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CERTIFICATE OF LIABILITY INSURANCE
CERTIFICATE OF LIABILITY INSURANCE 03T/T4i2oi4 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 NAME: Sam Muradyan LIBERTY UNITED INSURANCE SERVICES, INC. PHONE g18-761-8888 FAX 818-761-8878 A!C No 6005 N VINELAND AVE E-MAIL ADDRESS: SUITE 203 INSURER(S)AFFORDING COVERAGE N_AIC# NORTH HOLLYWOOD CA 91606 INSURERA:United States Fire Insurance Co. INSURED INSURER B All Around Amusements INSURER C INSURER D 4001 Willow Hills Court INSURER E: Plano, TX 75024 CERT # USP141855 I 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 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 TYPE OF INSURANCE ADD L SUBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDIYYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 SRPGP-101-0413 03/16/2014 03/16/2015; DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Eaoccurrence) $ 300,000 CLAIMS-MADE OCCUR MED EXP(Any one person) $ 5,000 A X PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 5,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $ 5,000 000 71/ POLICY PRO- LOC $JECT COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident I $ UMBRELLA LIAB OCCUR !USX100852 03/16/2014 03/16/2015 EACH OCCURRENCE $ 4,000,000 A EXCESS LIAR CLAIMS-MADE :AGGREGATE $ 4,000,000 DED RETENTION$ $ WORKERS COMPENSATION WC STATU- TORY OTH- AND EMPLOYERS'LIABILITY Y/N FIR -- ANY PROPRIETOR/PARTNER/EXECUTIVE El NIA EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder is an Additional Insured CERTIFICATE HOLDER CANCELLATION City of Clearwater Parks & Recreation SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. PO BOX 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 33758 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD DATE tsDnYrn 3f711; TJ�1 -LIAII$ � Sa� 04/0412014 MODUCEe THIS CERTFICATE M t=UED AS A MATTER OF INFORMATION, TNT Only One Insurance Agency ONLY' AND:.00NW.ERS NO RATS THE CERf*1CATE Y Y HOUR, . M41S CERTWICATE DOES NOT.Afs1im ex.1END OR 19510 Van Buren Blvd #300 ALTER THE Ct7�AFFORDED BY THE PWCIES.BELOW. Riverside, CA,92508 (951) 780-6375 Office (951) 780-7348 Fax WSURBRS WORMING COVERAGE NAIC* ,» Texas Mutual nsurance All Around Amusements NsUttESrs. . i — 4281 E. Hwy 380 Princeton, TX 75407 RERD ' tNStTR£R E: COV.ERAGES THE FOLIOIES OF INSERRANCE LW ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED Asove FOR THE P(x IcY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM'OR CONDITION OF ANY CONTRACT OR OTHER©ACUMENT WTH RESPECT TO wH1CN THI$,cFAnFICATE MAY BE ISSUED OR MAY PEFITAK THE INSURANCE:AFFORDED SY.THE tPoUctES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS;AND CONDITIONS OF SUCH POLICIES::AGCOEGATE LUT6 SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. .. . . _ -. i POUCYHFt�CTlYE lOUCY EXPIR11TN7N . �" ; �rucY Nu>MSEIe uNTa �.EACHOCCUFOKICE *.s, fMAMAGETORkNTEV CdAM C7feI.0ENERALLMILITY I CLAIM MADE � j OCCUR� � k MEDExA{J4�rcroP�2 ;s PEKSONAI.dADYN4.1URY S. k _ a Gt1ERlU.AGGREGATE 4 $ I C MLAGGREGA.'ML TAPPLIESPM£ ;PRODUCTS-COMPIOPAGG j S . fI P4UCYI EP -.. LOC f ALfTCMOBM.ELiA&1AT'l - I j COMBNMSNGLELUT ANY AUTO j ( BOOLYROURY ` �.SCHEDULEDAUTOS i -HIRED AUTOS ( j BODILY NJURY 1$ I NON-OWNEDAUTOS i €(Pbre�3d6nt} t PROPERTYDAMAGE S j 6ARA6EUA8LLtfY i AUTOON.Y-EAACCIDENF ES � k ANYAUTO OTHER EAACC=S 4 3 i AGG i S >;7tGES6NI�RELLAtli1BB.ITY {! I EACHOCCURRENGE S__..._._..__ ' OCCUR GLANDS MADE i e AGORE�i3A1'E DEDUCTWU i WOWAM COMPO SATM MW 1 I i SBP0001267469104/04/2014 04/04/20151'X A ,ktMPI.0YER8'Lt"W". ! ;E.LEACHACCIDENT 3 1.00010 I ANY PROPW70"AWINEREXECUTIYE i ! CFFfiCEiL'F�MBEREXCLUOED? j E1.D14FJS£-EA9JPL0YU1 S 1,000 O „ €E.LD€SEASE-Ptk.1CYtjwr i s 1.000.000 OTHER 1 Property Section taESCRtPTON Of'OPERATtONS J LOCATHbi3/YfHtCLE4!EXCLUiSlCFt4 ACOE09'VENDORSEt1ENTtSPECU€IPROVt6Nk13 EVIDENCE OF INSURANCE * 10 day cancellation clause for non-payment of premium. CERTIFICATE HOLDER CANCELLATM 8wxmo ANY OF THE A80Y$DESCRIBED POLICIES BE CANCELLED BEFORE TIC"NAM" INSURED'S COPY DAU nWMOf.TME MSUW.MUM W01 ENWAY RTO MAO.