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CERTIFICATE OF LIABILITY INSURANCE (426)ACORE® CERTIFICATE OF LIABILITY INSURANCE L__---- DATE(MM /DD/YYYY) 10/31 /2013 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 Aon Risk Services Central, Inc. Chita o IL Office g 200 East Randolph Chicago, IL 60601 USA CONTACT NAME: (a/C PHONE Exti: (866) 283 -7122 FAX 847 953 -5390 (AIC. No): ( ) E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A : National Union Fire Ins Co of Pittsburgh 19445 INSURED Hyatt Corporation dba Hyatt Regency Clearwater Beach Resort & Spa 71 S. Wacker Dr., 17th Floor Chicago, IL 60606 INSURER B : GL6819405 �� +-- r11 ttt ,a -:-, v INSURER C 11/1/2014 INSURER D : $ 2,000,000 INSURER E : $ 1,000,000 INSURER F : CERTIFICATE 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. LIMITS SHOWN ARE AS REQUESTED INSR LTR TYPE OF INSURANCE ADDL INSR SUER WVD POUCY NUMBER POLICY EFF (MM/DD /YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A GENERAL %( LIABILITY COMMERCIAL GENERAL LIABILITY GL6819405 �� +-- r11 ttt ,a -:-, v 11/1/2013 �� 4� ( 11/1/2014 EACH OCCURRENCE $ 2,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ 1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 2,000,000 GENERAL AGGREGATE $ 35,000,000 GEN'L AGGREGATE X POLICY LIMIT APPLIES PER: PRO JFCT LOC PRODUCTS - COMP /OP AGG $ Included $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS;, • - °- C 11 - '"' s ,ya..,`�._.� �ssbI . a �"'"° ., d,. =�' �-6-w 6'} i r r l Lr'- COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per BCf`IltPlll) $ $ UMBRELLA LIAB EXCESS LIAB _ OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N - N /A I WC STATU- OTH- I TORY I IMITS FR E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) 13 -14 ALGLWCEX City of Clearwater is an additional insured but only with respect to the negligence of Hyatt Corporation d /b /a Hyatt Regency Clearwater Beach Resort & Spa relative to the special event permit for the Weddings to be held throughout the policy period. CERTIFICATE HOLDER CANCELLATION City of Clearwater 100 Sourth Myrtle Ave. Clearwater, FL 33756 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED REPRESENTATIVE /Lt sR .. Ja mer c .tacea a, c .a esl, 57,er. ACORD 25 (2010/05) © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD