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CERTIFICATE OF LIABILITY INSURANCE (10) ACORN® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 12/3/2014 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 CONTACT NAME: Amy Burgess Arthur J. Gallgher&Co. A//CC,N EXt:727-796-6264 A/c No:727-791-1613 4904 Eisenhower Blvd. EMAIL Suite 250 ADDREss:amy p burgess&a0g.com Tampa FL 33634 INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:First Nonprofit Insurance Company 10859 INSURED INSURER B: Boys and Girls Clubs of the Suncoast, Inc. INSURER C: 2300 Tall Pines Drive INSURER D: Suite 150 Largo FL 33771 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:2026167551 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/YYY MM/DD/YYY • GENERAL LIABILITY Y NPP100154100 12/1/2014 2/1/2015 EACH OCCURRENCE $1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISES S Ea occurrence) $100,000 CLAIMS-MADE 15F] OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ X POLICY PRO ECT LOC $ J • AUTOMOBILE LIABILITY NCA100154200 12/1/2014 2/1/2015 Eaaccident $1,000,000 ANY AUTO BODILY INJURY(Per person) $ X ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS Per accident) $ • X UMBRELLA LAB X OCCUR NMB100154300 12/1/2014 2/1/2015 EACH OCCURRENCE $2,000,000 EXCESS LAB CLAIMS-MADE AGGREGATE $2,000,000 DED X I RETENTION$10,000 $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) Certificate Holder is included as Additional Insured on the General Liability policy, as per endorsement#PL1113 edition 06/06. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater Parks and Recreation Department ACCORDANCE WITH THE POLICY PROVISIONS. 100 S. Myrtle Avenue Clearwater FL 33756 USA AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD