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CERTIFICATE OF LIABILITY INSURANCE (7)RUTHECK OP ID: KG ,4co/2O" CERTIFICATE OF LIABILITY INSURANCE �� DATE(MM /DD/YYYY) 05/30/2014 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 Phone: 727 -447 -6481 Bouchard - Clearwater Fax: 727 -449 -1267 101 Starcrest Drive P 0 Box 6090 Clearwater, FL 33758 -6090 E Beck ; A Bouchard; P Runyan NAME: CT PHONE FAX (A/C, No. Ext): (NC, No): AE-MAIL DDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A :Zurich American Insurance Co 16535 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Rd Clearwater, FL 33759 INSURER B : American Guarantee & Liability 26247 INSURER C : RetailFirst Insurance Company 10700 INSURER D : $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ 10,000 • N NUMBER: vv.rvww ..�......... -.. .�................ _ 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 SUER WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X CP00171568-00 05/31/2014 05/31/2015 EACH OCCURRENCE $ 1,000,000 pREM SESO(Ea ocou ence) $ 100,000 MED EXP (Any one person) $ 10,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 GENT. AGGREGATE POLICY LIMIT APPLIES PRO- JFOT PER LOC $ B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED NON OWNED AUTOS CP00171568 -00 05/31/2014 05/31/2015 COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE AUC9672941 -06 05/31/2014 05/31/2015 EACH OCCURRENCE $ 10,000,000 AGGREGATE $ 10,000,000 $ DED X RETENT ON $ 0 C WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION DESCRIPTION OF OPERATIONS below YIN N / A 052046229 01/01/2014 01/01/2015 X WMT- S W- E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1 OOO,OOO E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) re: CAPITOL THEATER 405 CLEVELAND ST, CLEARWATER, FL CITY OF CLEARWATER IS ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO ALL TERMS, CONDITIONS AND LIMITS OF THE POLICY. WAIVER OF SUBROGATION AS RESPECTS GENERAL LIAB IS PROVIDED TO THE CERTICATE HOLDER. GCK I IrlVA I C MULUCIC CITYCLW CITY OF CLEARWATER A MUNICIPAL CORPORATION PO BOX 4748 CLEARWATER, FL 33758 -4748 1 " ^'--"-_.... ^- SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE — - -- All -._LL - -.....- .....J ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD • RUTHECK OP ID: KG CERTIFICATE OF LIABILITY INSURANCE DATE 07/16/2014Y) 07/16/2014 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). CONT PRODUCER Phone:727-447-6481 NAMEACT Bouchard-Clearwater Fax:727-449-1267 PHONE FAX 101 Starcrest Drive A/c No Ext: (A/C,No): P O Box 6090 E-MAIL Clearwater,FL 33758-6090 ADDRESS: E Beck;A Bouchard; P Runyan INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Zurich American Insurance Co 16535 INSURED Ruth Eckerd Hall,Inc. INSURER B:American Guarantee &Liability 26247 1111 McMullen Booth Rd INSURER C:RetailFirst Insurance Company 10700 Clearwater, FL 33759 INSURER D INSURER E 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 SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY X CP00171568-00 05/31/2014 05/31/2015 DAMAGE ( RENTED PREMISES Ea occurrence) $ 100,000 CLAIMS-MADE 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 X POLICY PRO LOC $ T JEC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1,000,000 000 Ea accident $ r r B X ANY AUTO CP00171568-00 05/31/2014 05/31/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,000 A EXCESS LIAB CLAIMS-MADE AUC9672941-06 05/31/2014 05/31/2015 AGGREGATE $ 10,000,000 DED X RETENTION$ 0 $ WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITY TORY LIMITS ER C ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N 052046229 01/01/2014 01/01/2015 E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE: 1111 MCMULLEN BOOTH RD, CLEARWATER, FL CITY OF CLEARWATER IS ADDITIONAL INSURED ON GENERAL LIABILITY SUBJECT TO ALL TERMS, CONDITIONS AND LIMITS OF THE POLICY. WAIVER OF SUBROGATION AS RESPECTS GENERAL LIAB IS PROVIDED TO THE CERTICATE HOLDER. CERTIFICATE HOLDER CANCELLATION CITYCLW SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF CLEARWATER ACCORDANCE WITH THE POLICY PROVISIONS. A MUNICIPAL CORPORATION PO BOX 4748 AUTHORIZED REPRESENTATIVE CLEARWATER, FL 33758-4748 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD