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CERTIFICATE OF LIABILITY INSURANCE (11) DAT ( CERTIFICATE OF LIABILITY I RG NSURANCE R054 12/29/2014 M/DD/YYYY) THIS CERTIFICATEIS 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(les)must be endorsed. If SUBROGATIONIS 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: AUTOMATIC DATA PROCESSING INS AGCY PHONE F (A/C,No.Ext) J(A/C,No): 250717 P: F: E-MAIL ADDRESS: PO BOX 33015 INSURERS)AFFORDING COVERAGE NAIC# SAN ANTONIO TX 78265 INSURER A: Hartford Underwriters Ins Co 30104 INSURED — INSURER B ALEXANDRA OF CLEARWATER BEACH INC DBA INSURER C PIER 60 CONCESSIONS INSURER D PO BOX 3337 INSURER E: CLEARWATER FL 33767 INSURER F 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. –iN—SR TYPE OF INSURANCE 7DDL Si7R2 POLICY E1111 POLICYNUMBER LICyEyp LTR JASR ff" (M2WDD1YYY1) 6MMDDffYYD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE DAMAGE TO D CLAIMS-MADE❑OCCUR PREMISES(Ea occuRENTE rrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLI ES PER: GENERAL AGGREGATE $ P JECT PRODUCTS-COMP/OP AGO RO- POLICY F F__1 LOC OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT — (Ea accident) — ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED �' — AUTO AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED AUTOS PROPERTY DAMAGE — (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LAB CLAIMS-MADE AGGREGATE $ DED [RETENTION$ WORKEPY COMPENSATION PER AND EMPLOYERS'LLIBILITY X STATUTE ER OTH- ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 1100, 000 OFFICERIMEMBER EXCLUDED? E.L.EACH ACCIDENT A (Mandatory in NH) NIA 76 WEG GG6663 01/04/2015 01/04/2016 E.L.DISEASE-EA EMPLOYEE $100 000 If yes,describe under DESCRIPTION OF OPERATIONS below F.L.DISEASE-POLICY LIMIT 1500, 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Those usual to the Insured's Operations. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. The City C l e a r W a t e r AUTHORIZED REPRESENTATIVE PO BOX 4748 CLEARWATER, FL 33758 @ 1988-2014 ACORD CORPORATION.All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD A`� D CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD /YYYY) 12/27/2014 THIS CERTIFICATEIS 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 SUBROGATIONIS 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 AUTOMATIC DATA PROCESSING INS AGCY 250717 P: F: PO BOX 33015 SAN ANTONIO TX 78265 CONTACT NAME: PHONE FAX (A/C, No, Ex[): (A/C, No): E -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIGYI INSURER A: Hartford Underwriters Ins Co INSURED ALEXANDRA OF CLEARWATER BEACH INC DBA pr m ,j, tbtis PO BOX 3337 CLEARWATER FL 33767 INSURER B : INSURER C: INSURERD: INSURERE: INSURER F: S 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. EVSR LTR TYPE OF INSURANCE INSR INSR S1/SR IVI'D POLICY NUMBER POLICY EFF (MM/O train) POLICY EXP IMM/DIIVYPYYI LIMITS COMMERCIAL GENERAL MADE LIABILITY OCCUR EACH OCCURRENCE S CLAIMS DAMAGE TO RENTED PREMISES PREMISES (Ea occurrence) MED EXP (Any one person) $ PERSONAL & ADV INJURY $ GEN'L AGGREGATE LIMIT PRO- JECT APPLIES PER: GENERAL AGGREGATE POLICY LOC PRODUCTS - COMP /OP AGG $ OTHER: S AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS COMINED (Ea accideSINGLE LIMIT t) S BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ S UMBRELLA UAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE S DEC RETENTION $ S A WORKERS COMPENSATION AND EMPLOYERS' L1ABILITY ANY PROPRIETOR/PARTNER/EXECUTIVEY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS /N N/A 76 MEG GG6663 01/04/2015 01/04/2016 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $100,000 E.L. DISEASE -EA EMPLOYEE 7/00,000 below E.L. DISEASE - POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICONIESIRD 101, Additional Remarks Schedule, may be attached if more space is required) Those usual to the Insured's Operations. The City Clearwater PO BOX 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 7 � ACORD 25 (2014!01) _2074 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD