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CERTIFICATE OF LIABILITY INSURANCE (14) CERTIFICATE OF LIASILIW INSURANCE 8054 1/ THIS 09RTIMCATFJS ISSUED A A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE:HO t 3 ."TfiI CERTIFICATES DOES NOT AFFIRMATIVELY ORNEGATIVELY AMEND,EXTEND OR AL."TER THE COVERAGEAFFORDED BY THE POLICIES, BELOW. THIS CE R111TI ATES OF INSURANCE:DOM NOT CONSTITUTE A co"TRACT ammEN THE I suiNG INSLIRERSj,AUTHQ REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE: HOLDER, IMPORTANT:If the oedificate holder Is oil ADDITIONAL INSURED,the p ollayties)must be endorsed. If SLISROCBATI tNIS VitAIWED,subject to the terms and conditions of the policy, In polities may requtro an enclarsemorA. A statement on this cerM do"not car Tights to the certMoste holder In Itau of such endors rerd(s), MWOMEN CMTACT - PA.YCHEX INSURANCE AGENCY IBC/PH : . . (877) 2B7-1312' � �: (888); 443-6112 210703 03 . (877) 287--1312 : (88R) 443-6112 "-A PO BOX 33015 I<SURERM AFFOMNa COVERAGE "C* SAN ANTONIO TX 78265 A:IIQ.I ford unde'rwritels Ina Co 36104: mum DER C FIELDS, INC. IBA BAREFOOT BEA HHOUSE R0< PIS BOX 3337 t- LEARWATER FL 33767 PERF COVERAGES CERTIFICATE NUMBER, REVISION NUM ER. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATEM NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT LATH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUFD OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.ULltiIIT x SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, 0aft ?°7'f dkF71k'Y....., iWL ST13�ff- PSJJ`icr ......;EF.F P�7LTCYr-W Lam M-M COMMERCIAL GENERAL UASIt:TTY _ EACFt OCCURRENCE CLAIMS4AAOE OCCUR DAMAGETORENTED PRE#Ai;SES€a MED EXP(My awpown) PERSONAL 0,AEW KKWY. GENT AGGREGGTT LiAAET AF? LIES PER; GENERAL AGGREGATE Me owdeno ANY AUTO SWLY INJURY(Pw ) ALL OYMEtL SCHEDULED SLY MAW W I AUTOS AUTOS Pw 441 EDAUT NON-OVYNED TYC c AUTOS I UMBRELLA UAB OCCUR EACH OCCURRE S: EXCESS LIAR C ADE AGGREGATE �... Fes. X 6£R A Y, .i`.ItINCITY ar'AT£8'EE. ANY P OPRIETOWPARTN CUTPa YIN Fl,FACHACCIDENT 4,100,000 Q IGSkt4utlEM R F MU 7 l -• - ry b, x 7 WFG Ts6'r3:9 01/04/2014 0x./04/2015 F-L i C�, C�Y04,aaw*0 3 _CL }�' -�%�5 u41T � 0 0,{ ( (DE PTION OPERATIONS bekW DESCRPnON OPOZA WNSILOGA'TRMStV,...VEWMES JACM IM,A ieuad may h*saactwdiF m opwals 'those usual to the Insured's Operations.Insured' CERTIFICATE 14OLDER CANCELLAT I ! SHOULD ANY OF THE ABOVE DESCRI13ED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE ANILL BE R IT 1!Y Mj ME eQLICY PR The City ClearWater A n Arn Pty BOX 474 LAR#IATR, EL 33758 0 1088-2014 ACORD CORPORATION.A.It rights reserved.. ACORD 26(2014101) The ACORD name and logo are registered mares of ACORD ,€tea I t EVIDENCE OF PROPERTY INSURANCE 211/20144 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A NATTER OF INFORMATION ONLY AND CONFERS,NO RIGHTS UPS THE ADDITIONAL INTEREST NAMED BELOW:THIS EVIDENCE NOT AFFIRMATIVELY CAR NEGATWEL'Y AMEND, EACI'END OR ALTER THE CO C&AFFORDED BY YHE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES 140T CONSTITUTE A CONTRACT WtVMEN THE ISSUING IN8UI R(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. MORE B19:f39 3flt snAeasr .. ._.... rci (813)FA' Covington Spedalty Insurance Company Web Fargo Insurance$ervioes USA,;Inc. 2602 N.Rocky Point Drive,Suite 400 Tampa,FL 33601 855,259.71 € L dw.c nest IsWgo=rn sve cage: w_.._ 13027 Ltd"MUIARM N FIeWs Inc:OBA 1 V A23050900 Sarelbot Beach House t SCTWE DATE RRATro"LAAIM CONTNUOD uhft- PO Euax 3337 0111412014 0111412615 'TERMOIATEDIFCHECKED Clearwater Beach,FL 3 b"�a HIS LA.G FRX*90Mi DXMD: StI #639269 7.11112014 PROPERTY INFORMATION L,0CJe Loc 1,Bldg 1:332 South Gulf Blvd,Clearwater,FL 33357 Loc 1,Bldg Z 332 South Gulf Blvd,Clearwater,FL 33767 THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I IC171<D. NOTWITHSTANDING ANY REQUIREMENT, OR CONDITION<OF ANY CONTRACT CAIN CATTIER DOCUMENT WITH RESPECT TO THIS EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFF O BY THE POLICIES DESCRIBED FEIN IS SUWECT'TO ALL THE TERM,EXCLUSIONS AND CONDITIONS(?F SUCH POLICIES. LIMITS SHOWN i�AY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE!EORMATION