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CERTIFICATE OF LIABILITY INSURANCE (338)04/25/2014 13:35 (386) 775 -3666 Michelle Bullis Page 1/1 ' i f CERTIFICATE OF LIABILITY INSURANCE DATE 0425DA Y) 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 pollcy(ies) must be endorsed. If SUBROGATION IS WANED, 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 First Commercial Insurance Agency P.O. Box 295 Cassadaga, FL 32706 Phone (386)775 -1781 Fax (386)775 -3666 CONTACT Tony Cannizzaro , N No): (386)775 -3666 (aco. Ext): (386)775 -1781 (AA/C AADD &Ss: insuranceguy@cfl.rr.com INSURER(S) AFFORDING COVERAGE NAIC s INSURER A : Canal Indennity Company 27790 INSURED Rent Viva Jump, LLC 9110 Camino Villa Blvd Tampa, FL 33635 INSURER B : 08/05/2013 INSURER C : EACH OCCURRENCE INSURER D : DAMAGE TO RENTED PREMISES (Ea occurrence) INSURER E : M COMMERCIAL GENERAL LIABILITY INSURER F : $ 5,000.00 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 IIN RL3ANDD POLICY NUMBER (MMWD POLICY (MMJDD/WYY) LIMITS A GENERAL LIABILITY Y GL104873 08/05/2013 08/05/2014 EACH OCCURRENCE $ 1,000,000.00 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 50,000.00 M COMMERCIAL GENERAL LIABILITY MED EXP (Any one person) $ 5,000.00 • • CLAIMS -MADE M OCCUR PERSONAL & ADV INJURY $ 1,000,000.00 • • GENERAL AGGREGATE $ 2,000,000.00 GENII_ AGGREGATE LIMIT APPLIES PER: ri POLICY • jEo- • LOC PRODUCTS - COMP /OP AGE $ 2,000,000.00 $ AUTOMOBILE LIABILITY CONFINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ • ANY AUTO BODILY INJURY (Per accident) $ SCHEDULED • ALL OWNED ❑ NON PROPERTY DAMAGE (Per accident) $ -OWNED II HIRED AUTOS M AUTOS • • $ ■ UMBRELLA LIAB U OCCUR • EXCESS LIAB • CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ ❑ DED • RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y J N ANY PROPRIETOR/PARTNER /EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) • N J A • WC STATU- al- TORY LIMITS ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE' $ If yes, describe unde DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS J VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) CLEARWATER COMMUNITY REDEVELOPMENT AGENCY ARE NAMED ADDITIONAL INSURED AS REGARDS THE GENERAL LIABILITY POLICY. Inflatable Rentals and Table, Tent & Chair Rentals Contact: Hector 813- 770 -9634 Special Event. El dia del Nino. 04/27/2014 CERTIFICATE HOLDER CANCELLATION I Clearwater Community Redevelopment Agency P.O. Box 4748 Clearwater, FL 33756 Fax: 727 -562 -4086 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 ACORD 25 (2010/05) OF © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD