CERTIFICATE OF LIABILITY INSURANCE (5) CERTIFICATE OF LIABILITY INSURANCE 1 aATE t1m1YYYY1
513112013
Ti�tS EFtTiFi TE 15 iS 1#E'f3 ATTE F Ifa� f?f2AA Ti t't ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THI'S
CERTIFICATE [DOES NOT AFFIRMATIVELY ORNEGATIVELY :MEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW, THIS.CERTWICATE OF I R E ES NOT CONSTITUTE A CONTRACT BETWEEN EE THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE R PRODUCER,AN[ TidBE TWI ATE HOLDER.
IMPORTANT. If'the certificate holder,is an ADb i JI INSURED, the policy(les) must be endorsed If SUBROG TI N IS WAIVED, s€abject to
the terms and condition of the�rrslic}i,certain policies may require an endorsement, A statement on this certificate dues not confer rights to the
certificate holder in lieu of such endorsement(s),
PRODUCER �_.. CONTACT riT;Thr.w-n.-rrra Commercial Lines-(813)639-3000 PHONE,Ex0. 813163913058 FAX,nlYa 31;3 63 192
Wells Fargo Insurance Services US' Inc- E-MAIL kris ti7 rm rs aI iJtvellst�m` v.cn, T
ADDRESS.
2502€~~i, Rocky Point Drive,Suite 400 INSURER&sl AFFOR€iNG COVERAGE NA€c r
Tarnpa EL 33607 INSURER A: Annerlcan Guaranrise and Liability insur r T;C,,-t m 26247
IN51JREC ._ INSURFR S FI-IM, nsSurxi €,ICsarsfll pry - 101�•E9
1
Ruth Eckeid Hail,inc,
tFkS€JI?ER:is
111 MOAuillert L oofl I i`oa6J rr$UREIY r;
Clearwater,LL. ,33x'5
INSURER F,
COVERAGES CERTIFICATE NUIiiQI 6117790 REVISIO N i'tLiM E ` See laeic i
TIAH i IS TO CERTIFY HAi' IHE "r?Ur ICIES OF tNSURANOF 1JSrFn BFL-(),'v HAVE BEEN ISSUED TO -H-1E INSURED NAMED AE:C'3'VE FOR THE PoLiCY
IIVDICAIEIJ NO Tt.FOTHEit..AW31"rrG ANY R,EQ,UIRF11017N-1 -1-f-RIO OR CONDITION OF ANY CONTRACT OR OriiFR ,,DC))IC;UMFNC 4'Y,iIT`FI Et'ESPk;'Cr JO VVI-IF;I: 1111S
CERIIFICAIE MAY BE I,SUED OR MAY PERrA`,Cv, 1HE INSURANCE A'°EORDEiP Em' [HE POLCIES DES( ReE'.I' I,IEEEI17 IS :=,UBjEC;1 TC) ALA CifE Ct$ NIS,
EXCI USiONE AND C71?I1Di It;NS OF SUCH POLICIES 1-1101-S SHOWN N MA 41tkVE BEEN REDUCED BY PAID Q-AIIM -
IESSI,` ADDL SUSS POLICY FFF POUCe`EXP
LY'k TYPE(b EIMtSfi:F3t.Am:3kC �P j POLICY h4m,fMg Ek lMMfDD1YYY"Y; IMITS
GENERAL LIABiLffY C,r� „,t CJ L H ':UR tEv,",F ;$
A ' ;C��''"8t7ECFECiC1 d1�,3i ?[113 05131. Cd1
s DAMAGE RAN FCl
" C.a_:?ISflrR l-�w�ir°§L�'nEi�l f{{:C' FtFiL T'± PREMISES f&�oc.cuv-,.,n,e}
CLAIM, MADE X OCCUR $ <Jl.(S3u
PERSONAL Ys ALm°,NJkJmt!'c T
uLNERALA G«I I 'Ali
GEN`LAGGREGATE urAll APPLIES PER _� wP&)PAG( $.... 000"I"Go'?� �;
PnC,... _
PLll IG4` ,bEC„;.-C. °e_ c..:' .,y.... �'
-... _. ,..,
AUTO C':AkTki,..S LIABILITY. ' tt,hS,h9I°IL ..h��6,M(_P8'
(,Fri 278060508 � 9E 31f<"`_013 QUF3' �01a1
(Ea aw nrT 1 UUU;J.Ir
ANY AUTO BODILY INJUR r(Perpor,3n) $
ALL OWNED 5CHEDUt EE'i
RUTrsw AUTOS j t BODILY INJURY IL 4 enil .�
( I I � NON?WNE D ' PJRO PE.RT a DAMAGE
HIRED AUTOS :
Pil.1t f.JS I j i..lh�'Fv€���i1et2'ij
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49TrEL�.,.AR �1 LL"" kC �9a7C3b t; 0513112013: cu, 1,120 twu r:M1EE E
EXCESS IwEA€3 _- CLAIMS MADE AGGREGATE
j ( WEE ,x, RETF,NI RiN
$WORKERS COMPENSATION
AND EAAPLOYFRS'LiABILiT'Y V r N tint x:306002079 01 E": 11112013 1,1112014 irk"$Ir'Ji1 Eo ,
IT.NS'PRO PR9ET(}}"dtP}t,R I N ERiEAE L,JIisC l , Et E 4, 3-tACC D E N F I S 13AJU.OIA"
'OFFICER;MENIBL'RExCLJNE1T? A ` --
( andatery In NH) r i 1 � � r,. (JLSEA�r EA E� i c�.,�EFi S 3 uuu.sau
it es!.(E�esra�t?
