CERTIFICATE OF LIABILITY INSURANCE (2)��.�� - � NORTSTA-01 SANDERSON
ACORO« DATE (MM/DDIYYYY)
�- CERTIFICATE OF LIABILITY INSURANCE 8/6/2015
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
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 coNrncr Sarah Anderson
NAME: _
Nashville (WE) /Assured Neace Lukens Insurance Agency, I(1C. PHONE ( � Fp'X 615 301-2597
3000 Meridian Boulevard, Suite 100 . 615 301-2500 ,vc Nor � )
E-MAIL
Franklin, TN 37067 nooRess_sarah.anderson@neacelukens.com_� _
INSURED
North Star Destination Strategies, Inc
209 Danyacrest Drive
Nashville, TN 37214
�n,suReRa:Cincinnati Insurance
iNSUReR e : Cincinnati Indemnity
�n,suRERC:AXIS Insurance Com
INSURER E :
INSURER F :
NAIC #
10677
23280
37273
COVERAGES CERTIFICATE NUMBER: REVI51oN 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 IADDL SUBR �. POLICY EFF i POLICY EXP LIMITS
LTR POLICY NUMBER ' MM/DD/YYYY MM/DD/YVYY
A X COMMERCIAL GENERAL LIABILITY I � EACH OCCURRENCE $ 'I,OOO�OO
� I� ECP 0289555 11/12/2014 11/12/2015 DAMAGE TO RENTED 1,000,00
CLAIMS-MADE OCCUR PREMISES Ea occurrence $
j MED EXP (Any one person) $ � �,��
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: . GENERAL AGGREGATE $ Z�OOO�OO
POLICY � jE�T � LOC � I� j PRODUCTS - COMP/OP AGG $ Z,OOO,OO
OTHER: � $
AUTOMOBILE LIABILITY . II . COMBINED SINGLE LIMIT $ 'I OOO,OO
Ea accident �
� ----
A ' ANY AUTO li � �ECP 0289555 11/12/2014 11/12/2015 � BoDl�v w,lURV (Per person) $ _
ALL OWNED SCHEDULED �'�. � j BODILY INJURY (Per accident) $
AUTOS AUTOS 'I �
X X NON-OWNED I �' ' Pe�a ctlentDAMAGE $
, HIRED AUTOS AUTOS '�� --
' $
UMBRELLA LIAB X OCCUR �, EACH OCCURRENCE __ $ 'I,OOO,OO
A EXCESS LIAB CLAIMS-MADE ECP 0289555 11/12/2014 11/12/2015 AGGREGATE $ 1,000,00
DED RETENTION $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS' LIABILITY STATUTE . �� ER
B ANYPROPRIETOR/PARTNERIEXECUTIVE Y�N EWCOZ9O922 11/12/2014 11/12/2015 E.L.EACHACCIDENT $ ��OOO�OO
OFFICER/MEMBER EXCLUDED? � N � A`
(Mandatory in NH) E.L. DISEASE - EA EMPLOYE $ �,�0�,��
K yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ �,OOO,OO
C Professional Liabili MCN000036991501 07/24/2015 07/24/2016 Each Wrongful Act 1,000,00
C Professional Liabili MCN000036991501 07/24/2015 07/24/2016 I Total Limit of Ins 2,000,00
DESCRIPTION OF OPERATIONS / LOCA710NS I VEHtCLES (ACORD 101, Additional Remarks Schedule, may be attached ii more space is required)
r',ECt_;`d.iu
CITY qF ,:I_�=,',R�:'., ,T F
r�:�� 1 � t���
r;i ;K 1,1A!V��,l:;':i'AEN!
City of Clearwater
112 S Osceola Avenue
Clearwater, FL 33758
ACORD 25 (2014101)
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 REPRESENTATNE
---- y � �-�,�__
�
O 1988-2074 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
�. ....
...._..........,.._.._.._...__�
. V� .. ..�
/'� t`" �'�`- �,