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CERTIFICATE OF LIABILITY INSURANCEOCEAPRO -29 JJACK ACOR Y CERTIFICATE OF LIABILITY INSURANCE `�" DATE:(MM/DD/YYYY) 7!15/2013 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 terms 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 The Loomis Company P &C Division P 0 Box 7011 Wyomissing, PA 19610 -6011 NAME: CT Joy Jack PHONE 374 -4040 (A/C, No, Ext): ( 610 ) FAX 6101 376 -1049 (NC, No): E-MAIL SS: JJack @loomisco.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Tokio Marine Specialty Insurance Company INSURED The Sandpearl Resort LLC 1000 Market Street Building One, Suite 300 Portsmouth, NH 03801 INSURER B : Philadelphia Indemnity Ins Co 18058 INSURER C : National Union Fire Ins Co of Pittsburgh PA 19445 INSURER D : INSURER E : INSURER F : 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. 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 POLIC ES DESCRIBED 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 INSR SUBR POLICY NUMBER (MM/DD/YYYY) (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY PPK1048883 ! � ry ., f'_'.. V 7/15/2013 ' '. 7/15/2014 EACH OCCURRENCE $ 1,000,000 pREMISESO(Ea occur ence) $ 1,000,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GE 'L AGGREGATE POLICY LIMIT APPLIES PRO- E X PER: LOC $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS AUUTOSWNED a. PHPK1048868" " " '` `' f 7/15/2013 7/15/2014 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (PER ACCIDENT) $ $ C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE BE84145119 7/15/2013 7/15/2014 EACH OCCURRENCE $ 25,000,000 AGGREGATE $ 25,000,000 $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE Y / OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A WC STATU- TORY LIMITS OTH- ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TRIA is included on all policies except EPLI. Employment Practices Liability: Travelers Casualty & Surety Co, Pol #5926284; $3,000,000 limit 7/15/13 to 7/15/14. Insured Location: Sandpearl Resort, 500 Mandalay Ave, Clearwater, FL. The following are included as additional insureds under the General Liability: City of Clearwater & Floridata Capital Assets Group, Inc., 2085 CR 753 South, Webster, FL 33597 CERTIFICATE HOLDER CANCELLATION City of Clearwater PO Box 4748 Clearwater, FL 33755 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE WC-7144"" d ACORD 25 (2010/05) ©1988 -2010 ACORD CORPORATION. All rights reserve. The ACORD name and logo are registered marks of ACORD