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CERTIFICATE OF LIABILITY INSURANCE ,•�"""� � ATE tPWMYppfYYY'Y1 '' [ CER'TIFICA'TE OF LIABILITY INSURANCE ED8/29�2016 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 CON COLLEEN B BURKE BURKE INSURANCE SERVICES, INC RHONE 727-441- U94 FAX 727-449-0102 P 0 BOX 11 4 E-MAAL�'Ex!}: (ARC,NaI. DUNEDIN, FL 34697 A111E55. COLBUR EPHOT' AIL.CON _ INSURER(S)AFFORDING COVERAGE NAIC# INSURER A. United StateslLliabillty Insurance Company INSURER INSURER B Florida Worker Compensation,JOII7t Undervwriting..Assc Youth Development Initiatives, Inc INSURES c 900 Martin Luther King Avenue Clearwater, EL 33755 INSURER R3. INSURER E: INSURER,F 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 'r HE TERMS, EXCLUSIONS AND CONDITIONS of SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN....SR. _... ADDL SURER:. ..._ "...POLICY EFF POLICY EkP _._. ..... __... ..... ...... ........... LT'R. TYPE OF INSURANCE POLICY NIUMI ER MMIDCB!YYYY MMIDDNYYY LIMITS A COMMERCIAL GENERAL LIABILITY... X NPP1 566973 ,. 08/0112016 08/01/2017 El1cF�I OCCURRENCE $ 1,000,000 _. CLAIMS-MADF +YY� (7G::CUR ,..DAMAGE TO IRENTE[? ...... _.. _. ._IREMISE:ti.(F"�x�ncr�.Prrerl.ey �' ���,�' � Sexual Abuse&halciest'ation NPI D EXP(Arty one persratw) $ 5,099 X Each ClairTnl$1,0100,00O PERSONAL&AC)V INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APP L I S PER. GENERAL AGGREGATE s 2,000,000 X €'c°U Y JERCT LOG PRODUCTS-Cor ,R. OP AGr, .� 1,000,000 07HE R $ . JBfUIf "16 J�1�td2Q1� �IJC LE.I.IM1T A AUTOMOBILE LIABILITY X NPP1�6697 A (E"aacaden E ANY AUTO HODR Y INJURY(Per peirsrit) E ALL OWNED SCHEDULED _.. ....._ _..... ......._ ..._A+OR`OS AUTOS _.BOLNLY INJURY(Pura✓cidert) S' X X W)N.-+AWNED F Rd✓°,PER"I'"Y DAP,1AGIm', HIREDAOTOS AUTOS ._..(Pkyaccide;nt) Included in Aggregate s 2,000,000 UMBRELLA LIAR OCCUR EACH OCCURRENCE. ,S EXCESS LIAR§ CLAIMS MAfYE AGGREGATE ,1! DED RFIE.NrIC,INS AND hE@RR'LtSYERS LIABILITY 6F13UB-71 76466-6-16 03/2612016 ©3/2612017 X PER _..ER„YIN ANYP!�.CtPRI ETOR`�EkRkN�R/l,XF:CUTIVE t NrA .EJ EACH,ACCOEN'r_ s. 100,090 .... (Mandatory no NH) ' E,IL I)ISI°AFF EA EMPLOYEE b 100,000 UP.s.,descrrkse Guider ...... .... ... ���'� � L; C RIPTi0N .TF 0PERATI(DNS P�klow E.L.DISEASE-POLIC:'Y IJRMT DESCRIPTION OF OPERATIONS F LOCATIONS I VEHICLES IACORD 101...,Additional Romairks Schedule,may be attached)if more space is requiredy Certificate Holder Listed below is Additional Insured with respects to Commercial General L atllity, CERTIFICATE HOLDER CANCELLATION City Of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Martin �L1 hCr �aln Avenue THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED I',N ACCORDANCE WITH THE POLICY PROVISIONS, Clearwater, Ft_ 33755 AUTHORIZED REPRESENTATIVE COLLEEN B BURKE C 1988-2014 ACORD CORPORATION. All rights reserved), ACORD 25(2014/01) The ACORD name and logo are registered marks ofACORD