---+(>f JY��l 1 p 3't-FiCj OF 4PP'Y`-",AT 171'&`3 ue{LY a?t 01,,1-A-5E f tLIC t .11"il i A
DESCRIPTION CP OPERATIONS f LOCATIONS I VEHICLES 1AT$a3ch A ORD 101,A.uTa iVoroal Rein a:ds Scltwdui e,if imears space is required;
cediEr,alo I tofu€,m is I earned as aijaIlion EI Irluasrea�wan I t tiitr;C to?C3enerai Liability
CERTIFICATE MOLDER CANCELLATION
City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Parks and Recreation Deaariment T14E EXPIRATION MATE. THEREOF, NOTICE WILL BE DELI ESfr= IN
ACCORDANCE WITH THE POLICY PROVISIONS,
P CL Box 4748
C.`lear°WatT:r, FL 33758-4748 A.u'tHOIo,reu RePRESENTATPIYE
' Crm �Y ,
The s�,a, ,�RD na ,, I1,. u,, ' i..4 r i.,;rasa. Ai''-OR.EI b 1989-2010 AC RL1 CORPORATION, All Fi ighEE reserved,
1,111111111111 IN 1111111111111111,1111111111111 1111i ill 1111111111111111111111111111
F, w
....................
-�iITTi(MMIDD'yyyyi
EVIDENCE OF PROPERTY INSURANCE 5/31/2013
THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF IEIF ORMATiON ONLY AND CONFERS NO RIGHTS UPON THE
ADDITiONAL INTEREST NAMED BELOW. THIS EVIDENCE OOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW, THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE
ISSUING INSURER($),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST,
PWQWE' 813 639,3000 COMPAl,
AGENCY
Con-m-wrcial Li ies-(813)639-3000 Zurich An�,erjcan nsurance Cram as iy
Welij Fasgo h-)surarcc-Services USA, kic
2502 N Rocky Point Drive,Suite 400 560 ktliss,on Siref,,I, SiAlle,2400
Tafripa,FL 33607
FAX 8 13.639,7180 i E-MAiL kris IkZ7--pso ................. San Francisco,CA 94105
AIC_14A):
L AQDRESS�
.............
CODE', SUR CODE�
AGENCY 1,5,,,)3 5
-----------
---------------
MURED LOAN NW0.W-',A POMY NUMBER
Ruth Eckefd Hal-Iric C P 0 27 8 0 6 8
111 1 McMullen Bcorh Rc,,,ad EFFFCTtVE DATE EXPIRANONDATE
(-C-04 I Wu Lb ttNl H
05E31/2013 i 0513 1,2014 Fi 1ERNMINAIF iflF
C,learwater,FL 33759
MS REPLACE 8 PRIA,-JR EVIDEME WA�EU
PROPERTY INFORMATION
LOCKMWDE84,RIPTION
Loc 1, t-2, Lcm',,3
THE POLICIES (IF INSURANCE LISTED IBELOW HAVE BEEN ISSUED TO TrIE INSURED NAMED ABOVE FOR THE P()UCY PERIOD ,NDICATEII.
NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONIRACT OR OTHER DOCUMENT WITH RESPECT TO INHICH THIS
EVIDENCE OF PROPSRT• INSURANCE MAY BE ISSUED OR MAY PERTAIN, T'1-4":H INSURANCE, AFFORDED BY THE POUC&S DESCRIBED i EREIN IS
SUBJECI 1-0 ALL THE TERMS,EXCLUSIONS AND CONDI-TIONS OF SUCH POLICIES. I-All FS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAPAIS,
COVER-AGE INFORMATION
COVERAGE I PERILS�rOR418 AMOUNI OPI'NSURANCE r DEDUCIMU
Luc 1" B u i I-d-h n-g W-Ii-0-1 H a!'I'$"1 50,0",00 0--ffe d- 40,000,000 11411, L�5'�0 0
Loc I Business Personal Property Ji rcruding Stucx 1,500,000 2 00 0
Loc I-EDP Hardware-EDP Equip&Media Per Scheckile,Attacho',J 217 300 1,000
Loc 1, RapIa(;eryient Cost,Special Form
Loc,1: business I ncome w/Extra Expeqis�-Agreed Amount 3,000,000 24 Hws
Loc 1: Flood-CPDS65 Blanket Lacs 1,2,3 fol Bldg,Personal Propoay
U00"", ',00"Oo
Loc 2. Buticing -$1 500.000 De d 250,000 25,000
b3c 2: Business Personal Property,$1,500,000 VandlHail Dad, 11,71,000, 25,000
Lrx 2 Repel",ement Cost,Speba[Form,
Loc 3:BmIding-I nel Boiler&M,,ch nc4ry C-uvef ag e $1.500,000 A6nd/Hail bad, 505,280 2� ,000
Loc 3: Business Persor:al Prope4y hicluding Stlack-$1,500,000 vVind/Hail Ded, 50,000 250000
REMAR.K8.0mc!ud
CANCELLATION
OTICE WILL BE
CE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N
SH6 LD ANY -ME ABO
""0 ILI)
=DELIVEREtD ACCORDANCE WITH THE POLICY PROVISIONS.
ADDITIONAL iNTFRFs'r
"'ICRTGAGEF iu,AiRED
NAME ANra ADDRESS
Ira S5F r.a,
CAV-of Ciearwaier L-0-ANJ 4
rlwks and
P 0 Box 4748 AUTHORIZED REPRE3f.-NTATiVF'
41--1
Clearwaleri, Ft. 33758-4748
ACORD 27(2009A 2) 4h, A(.0R0,narns aadikt'p are rnaTks;A ACCORD @ 1993-2009 ACORD CORPORATION, All rights reserved,
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