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CERTIFICATE OF LIABILITY INSURANCE ----- --=-- 114-CORD,. CERTIFICATE OF LIABILITY INSURANCE OP 10 D2 DATE (MM/DDIYYYY) JMCDE-1 05 09 07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Wallace Welch & Willingham Inc 300 First Avenue South, 5th FI P.O. Box 33020 St. Petersburg FL 33733 Phone:727-522-7777 Fax:727-521-2902 INSURED INSURERS AFFORDING COVERAGE NAIC# Marquesas LLC & JMC~esign & Develop'ment 2201 4th Street N, ~200 St. Petersburg FL 33704 Inc. ! INSURER A: ! INSURER B I INSURER C. Everest Indemnity Insurance Co I ; INSURER D. I i INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR[ TYPE OF INSURANCE POLICY NUMBER PD~~~TJ~rt~~~E P~k~1Y(~~bRDA~~~N LIMITS GENERAL LIABILITY i ~ EACH OCCURRENCE $ - COMMERCIAL GENERAL LIABILITY ~~EM;SEs (Ea occurence) $ _I CLAIMS MADE D OCCUR MED EXP (Anyone person) $ .... - - ---.--- - - - '_.-- - --_.-- - - I - -- PERSONAL & ADV INJURY $ - I ! GENERAL AGGREGATE $ - I I GEN'L AGGREGATE LIMIT APPLIES PER: I I PRODUCTS - COMP/OP AGG $ I .nPRO- n j i POLICY JECT LOC I ! AUTOMOBILE LIABILITY ! - i COMBINED SINGLE LIMIT $ ANY AUTO ' (Ea accident) - - ALL OWNED AUTOS I BODILY INJURY (Per person) $ SCHEDULED AUTOS - - HIRED AUTOS BODILY INJURY (Per accident) $ ---'- NON-OWNED AUTOS - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ==l ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $10,000,000 A ~ OCCUR D CLAIMS MADE 71R9000002071 05/01/07 05/01/08 AGGREGATE $10,000,000 over: $ GL ==l DEDUCTIBLE ! $ Au to RETENTION $ I $EL WORKERS COMPENSATION AND r i TO~v" ~t~'I~S I IU~R- EMPLOYERS' LIABILITY $ ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT OFFICER/MEMBER EXCtUDED? .-- :.....,~- ~~_~--...::...c_.-- _ - - c---,;.o.-:::__-~, -- ---- E:LDISEASE--EA EMPLOYEE $ --- -- - 11 $8S-, -(j8t"l'ftje undef - EL DISEASE - POLICY LIMIT $ S ECIAL PROVISIONS below OTHER I I I I I I I I IJ ..,. ._~ DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS ,- -. _. 11' ..._ Certificate holder is listed as additonal insured with respects to Genera} Liability ATlMA. t~.AY 1 0 2007 OFFICIAL RECORDS AND tEGISLATlVE SRVCS DEPT CERTIFICATE HOLDER CITCL-1 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIO DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR City of Clearwater City Manager PO Box 4748 Clearwater FL 33758-4748 IVE ACORD 25 (2001/08) @ ACORD CORPORATION 1988 " "- ~~ IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) A CORDTM CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 5/7/2007 PRODUCER (727) 391-9791 FAX: (727)393-5623 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Stahl & Associates Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 110 Carillon Parkway ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. St. Petersburo- FL 33716 INSURERS AFFORDING COVERAGE NAIC# INSURED Marquesas LLC INSURER A: Amerisure Mutual Ins Co JMC Design & Development Inc. INSURER B: 2201 4th St N, Suite 200 INSURER c: INSURER D: St Petersburg FL 33704 INSURER E: 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. AGGREf:::ATE LIMITS SWIWN MAY HAVE BEEN REDUCED BY PAID r.1 AIM!': INSR ADD'L TYPE OF INSURANCE POLICY NUMBER P~kl-i1:~8,wf Pgklfl,~~~~N LIMITS GENERAL LIABILITY FAr.H OCCURRENr.E $ 1,000,000 - ~~~~*H?E~~~J.;;?ence' X COMMERCIAL GENERAL LIABILITY $ 300,000 A 1 