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CERTIFICATE OF LIABILITY INSURANCE (563)JUSTD -1 OP ID: TM "et ,RO CERTIFICATE OF LIABILITY INSURANCE DATE(MM /DD/YYYY) 11/21/2014 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 MORROW INSURANCE GROUP LENORA C. OLNEY /A196064 18936 NORTH DALE MABRY HIGHWAY TAMPA, FL 33548 GEORGE SALTSMAN CONTACT PHON: MORROW INSURANCE GROUP (A/c,, "N , Ext):813- 963 -1669 FAX No): 813- 961 -3743 ADDRIESS: TEREASA@MORROWINSURANCE.NET INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: UNITED SPECIALTY INSURANCE COMMERCIAL GENERAL LIABILITY INSURED JUST DESSERTS INC 14202 CARLSON CIRCLE TAMPA, FL 33626 INSURER B: AMERICAN STATES INS CO 19704 INSURER C: TORUS SPECIALTY INSURANCE CO 44776 INSURER D : $ 1,000,000 INSURER E : INSURER F : X COVERAGES 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. INSR LTR TYPE OF INSURANCE ADDL [NW SUBR WVD POLICY NUMBER POLICY EFF (MM /DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X USA4070452 CEIV RE a• ,j N OW 2 C 2O 11/15/2014 D 4 11/15/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) 100 000 $ � MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GEN'L X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO- ECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE X LIABILITYOFFICIAL ANY AUTO ALL OWNED AUTOS HIRED AUTOS FL PIP X X SCHEDULED AUTOS NON -OWNED AUTOS STATUTORY 01CI418 '14 ��l • �- s +a y'fC Alva... Dp�'''�'7 d%mi + 1 12/21/2015 COMBINED SINGLE LIMIT accident) $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ BASIC PIP $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 86873H141ALI 11/15/2014 11/15/2015 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED X RETENT ON $ NONE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? L _i (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below N / A r STATUTE I ] ER H E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) REF:CONCESSION THE CITY OF CLEARWATER, PO BOX 4748, CLEARWATER, FL 33758 AND COACHMAN PARK ARE NAMED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY PER FORM CG2033 CERTIFICATE HOLDER EL CITYCLW THE CITY OF CLEARWATER P 0 BOX 4748 CLEARWATER, FL 33758 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 at ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD JUSTD -1 OP ID: TM A`...." CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11/21/2014 11 /21 /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 MORROW INSURANCE GROUP LENORA C. OLNEY /A196064 18936 NORTH DALE MABRY HIGHWAY TAMPA, FL 33548 GEORGE SALTSMAN CONTACT NAME: MORROW INSURANCE GROUP (A/CC, No, Ext):813- 963 -1669 FAX No): 813 - 961 -3743 ADDRESS: TEREASA @MORROWINSURANCE.NET INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: UNITED SPECIALTY INSURANCE COMMERCIAL GENERAL LIABILITY INSURED JUST DESSERTS INC 14202 CARLSON CIRCLE TAMPA, FL 33626 INSURER B: AMERICAN STATES INS CO 19704 INSURERC:TORUS SPECIALTY INSURANCE CO 44776 INSURER D : EACH OCCURRENCE INSURER E : INSURER F : CLAIMS -MADE COVERAGES 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. INSR LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM /DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY X USA4070452 O F C NOV � C( P CORDS /2014 �4 Mr) 11/15/2015 EACH OCCURRENCE $ 1,000,000 CLAIMS -MADE X OCCUR DAMAGE TO RENTED PREMISES (Ea occurrence) $ 100,000 MED EXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENII X AGGREGATE POLICY OTHER: LIMIT APPLIES PRO JECT PER: LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP /OP AGG $ 2,000,000 $ B AUTOMOBILE — _ X LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS FL PIP X X SCHEDULED AUTOS NON -OWNED AUTOS STATUTORY . �C � A SRVCS LG1SL ig iVE SRV DEPT 01C141845 12/21/2014 12/21/2015 COMBINED SINGLE LIMIT CO accident) (Ea $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ BASIC PIP $ 10,000 C X UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE 86873H141ALI 11/15/2014 11/15/2015 EACH OCCURRENCE $ 2,000,000 AGGREGATE $ 2,000,000 DED X RETENT ON $ NONE $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below / N N / A PER STATUTE OTH- ER E.L. EACH ACCIDENT $ — -- E.L. DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) THE CITY OF CLEARWATER, PO BOX 4748, CLEARWATER, FL 33758 AND THE CLEARWATER JAZZ HOLIDAY FOUNDATION INC P 0 BOX 7278 CLEARWATER FL 33758 ARE NAMED AS ADDITIONAL INSURED WITH RESPECT TO GENERAL LIABILITY PER FORM CG2033 CERTIFICATE HOLDER CANCELLAT CITYCLW THE CITY OF CLEARWATER P 0 BOX 4748 CLEARWATER, FL 33758 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 J1 44,4 ;A-- .G • I X44_, ACORD 25 (2014/01) © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD