CERTIFICATE OF LIABILITY INSURANCE (2)
14 2007 9:26AM
HP LASERJET FAX
p.2
Spec~alty Insurance,
Ioc
FL 33706
Emerald Coast Bungee, Inc.
~15Lantana Avenue
Clearwater FL 33767
INSURERS AFFORDING COVERAGE
INSURER A: T. H . E. IrJ.suranc e
INSURER B:
ER C,
INSURER 0:
COVERAGES
THE POUCIES OF INSURANCE USTEC BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTVil1THSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMENTIJIJI11-I RESPECT TO V\+iICH THIS CERl1FICATE MAY BE ISSUED OR
MAY' PERTAIN. THE INSURANCE AFFORDED BY 11-IE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TI:RMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES_ AGGREGATE UMITS SHO,^", MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ --
.....;:.~ ............" f'OLJc:Y NUMBER POUCY I!FFECTlVE! POLIcY I!XPIRI\".lON UMITS
~ EAA\.UAIJn.rTY EACH Ol::CUAREN~ 5 1,000,000
F. X COMMEi;{CIAL GENEAA~ UASILITY M7LF3442 03/~1/07 03/11108 DAMAGE TO RENTED S 50!..~..Q.~_._.
I CLAIMS MAOE .00 OCCUR MEt) I!l(P I~... ono ....l'IClnl .. L_......._____
PEASONAL&AO\IINJURY S 1,000,000
GENERALJlGGREGATe S 2,000,000
~~AGGREnUMIT "rfER: - COMPIOP AGO S 1,000,000
POL'CY~Ll.e; 'lOC
~TOMOBLl!.UABIUiY COM8lNeDS:NOLE UMrr .
ANY AUTO (EnCGIden Q
1-
~ ALLOWN~D AUTOS BODILY IN.AIRY S
SCl-IEOULEDAUTOS (Per p_1
-- -...---.----
-- HIRED AUTOS BODILY INJURY S
NON-O'MllED AUTOS (Per .a1ent)
- -
---, PROi>ERTY DAMAGE S
.' , (Per eCClClent)
~GE UABILl1Y AUTO ONl'" - EA ACCIDENT 5
/lMV AUTO OTHER 1l4I\N EA N;J:; S -..-
. AUTO ONLY: AGO 5
3CESlIJUMBRElLA UABUTY EACH OCCURRENCE $
OCCUR D CU\lMS MACE AGaRE"'.....,iE S ---~_..-
5
~ DEtJUCTlBLE ~.
REl'ENTlON S S
WORlURS COMf'ENSA1l0N AND I we STAl\J- I I~
I!MPl.OYl!~'.UABILITV ---
ANY PRCPRIETORlPARTNERlEXECUTIVE E. "...u .-,DENT 5
OFFICEFlIMEMIIER EXCLUDED? E.L DISEASE. EA EMP~OYEE I
1~rn:,~~IQ1bl/ 'r~.r .-.--
E.l DISEASe - f'Ot.lCY UMrr S
DTHER
..' :
DESCRIPTION OF OPEIUlTlONS 'LOCATIONS I VEHICLI!8 I III CUlSIONS ADDI!D BY !NDDRSIIMENT IIlPECIALPAOVISIONI
ADDITIONAL INSURED: CITY OF CLEARWATER AS RESPECTS TC THE OPERATION OF THE
NAMED INSURED ONLY.
CITY OF CLEARWATER
~OO MYRTLE AVENUE
CLEARWATER FL 33767
SHOULDIUf'f DFTHEAB~DES\lRlBED POUCIE. BE CANCEL1.ED BEFORE lME EllPlRAnON
DA'TIETIlEREOP,lME ISSUING IN$lJR!!" WILl. ENDEAVOR TO MAL ~ DAYS WRITTEN
NonCE 10 THE CERTJFICA TE HOLDER NAMED TO lltE LEFT, BUT FAILURE TO DO 80 SHALL
IMPOSE 110 OBUGATION OR UABI..I1Y OF ANY KIND UPON tHE INSURER, ITS AGENTS OR
S S.
RE ESE lIVE/.
tA.).
ACORD 25 (2001/08)