The URL can be used to link to this page

CERTIFICATE OF LIABILITY INSURANCE (483)ECKER -2 OP ID: JJ 4WRL CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 07/01/2014 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 CONTACT NAME: PHONE FAX (A/C. N). Ext): (NC, No): E-MAIL LSS: INSURER(S) AFFORDING COVERAGE NAIC A INSURER A : Nautilus Insurance Company 17370 INSURED Eckerd Youth Alternatives, Inc 100 N Starcrest Drive Clearwater, FL 33765 -3224 INSURER B : Everest National Insurance Co 10120 Phoenix Insurance Company INSURER C 07/01/2015 INSURER D : Charter Oak Fire Insurance Co $ 1,000,000 INSURER E : $ 100,000 INSURER F : $ 5,000 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 LTR TYPE OF INSURANCE ADDL INSR SUBR MD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MMIDD/YYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY X - - - GFP1000173P3 07101/2014 07/01/2015 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurtence) $ 100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP /OP AGG $ 1,000,000 GEN'L AGGREGATE ^ I POLICY LIMIT APPLIES JET PER: LOC Emp Ben. $ 1,000,000 B AUTOMOBILE X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS CF4CA00094131 07/01/2014 07/01/2015 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 CFX1000123P3 07/01/2014 07/01/2015 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 Excess $ $4M of $5M DED X RETENTION $ 0 D L.: WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE Mandatory In NH) EXCLUDED? If yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A TROUB9D904190 -14 TC2NUB 9D904189 -14 07/01/2014 07/01/2014 07/01/2015 07/01/2015 X TOTMUT- S 0R - E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT $ 1,000,000 A A Professional Liab Abuse & Molestatlo PFP1000223P3 PFP1000223P3 07/01/2014 07/01/2014 07/01/2015 07/01/2015 Limits $1MM /$3MM Limits $1 MM /$3MM DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) TROUB9527826013 - WC POLICY FOR STATES: FL, SD, TN TC2KUB488D027813 - WC POLICY FOR STATES: AL, IA, LA, NC, OK, SC, TX 6 VT CERTIFICATE HOLDER IS ADDITIONAL INSURED AS RESPECTS GENERAL LIABILITY ONLY IF REQUIRED BY WRITTEN CONTRACT, AND SUBJECT TO THE TERMS, CONDITIONS AND LIMITS AS SPECIFIED IN THE POLICY.. CERTIFICATE HOLDER CANCELLATION CITYOFC CITY OF CLEARWATER P.O. BOX 4748 CLEARWATER, FL 33758 -4748 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) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD