The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (268)AoRE T i� c CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDD/YYYY) 12/31/2013 AMEN 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 Willis of New Jersey, Inc 350 Mt. Kemble Avenue P.O . Box 1969 Morristown NJ 07962 NAME: Erica Adams INC. ° ° No. E>d1:973 539 6677 (a/c No):973 410 4600 E -MAIL ADDRESS:Erica.Adams @willis.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A Zurich-American Insurance Group 16535 INSURED SURFSTY Surf Style Retail Management, Inc. 4100 N. 28th Terrace Hollywood FL 33020 INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 146070912 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 THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDL INSR SUBR WVD POLICY NUMBER POLICY EFF (MMIDD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL LIABILITY GLA554285401 -- - -- -- 12/30/2013 12/30/2014 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES (Ea occurrence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $2,000,000 POLICY PF LOC $ A AUTOMOBILE LIABILITY GLA554285401 _ 12/30/2013 12/30/2014 COMBINED SINGLE LIMI I (Ea accident) $1,000,000 $ X ANY AUTO BODILY INJURY (Per person) ALL OWNED HIRED AUTOS SCHEDULED NON -OWNED AUTOS BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ A UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE AUC554279401 12/30/2013 12/30/2014 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED X RETENTION $10,000 $ WORKERS COMPENSATION WC STATU- OTH- TORY LIMITS ER AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE YIN OFFICER /MEMBER EXCLUDED? (Mandatory in NH) N I A E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) City of Clearwater is included as Additional Insured as required by contract and per policy terms. CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 Myrtle Street SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater FL 33756 1, AUTHORIZED REPRESENTATIVE Q. z.«^'t © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD