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CERTIFICATE OF LIABILITY INSURANCE (573)��-� ���m WELCTEN-01 LTREMBLAY ACORO ° DATE (MM/DD/YYYY) �� CERTIFICATE OF LIABILITY INSURANCE g/7/2014 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 dces not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Acentria, Inc / Jennings & Assoc. 308 Elizabeth St Brandon, FL 33511 INSURED Welch Tennis Courts, Inc., Herrens Tennis Court Company, a div of Welch Tennis Courts Inc PO Box 7770 Sun City, FL 33586 689-0021 INSURER(S) AFFORDING COVERAGE ir,suRER a: Massachusetts Bay Insurance Co INSURER C : E: F: Hanoverinsurance 654-7656 NAIC # 22306 22292 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. NOTIMTHSTANDING 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 � POLICY NUMBER MM/DDYIYYYY MM/�DD/YYYY LIMITS LTR A X COMMERCIAL GENERAL LIABILIN EACH OCCURRENCE $ 'I,OOO,OO CLAIMS-MADE � OCCUR RDJ 6195903 05 08/15/2014 08/15/2015 pREMISES Ea occurrence S 100,00 MED EXP (Any one person) $ 5,�� PERSONAL 8 ADV INJURY $ 'I,OOO,OO GEN'LAGGREGATELIMITAPPLIESPER: GENERALAGGREGATE $ Z,OOO,OO POLICY � jECT � LOC PRODUCTS - COMP/OP AGG $ Z�OOO,OO X oTHeR:Per proj agg by endor s AUTOMOBILE LIABILITY COMBINED SINGLE LIM�T $ 'I OOO,OO Ea accident � A X ANY AUTO ADJ 8378615 08 08/15/2014 08/15/2015 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ AUTOS AUTOS PROPERTY DAMAGE $ NON-OWNED Per accident X HIRED AUTOS X AUTOS $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ S�OOO�OO B EXCESS LIAB CLAIMS-MADE UHJ 6190253 05 08/15/2014 08/15/2015 AGGREGATE $ DED X RETENTION $ � Aggregate g 5,000,00 WORKERS COMPENSATION PER OTH- AND EMPLOYERS' LIABILITY Y� N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH ACCIOENT $ OFFICER/MEMBER EXCLUDED? N /A (Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ If yes, describe under CESCRIPTICN OF OFERATIONS telow E.L. DiSEASE - FOLiCY LIMiT $ q Equipment Floater RDJ 6195903 05 08N 5/2014 08/15/2015 LeasedlRented 100,00 A Equipment Floater RDJ 6195903 05 08/15/2014 08/15/2015 Deductible 2,50 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached'rf more space is required) City of Clearwater c/o Risk Management Engineering Dept PO Box 4748 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. AUTHORIZED REPRESENTATIVE �j�,rL�, �. +�i'h'YU�Y�_{� " � O 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014I01) The ACORD name and logo are registered marks of ACORD ---�� '� -�,� c,� \ �n�,S C ��-�.5 �`�C - �_� ��----i -�� �e�� �eQ s � �t �c �� . �f Zc.e� �3 \ � � ��- '� O �j ��� — � °� 'Q_._ , � X � � � .��� c I v�/S `� 5 p � �� , C�'�.' / , r�� � �-1`-�, `h � S C � Q Zl�s � � -�2 M; j O .X � � � �C ��. ; � \ /( �-/ �� �Z� ) '�2 � � ���-� r �x P �� �e.� � 1 �-Q- � 15 �/ t � � _ U � �� -� � P� �,r -� 2 n �� S �O �..� �--� � �.� � � �\\ � � � � �°� �- � �c ��--�. ` , � / I 1 / I � � f �, �/` S�� �� . ��C�''` � ��,�J� , � � � --�, i e . �� � � ���,�''� t�-��.. ye SJ c-� �c� ��-� c\� � �� � .� c-.��- � . �� �- . 1�-��5�, \ r��� �_5