CLAIMS MADE ~ OCCUR GL2027887 5/1/2007 5/1/2008 MED EXP IAnv one ""rsan' $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 - - GENERAL AGGREGATE $ 2,000,000 ~'L AGGRErilE LIMIT AflES PER: PRODUCTS - COMP/OPAGG $ 2,000,000 POLICY X ~~8T LOC ~TOMOBILE LIABILITY ~ COMBINED SINGLE LIMIT $ ECEIVE ~ (Ea accident) - ANY AUTO - ALL OWNED AUTOS BODILY INJURY (Per person) $ - SCHEDULED AUTOS M ~y 0:) 2007 - HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS OFFICL ~ RECORDS (Per accident) - "NO lEGISL PROPERTY DAMAGE I-- JIVE SRVCS [ EPT $ (Per accident) RRAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ OESS/UMBRELLA LIABILITY , 'cc"..,." $ OCCUR 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ A WORKERS COMPENSATION AND X I T~~T~I.\t(, I OJ~- --- ---- EMPLO, ~R&"l:IAtiILl1'Y"--'- -- --~..-- --- --~----- --"-'--- -"--- ---- .-----,,-~--- '.- -"-,------- -_.--- - ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? WC1385656 5/1/2007 5/1/2008 E.L. DISEASE - EA EMPLOYEE $ 500,000 II yes, describe under E.L. DISEASE - POLICY LIMIT $ 500,000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONSlVEHICLEs/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Certificate Holder is listed as additional insured with respects to General Liabili ty ATlMA CERTIFICATE HOLDER CANCELLATION City Of Clearwater City Manager PO Box 4748 Clearwater, FL 33758-4748 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ~ ~ ~ Kelly Petzold/HANSEN ~~d p~~ ACORD 25 (2001/08) INS025 (0108)OBa @ ACORD CORPORATION 1988 Page 1012 ACORDN CERTIFICATE OF LIABILITY INSURANCE OP 10 H DATE IMM/DDJYYYY} JMCDE-l 05 08 07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER Wallace Welch & Willingham Inc 300 First Avenue South, 5th Fl P.o. Box 33020 St. Petersburg FL 33733 Phone:727-522-7777 Fax:727-521-2902 INSURERS AFFORDING COVERAGE NAIC tI INSURED Marquesas LLC & JMC Desi~ & Develomnt 2201 4th StreetN, 200. St. petersburg FL 3 704 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOT'MTHSTANDING 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Inc. INSURER A INSURER B: INSURER C: INSURER 0: INSURER E: Everest :Indamni ty :Insurance Co TYPE OF INSURANCE - GENEIQLUABlUTY . COMMERCIAL GENERAL LIABILITY CLAIMS MADE 0 OCCUR POUCY NUMBER LIMITS EACH OCCURRENCE $ $ $ PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ PRODUCTS - COMPIOP AGG $ GEN'LAGGREGATE LIMIT APPLIES PER: ~rg: LOC AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT (Ee accident) $ BODILY INJURY (Per parson) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per eccldent) $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EA ACC AGG $ $ $ $10,000,000 $ 10 000 000 $GL $ Auto $EL A EXCESSlUMBREULA UABIUTY X OCCUR 0 CLAIMS MADE 71R9000002071 05/01/07 05/01/08 EACH OCCURRENCE AGGREGATE over: DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND .EAll'LOY:E8S: L1ABIJ.lIL_.. ANY PROPRIETORlPARTNERlEXECUTIVE OFFICERIMEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER E.L DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCWSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION CITCL-l SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBUGAT1ON OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR gw @ACORDCORPORATION1988 City of Clearwater City Manager PO Box 4748 Clearwater FL 33758-4748 ACORD 25 (2001/08)