Loc I r 9"I e�_Suildlng Lac 1,BJdg 1 Building-Roplacement Cost 150.000 1;L?0 Loc 1,BW9 1, is 50,000 39/6 Lon 1,Bldg V Business Personal Property-Actual Cash Value 5000 1,000 Loc 1,Bldg 2:Bari 94,000 3% Loc 1,Bldg!1.90%Coinsurance,Special Form,-Excluding Thaft,Excluding Wnd&Hag Loc 1,Bldg 2;Contents 10,000 3% Loc 1,BWg 1.Business Income wtFxtra Expense* al Foam Excluding Theft 1W000 Loc 1,Bldg 1,,*1/6 Monthly I aftoors Loc 1,Bldg 2>Building-Replacement Cost 77,000 1 000 Loc 1,Bldg 2:Business Personal Property-Actuat Cash Valise 1"60 REMARKS inc dl al Conditions CertMcatte holder is adriftwiall adrift insured with regards to equipment breakdown. Bldg 1 Wright:National Indemnity Ins Co;#091160228885 2123114-1$--Mg$16f,500-,Ded$2,000.,Contents$56,100,,Lied$2,000 Bldg 2 Fl Wright National Indemnity Ins Co#091150228884 2123114-1 $BW9 W,2 ..,Ded$2,000.,Contents$11,000.,Dad$2:,000 11 indstorWHatl-Waston ins Co#CFA90021,03WW9 8!15113-14 CANCELLATION SHOULD ANY OF TIME ABOVE OESCPJBED POLICIES BE CANCELLED BEFORE THE MRATICAN DATE THEREOF, NOT109 VALL BE DELIVERMIN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST L033 PAYEF City of Clearwater I LOAN� A Municipal Corpomton 25 Causeway Blvd: � Clearwater,FL:33767 9 0 21 I 21 Tt s and Wgo ere marks et 190-2009 CORD l~II<t f RATIC)I`+I. All Alts reserved. This evidence replaces evidence#639M Issued on 211 V2014 .......... C*verage(Continued bom Page 1) COVERAGE I PERILS I FORMS AMOUNT OF INSURANCE DEDUCTIBLE Loc 1,Bldg :90%.Coinsurance,Special Form Exoluding Theft,Exckiding Wind REMARKS(Continued from Page i) Bldg 1$187,460 V/16 Wind Ded.,Contents$50,00D 3%Wind Eked Bldg 2$96<82().,3%Wind Ded.,Contents$10,000.,3%Wind ded This evidence replaces evidence#639269 issued on 2t1 V2014 ' EVIDENCE OF PROPERTY INSURANCE °Ar211112014 I THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIG itTB Ilt'KDN THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES 140T AFFIRMATIVELY OR N ATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE CIF IN$($RA CE IM$t+lOx:.ONSTi"I'UTE A CONTRACT BEEN THE f I��S�iSUIN INSURER(S),AUTHORIZED REPI2ES; i"I"ATIVE PRODUCER,RAID THE ADDI I N,AI_INTEREST. Comm rcial Lines-(813).639-300D Phoenix Insurance Company y Wells Fargo Insurance Services USA.,Inc. 2502 N_Rocky Point Orive,Suite 400 Tampa,FL 33607 855.299.7117re� ctw.certr uesMw argo.eorn sua com: _. 25Fi23 LZAN NUMBER POLXV NUMSER �Po Fiekfi Inc,D13A BM213CI96:309 frsrat Boach House ©AW CONTINUED UKM PO Box 3337 0Q12013 00 14 TERMOAXTED IF COECKFM Clearwater Beach,FL 33767 SlD#639M 211114 PROPERW INFORMATION x t5 no ii Loc 1,Bldg 1 332 South Gulf Blvd,Clearwater,FL 33757 Loc 1 Bldg 2:332 South Gulf Blvd,Clearwater,FL 33767 THE POLICIES OF,INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED WMED ABOVE FOR THE POLICY PERIOD INDICATED: NOTWITHSTANCIING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS VA CE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERM,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS St OWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVE.qAGE INFORMATION _ GC+ 1 f AMOUNT OFINSt1PWC LE fpment Breakdr»n-332 ulf Blvd.,Clearwater Beach,14L-Co&ieS 95WOM shop 150,6m 1"OW i i REMARKS ftLludlng§geg!al Condltioas Bkfq 1 Floe-Wright National Indemnity Ire Co#0911502288852123/14-15--Bldg$181.500_,Dad$2,103,,Contents$55,100..Ded$2,0 Bits 2 F -WTI*National Indemnity Ins Co#091/5022 2123114-15-Bitfrg$03,2110.,Ded$2,000.,Contents$11,000.,Red$2,000 VAndstorta/Rail--Weston Ins Co#CFA9=10300009 8115113.14 sidg vsiv.46o 3%Yt1Nnd t)ed_,,contents$513,€ It 3%wind Cled Bldg 2$96,820,,30A Wind led„Contents$111,0119.,3%Wind ded CANCELLATION. t3LILD I+IY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EMRATION DATE THEREOF, 140TICE WILL BE IDELIYI4REp II+I ACCORI'DANCEV ITH TIME POLICY PROVISION& TIO IAL INTEREST NAMEANOADORM ram AOOmOftkL uasu to LOSS PAYS City of Clearwater LOAN _._. A sMunicipal Corporation 25 Causeway Blvd ac» e � srslvi — Clearwater,FL 33767 X3R027120,0112) Ttxa rmm and toga are rn ACORD 1 ACOR[D CORPOiIB4TtKDN. A dqh r rved. 311 This evidence re am evidence#639309 Issued on 211::112014 i