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CERTIFICATE OF LIABILITY INSURANCE (5)CLEARWAT3 ACORD„ CERTIFICATE OF LIABILITY INSURANCE DATE (MM /DD/YYYY) 3/27/2015 I 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 tipifIfftetvitaDITIONAL 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 2 6,2U Bouchard Insurance Inc OCT I v L REC �]�)' E�V f0 101 N Starcrest Dr. �FC!/cAR Clearwater, FL 33765 GAS ADMIN wA TER 727 447 - 6481 11 Ql 2015 CONTACT NAME: PHONE 727 447 -6481 FAX 727 449 -1267 (A /C, No, Eat): (A /C, No): EMAIL : cicerts @bouchardinsurance.com INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Scottsdale Insurance Company 41297 INSURED RISK M J Clearwater Marine Aquarium ANqG; til 249 Windward Passage 9)]3 E�1T Clearwater, FL 33767 I INSURER e: Aspen Specialty Insurance Co 10717 Indemnity Ins Co of North Ameri INSURER C : Indemnity 43575 INSURER D : Comp Options Insurance Co. 10834 INSURER E : $100,000 INSURER F : $ 5,000 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. 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 LTR TYPE OF INSURANCE ADDL INSR SUER WVD POLICY NUMBER POLICY EFF (MM /DD /YYYY) POLICY EXP (MMIDDIYYYY) LIMITS A GENERAL X LIABILITY COMMERCIAL GENERAL LIABILITY Y Y CPS2091834 R E 14o„ ['� �p� �g ONIC9i'is. RfoC) 4 J 5 201 /°�/� �. , �^ 10101/2015 _ (; - � EACH OCCURRENCE $1,000,000 PREMISES a occurrrence) $100,000 MED EXP (Any one person) $ 5,000 CLAIMS -MADE X OCCUR PERSONAL & ADV INJURY $ 1,000,000 X BI /PD Ded:500 GENERAL AGGREGATE $ 2,000,000 PRODUCTS - COMP/OP AGG $ 2,000,000 GEN'L X AGGREGATE POLICY LIMIT APPLIES PRO- PER: LOC $ AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS HIRED AUTOS SCHEDULED AUTOS NON -OWNED AUTOS �V�w7�'yl8 7 .�3W`"•`�%DE, ) COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ B x UMBRELLA LIAB EXCESS LIAB X OCCUR CLAIMS -MADE CX002H214 10/01/2014 10/01/2015 EACH OCCURRENCE $9,000,000 $9,000,000 AGGREGATE $ DED X RETENT ON s$0 D WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR /PARTNER /EXECUTIVE OFFICER /MEMBER EXCLUDED? (Mandatory in NH) If yes. describe under DESCRIPTION OF OPERATIONS below Y / N N N / A WC810007625 -002 04/01/2015 04/01/2016 X TOCRyTAT TS I EERH E . EACH ACCIDENT $1000000 E.L. DISEASE - EA EMPLOYEE $1000000 E . DISEASE - POLICY LIMIT $1000000 C Protection & Indemnity HUN00876008012 10/01/2014 10/01/2015 $1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) NOTICE: Bouchard Insurance is required to comply with the licensing agreement we hold with ACORD. ACORD, in conjunction with the Department of Insurance, creates and enforces the rules and regulations pertaining to proper use of the Certificate of Liability Insurance form. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION CITY OF CLEARWATER P 0 BOX 4748 CLEARWATER, FL 33758 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 ACORD 25 (2010/05) 1 of 2 #S153053/M151774 © 1988 -2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BRIBO DESCRIPTIONS (Continued from Page 1 We are required to mark a Y next to the line of business in which the Additional Insured or Waiver of Subrogation coverage applies. According to ACORD, the Description of Operations section must be limited to describing information necessary to identify the operations, locations and vehicles for which the certificate was issued. Please note the Description of Operations section of the Certificate cannot be used to add additional information except as just described. Marking a Y next to the line of business adequately documents coverage. Equally important, it satisfies the rules and regulations governing the proper use of the Certificate of Liability Insurance form. Certificate is a reflection of the current coverages provided for the insured. Limits and coverages are afforded to the certificate holder only if required by written contract. 9' 3 c'e9 (6c SAGITTA 25.3 (2010/05) 2 of 2 #S153053/M151774