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CERTIFICATE OF LIABILITY INSURANCE (12) 0 DATE(MM/DD/YYYY) ACRD CERTIFICATE OF LIABILITY INSURANCE 2117/2015 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 '.EPRESENTATIVE 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 P NAME: Certificate Department Commercial Lines-(813)639-3000 PHONE FAX A!C No Exg: 813-639-3000 _ sA Not:855-299-7117 Wells Fargo Insurance Services USA,Inc. E-MAIL com o t e t l cw.cerr ues wellsfar . _ADDRESS: q @ g 2.502 N.Rocky Point Drive,Suite 400 INSURER(S)AFFORDING COVERAGE _ i NAIC# Tampa, FL 33607 INSURER A: Y P National Suret Corporation 21881 INSURED INSURER B: Alexandra of Clearwater Beach, Inc.dba Pier 60 Concessions INSURER C P O Box 3337 - -- INSURER D INSURER E:_ Clearwater FL 33767 INSURER F: I COVERAGES CERTIFICATE NUMBER: 8735945 REVISION NUMBER: See below -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. ADD L SUBR POLICY EFFPOLICY EXP II I R R TYPE OF INSURANCE POLICY NUMBER MMIDD/YYYY MM/DD/YYYY LIMITS Ll - X COMMERCIAL GENERAL LIABILITY MZX80961402 02/15/2015 02/1512016 EACH OCCURRENCE IS 1,000,000 A - --' DAMAGE TO RENTED --t-_..___.._..—_____..-_____ CLAIMS-MADE OCCUR PREMISES Ea occurrence S 100,000 - MED EXP(Any one person) IS 5,000 PERSONAL&ADV INJURY S 1,000,000 G_I AGGF2F_GA_N'L AGGREGATE LIMIT APPLIES PER: 2 000,000 GENERAL TE $ 1 POLICY CJ PRO- JECT LOG PRODUCTS-COMP/OP AGO $ 2,000.000 OTHER: A AUTOMOBILE LIABILITY MZX80961402 02/15/2015 02/15/2016 COMBINED SINGLE LIMIT S 1,000,000 r Fa accident ANY AUTO BODILY INJURY(Per person)) $ ALL,OWNED I SCHEDULF_D BODILY INJURY Per accident $ AUTOS Ir AUTOS x- AIREDAU-IOS X AUTOS WNr0 Pe�acc d_eniUAMAGE $ A xx UMBRELLA LIAR x . -- 1,000,000 occuR XAU48II28206 02/15/2015 02!15/2016 rCH OCCURRENCE_ $ - E-X_CE SS L�IAB �J CLAIMS-MADE I � I�AGGRE7G--/—TG - _-- —t$ 1.000,000 REI ENTION$DEU 3 - ----- - WORKERS COMPENSATION PER _[fl, I- !AND EMPLOYERS'LIABILITY STA'TUTC_ Eli _ - Y❑ NIA I_E H A N1 �__.-- OFFICER/MEMBER NH EXCLUDED E L DISEASE EA E MP OYEE 5 ANY PROPRIETOR/PARTNER/EXECUTIVE E 1.EACH ACCIDENT (Mandatory. ) S --._ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT IS DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) City of Clearwater is named as additional insured as it relates to general liability in accordance with the terms and conditions of the policy. Named Insured includes Pier 60&Barefoot Beach House E I V E- CERTIFICATE HOLDER CANCELLATION Parks & Recreation City of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Parks and Recreation ACCORDANCE WITH THE POLICY PROVISIONS. Attn:Billie Kirkpatrick P.O.Box 4748 AUTHORIZED REPRESENTATIVE ;learwater,FL 33758 i The ACORD name and logo are registered marks of ACORD ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101)