CERTIFICATE OF LIABILITY INSURANCE� 7 � DATE (MM/DDIYYYY)
4�!ZO CERTIFICATE OF LIABILITY INSURANCE
10/27/2015
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 NAMEACT HEAdi1Ck8 Office
Erwin Inaurance PHONE .(904) 396-1440 �C No: (904)396-1550
E•MAIL
P. O. BOX 40826 ADDRESS:
Jacksonville FL 32203
INSURED
Intuition Systems, Inc.
9428 Baymeadows Rd.,#500
p:The Travel
B:
D:
AFFORDING
of
NAIC #
I Jacksonville FL 32256 � INSURERF• I I
COVERAGES CERTIFICATE NUMBER:CL1582013619 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.
ADDL UBR POLICY EFF POLICY EXP
�LTR TYFE OF INSURANCE POLICY NUMBER MMIDD/YYW MMIDD/YYYY LIMITS
COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $
DAMAGE TO RENTED
CLAIMS-MADE � OCCUR PREMISES Ea occurrence $
MED EXP (Any one person) $
PERSONAL & ADV INJURY $
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $
POLICY ❑ PR� � LOC PRODUCTS - COMPIOP AGG $
JECT
$
OTHER:
AUTOMOBILE LIABILITY Ee aBctleDtSINGLE LIMIT $
ANY AUTO BODILY INJURY (Per person) $
ALL OWNED SCHEDULED BODILY INJURY (Per accident) $
AUTOS AUTOS
NON-OWNED PROPERTY DAMAGE $
HIREDAUTOS AUTOS Peraccident
$
UMBRELLA LIAB OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE $
DED RETENTION $ $
WORKERS COMPENSATION X PER OTH-
AND EMPLOYERS' LIABILITY STATUTE ER
Y�N E.L. EACH ACCIDENT $ 1, 000, 000
ANY PROPRIETOR/PARTNERIEXECUTIVE N / A
A OFFICER/MEMBER EXCLUDED? � UB-BF43001-6-15 9/1/2015 9/1/2016 E.L. DISEASE -EA EMPLOVE $ 1, 000, 000
(Mandatory in NH)
If yes, describe under
DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 1, 000, 000
DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schadule, may be attachad if more spaca is required)
C
�
City of Clearwater
Attn: Customer Service
100 South Myrtle Ave
Clearwater, FL 33756
ACORD 25 (2014/01)
INS025r�m4mi
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
«r-^ �a/�, ',��
John Alexander/JALEX3 �.+�-� +"�� �f��'" `� - �
O 1988-2014 ACORD CORPORATION. All rights reserved.
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