersburg FL 33704
COVERAGES CERTIFICATE NUMBER:13-14 Cert 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. 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 T'RiE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TypE OF INSURANCE � UBR pOLICY NUMBER MM DDYfYYYY MM% �CY EXP LIMITS
LTR
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILIN PREMISES Ea occurrence $
CLAIMS-MADE � OCCUR MED EXP (My one person) $
PERSONAL & ADV INJURY $
GENERALAGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $
POLICY PR� LOC $
AUTOMOBILE LIABILJTY s�;, b` .^' COMBINED SINGLE LIMIT
Ea accident
ANY AUTO BODILY INJURY (Per person) $
ALL ONMED SCHEDULED ?'\?
AUTOS AUTOS �.yy€;� � �'��� BODILYINJURY(Peraccident) $
NON-OWNED PROPERTY DAMAGE $
HIRED AUTOS AUTOS Per accideni
"�E"_�:3"'"� F� ;°"'�'.wa.:�, i.»_. $
UMBRELLA LIAB OCCUR ���'iw � �"+ ' �. '` �� '"� +�".i" EACH OCCURRENCE $
es�W,:.�a`b �{�:�- u� i��ecJ �_ �I 1
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION WC STATU- OTH-
AND EMPLOYERS' LIABILITY '
ANY PROPRIETOR/PARTNER/EXECUTIVE Y� N E.L. EACH ACCIDENT $
OFFICERlMEMBER EXCLUDED? ❑ N/A
(Mandatory in NH) E.L. DISEASE - EA EMPlOYE $
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $
A Professional Li8bility GIARR0107302 6/5/2013 6/5/2014 EACtiCLAIM $2,000,000
C1d1IIlS Made AGGREGATE �2,000,000
DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Altach ACORD 101, Add'Rional Remarks Schedule, H more space fs required)
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
C1ty Of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
Attention: City Clerk
P.O. BOX 4748 AUTHORIZEDREPRESENTATIVE
Clearwater, FL 33758-4748
P Schmaltz/JOANR --{ ' :1��='�'7�'
ACORD 25 (2010/05) O 1988-2010 ACORD CORPORATION. All rights reserved.
INS025 �2o�oos�.o� The ACORD name and logo are registered marks of ACORD