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CERTIFICATE OF LIABILITY INSURANCE
CLEA -37 OP ID: 2L '.% +`,:'�O CERTIFICATE OF LIABILITY INSURANCE DATE 09/30/2013 09/30/2013 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 Phone: 727-447-6481 Bouchard - Clearwater Fax: 727 -449 -1267 101 Starcrest Drive P 0 Box 6090 Clearwater, FL 33758 -6090 Josh Bouchard, AAI NAME: PHONE FAX IA/C, No, Ext): (NC, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : Scottsdale Insurance Company 41297 INSURED Clearwater Marine Aquarium Mr. Don Dewsnap 249 Windward Passage Clearwater, FL 33767 INSURER B : Aspen Specialty Insurance Co 10717 INSURER C : 10/01/2014 INSURER D: $ 1,000,000 INSURER E : 100 000 $ , INSURER F : COVERAGES CERTIFICATE 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSI_ SUBR WVQ- POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CPS1642892 10/01/2013 10/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ , CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE POLICY LIMIT APPLIES PRO JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CXA61QY13 10/01/2013 10/01/2014 EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 9,000,000 DED X RETENTION$ NONE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNERIEXECUTNE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N 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) RE; RENTAL SPACE AT HARBORVIEW CENTER, 320 CLEVELAND STREET, CLEARWATER, FLORIDA - 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 CITY OF CLEARWATER 112 S. OSCEOLA AVE CLEARWATER, FL 33756 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 1 ACORD 25 (2010/05) © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CLEA -37 OP ID: 2L A '`"' CERTIFICATE OF LIABILITY INSURANCE DATE 09 /30 /DD/YYYY) 09/30/2013 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 Phone: 727 -447 -6481 Bouchard-Clearwater Fax: 727 -449 -1267 101 Starcrest Drive ax P 0 Box 6090 Clearwater, FL 33758 -6090 Josh Bouchard, AAI mom- PHONE FAX (A/C. No. E x t 1 : (A/C, No): ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Company 41297 INSURED Clearwater Marine Aquarium Mr. Don Dewsnap 249 Windward Passage Clearwater, FL 33767 INSURER B: Aspen Specialty Insurance Co 10717 INSURER C 10/01/2014 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : CLAIMS -MADE COVERAGES CERTIFICATE NUMBER: R 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. INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYYL LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CPS1642892 10/01/2013 10/01/2014 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GE X 'L AGGREGATE POLICY LIMIT APPLIES PRO- JECT PER: LOC PRODUCTS - COMP /OP AGG $ 2,000,000 $ AUTOMOBILE _ LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B X UMBRELLA UAB EXCESS LIAB X OCCUR CLAIMS -MADE CXA61QY13 10/01/2013 10/01/2014 EACH OCCURRENCE $ 9,000,000 AGGREGATE $ 9,000,000 DED X RETENTION$ NONE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N 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 I VEHICLES (Attach ACORD 101, Additional Remarks Schedule if more space is required) CITY OF CLEARWATER IS ADDITIONAL INSURED AS RESPECTS TO GENERAL LIABILITY ONLY IF REQUIRED BY WRITTEN CONTRACT AND SUBJECT TO TERMS, CONDITIONS AND LIMITS AS SPECIFIED IN THE POLICY. CERTIFICATE HOLDER CANCELLATION CITYOFC CITY OF CLEARWATER P 0 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 THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD