CERTIFICATE OF LIABILITY INSURANCE (10) iA �iQtgoR;d+;.471��
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CERTIFICATE OF LIABILITY INSURANCE 29/2013
1 117;
THIS CIERTIFICATSIS 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*It the vartificataholder Is an ADDITIONAL INSURED,the policy, (108)numt t*endorsett. If SUBROGATIONIS WAIVED,subject to the
tems and conditions of tho policy,certain policies may require an andorsoinant Astatenwnt on thin,certificate does not confer rights to the
certificate holder In lieu of such andorsement(s).
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I YCHEX INSURANCE AGENCY INC/PHS PHONE rAX
wc,tio�zgy 1877) 287-131.2 PIC,Nt,� (988) 443-6112
210703 P'.* (877) 287-1312 F.- (8 8) 443-6112 ,---
ADDRUS,
PO BOX 33(j 15 I1 RISKS)AFFMONG COVE NAIC9
SAN ANTONIO TX 78265 WSUREAA.
ALEXANDRA OF CLEARWATER BEACH INC DBA 04 SUPIER C
PIER 60 CONCESSIONS N"EA 0
PO BOX 3337 WMAIER E
CLEARWATER FL 33-767
COVERAGE$ 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 NOTWITHSTANDING ANY REQUIREMEUT, TERM OR CONDITION OF ANY CONTRACT OR OTHER VMEN'T WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DES.0,RIDED, HEREIN IS SUBJECT to ALL THE
TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TIPE Of w11zt'vCf 'ID01 S14A Iv"CrINIUMEN P041crArrF PM10'rAr Litt Ts
EACH OCCURRENCE
=COMMDAMAGE
ERCIAL GENERAL LMILrTY P'EMtSES?E. J
$
--iCLAIMS-MADE OCCUR MED EX9(Any o"peaon)
PERSONALS XDV INJURY
GENERAL AGGREClATE
GEN'L AGGREGATE LIMIT A PP LkESPER: PRODUCTS-COMPfiOP AGG
POLICY LCD
El
COMBINED SINGE LIMIT
w wwwtE t"sicin, L
&WAIJTO 80DILY WURY JlPefpempo)
ALL CfflWD 50KEPULED BODILY INJUqY JPw be6d6dj I
AVM ARfTL
PROPERTY DAMAGE
HIRED AUTOS
AVT0$ (Pv wddso.l)
11 Li A UAS OCCUR EACH OCCURRENCE
EXCESSIJAS. H CLAIMS-MADE AGGREGATE
TW
O�Y VA W7T I 5 R7 .
A7 ETMPARTNffRMXECUTWEYIN EL.EACM ACCIDENT 11,00,0.00
0 FaP0JPM'I'E'MBfiR EXCLUDED? *A 4 LL,WISASIE-EAEMPLOYEErloo 000
A ('w*,Qd*twy1nNH) Li If j.64,*s4mb*WW*
DESCRIPTION OF OPEFV,,�110NS Wow E-I.DISEASE-POLICY LIW 111-300,000
DZ30R#1n0N OF OPERATIOM;L4CATIWI;I VEWLEI(#AXtJn*LwVO is Aff"A ACORD 101,:A;(dW*#0 PohIo*s$0Wdw$k 0 mom"co is maul
Those usual to the InsuredIs Operatlons.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED
BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE
QIEUYMQJKACqQBPA L 40E WITH THE POLICY-L>ROVt$I0NS;
The C.Lty ClearKater AUTWIRWWREPRES"TATIVE
PO BOX 4748
CLEARWATER, FL 3378
I .. ................
01988-241£I ACORD CORPORATION.All rights roserved.
ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
DST W07 I 9V,
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