*-3D-DA''g WOM" NOTICE TO THE CERTSiCATE WLDER NAM TO THE LEFT,But FAILURE TO DO$O SHALL WPOSE No OBL%UTMK OR LIAWLfFY OF ANY MW UPON THE"URER,ITS AGENTS OR REPRESENfATAMS. • __. _. _ Ai1THOR6tEDREPRESEIiTATNE - Nioka Marks ACORLI..?5(2001M) 0 ACORD CORPORATION isss 1 0 DATE(MWDDNYYY) ACCM1:� CERTIFICATE OF LIABILITY INSURANCE 04/16/2014 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 CONTACT NAME: Todd Campbel](355231J) PHONN Ext; 214-420-7500 ac No: 'F Ste 550 A MAIL 7616 Lb ) WY ADDRESS: Ica f rm rsa ent.COm INSURERS AFFORDING COVERAGE NAIC# Dallas TX 75251-1122 INSURER A. Truck Insurance Exchange 21709 INSURED INSURER B: Farmers Insurance Exchange 21652 ALL AROUND AMUSEMENTS LLC INSURER C: Mid Century Insurance Company 21687 4281 E HWY 380 INSURER D: Texas County Mutual 24392 INSURER E: PRINCETON TX 75069 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 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 TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $- GE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) $ CLAIMS-MADE r_1 OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY I PRO LOC $ AUTOMOBILE LIABILITY Ea eclZN er°itSINGLE LIMIT $ 1,000,000 ANY AUTO BODILY INJURY(Per person) $ D ALL OWNED SCHEDULED Y 605828159 04/02/2014 04/02/2015 BODILY INJURY(Per accident) $ AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS P AUTOS are dent UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN ER _ ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ NIA E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) See Declarations CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CLEARWATER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 10 Pier 60 Dr ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Clearwater Beach FL 33767 ACORD 25(2010/05) ©19 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD TEXAS LIABILITY INSURANCE CARD t � CommerehlPbky 1~11 Ili M: R ALL AROUND AMUSEMENTS kLC ALL AROUND AMUSEMENTS Policy Number. 605828159 4281 E HWY 380 Effective Date: 04/02/2,014 PRINCETON,TX 75069 Expiration Date: 04/02/2015 NAIC Number: 24392 Year2008 Make DODGE Model RAM 3500 QUAb ST/SLT VIN qD7NIX48AX8G161745 Texas County mutual 1-800-225-001.1 This policy provides at least the minimum amounts of liability insurance required by the Texas Motor Vehicle Safety Responsibility Act for the specified vehicle and named insureds and may provide coverage for other persons and other vehicles as provided by the insurance policy. Apt Flame:Todd Campbell Phone W. 214-420-7500 23-7700 10.12 a7700301 Texas Liability Insurance Card Tarieta de Segura do Reslimsaliffidad do Texas Kee This Card wide esta to i*a. NPORTANT:This card or a copy of your insurance policy must 1MPORTAN E: Esta taleta o Una copia de su poliza de seguro be show when you apply for or renew your. debe ser mostrada cuaruio usted solicite o renueve.su • motor vehicle registration . registro de vehiculo de motor • driver's license s licia pare conduit • motor vehicle safety inspection sticker. a eliqueta de inspection de seguridad Para su vehiculo. You also may be asked to show this card or your poky K you Puede que usted tenga tambien que mostrar esta larjeta o su have an accident o(�a peace officer asks to see it. pokza de seguro si tiene un sccidente o;si un ofidal do la paz se la All drivers in Texas must carry liability insurance on their pde. vehicles or otherwise meet legal requirements for financial `todos los conductores en Texas deben de tenet seguro de responsibility.,failure to do so could result in fees up to$1,000, responsabilidad para sus vehiculos, o de otra marin llenar los suspensW of your driver's license and motor vehicle requisilos legates de responsabilidad civil. Fallo en llenar este registration, and impoundment of your vehicle for up to 180 requisito pudiera resultar en multas de hastall,W0,suspension days. de su licetxia para conducir y su registro de vehiculo de motor,y la retention de su vehiculo por un periodo de hasta 1.00 dins: