CERTIFICATE OF LIABILITY INSURANCE
~ CERTIFICATE OF LIABILITY INSURANCE I DA1E(UMmDIYYVY)
3/3i706
_CEIl Al1~ed Spec~alty Insurance, Inc THIS CERTIFICATE IS ISSUED AS A MAnER OF INFORMATION
, 10451 Gulf Blvd. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
I HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
Treasure Island, FL 33706 .a( TJ:A '" '~ll::al:ii:1 niN
800/237-3355
INSURERS AFFORDING COVERAGE NAIC#
INIUUD Emerald Coast Bungee, Inc. INSURER AI. T. H . E . Insurance Company
800 Narcissus Avenue INSURER B:
Clearwater FL 33767 INSURER c:
INSURER D:
INSURER E;
THE POUC1ES OF INSURANCE USlEO BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POlICY PERIOD INDICATED. NOlWTHSTANDING
ANY REQUIREMENT. TERM OR CONOI11ON OF ANY CONTRACT OR 01llER DOCUMENTYtIIlH RESPECT TO VIR-IICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY lHE POLICIES DESCRISEO HERBN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONCITlONS OF SUCH
POliCIES. AGGREGATE UMlTS SHOWN MAY HA\IE BEEN REDUCED BY PAID CLAIMS.
~~ POLICY NUMBER PClLJCW' I!FFEC1l\IE POLICY DPlRAlION LIMITS
~ERAL LL\lItUTY EActi OCCURAEflCE S 1,000,000
1l X COMMERCIAL GENERAL LlABlJn M6LF9617 03/11/06 03/~1107 DAMAGE 10 Rl:NreD S 50,000
I C......MSMADE 00 OCCUR MEDEX~(~on'~nl S
- PER$ONAL &IDIINJURY S 1,000,000
- GE:NERAlAGGREGATE S 2,000,000
~'I.AGGREfiUMrr APnEA: I PRODUClS-COMPiOPAGG S 1,000,000
.nLICY ~,!?; LOC
~llILE UABIUTY COMSlNI!D SINGLE UMlT S
,,,- AlfY AlITO (EIlICddenQ
-
- ALL OWNED AUTOS E1ODlL.Y INJURV S
(pill' p.~n)
- SCHECUI.EDAUTOS
- HIRED AoUTOS BODILY INJURY S
NOtI-owNED AUTOS (plrlCCidtnO
-
- PROPERTY lWIIAGE S
(1'81' 8GIlId1lllJ
~EUABIUTY I\UTO ONLY .EAACCIDENT S
NfY AUTO , O'TliER TItAN EAACC I S
AUTO CNLY: AGG ~
~15SIUM8RE1.Ul UABWn EACH OCCURFlEHCE S
0CCl.IR 0 CLAIMS MADE I AQGREQATE S
.
.
~ DEDUc:rIBLE S
RElIEtlTlClN I .
WONKERS COMI'I!NlIA11CIN ANI) loW ST;, 'T1J- I IO~
EMPLOYERS' UABIUTY E.L. EACH ACCIDENT S
PIN PROPRIETOM'ARTWERlEXECUTlVE
OFFlCERlMEMBER El(ClUl:leC7 e.L DISEASE - EA EMPLOYEE S
~~~~~lCIit.o under E.L. DISEASE - POLICY LIMIT S
OTIER
DDOIUPlION OF OPERA"lIONSILOCAllONI I VEHJCI.ES, EXCW810NS ADDED BY ENDOMeMBIT' IPI!ClAL'ROVIIIQt\lS
ADDITIONAL INSURED: CITY OF CLEARWATER AS RESPECTS TO THE OPERATION OF THE
NAMED INSURED ONLY.
,
CITY OF CLEARWATER
100 MYRTLE AVENUE
CLEARWATER FL 33767
SHOULD ANY OF TlIIUBClYl! IWiCRlaEl) PClLIClU BI! c:NtC:aLlP BEFOAe nil UPIRA110II
DATE nlERiOF. TIlE 1llUH8IN1URBR. WIU.DlDEAnJR TO IIAIL ...1..Q.... DAYS WRITTEN
NOlie! 10 lME CERI1FlCA 1&. HOLDER tlAMED 10 lIIELI!F1; BUT FAILURE TO DO 10 SHALL
IMPOII!NO ClBUGATION ORIJAil\U'l'I OF MYIONO UPON nte IHIUREIl, ITa AGENTS OR
A
ACORD 25 (2001108)