CERTIFICATE OF LIABILITY INSURANCE (2) CERTIFICATE OF LIABILITY INSURANCE a f2�s
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HC1LOER THIS
CERTIFICATE-DOES NOT AFIFIK NATIVELY OR NEGATIVELY AWA ND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CE=RTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURIEN J, AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE C£KnmATE HOLDER_
IMPORTANT: N the certificate holder is an ADDITIONAL INSURED,the pofty(Ies)MUSt be endorsed. If SUBROGATION ES WAIVED,subject to the
terms and conditions of the policy,cwlain policies may require an endorsement. A statement cur this Cer[W"le does not confer rights tD the
certificate holder in Iieu of such endorsemeutts).
PRt7PncErx FLIP Program Support
Veracity Insurance Solutions,LLC. (988)565-0548 FAx
264 South 2500 West,Suite 303 w L info @filprogram.com
Reasant Grove Lfl- 84062 D=Ft AsFORO7Na covsRAra NNC r
aiQUR»RA: GreatlVCle Can IUACe RSurance 1 26832
INSURED Pr51lkERB: }
Edward gates,DRA Kinney's Kitchen
765 LDmonwood Dr. I mERa.
Oldsmar FL 34677 raukM E;
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COVERAGE$ CERTIFICATE NUMBER; REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN i55uEt TO THE INSURM NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING AMY REQUIREMENT.TE"OR CONDITION OF ANY CONTRACT OR OTHER DOCUNENT WITH RESPECT To WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY TILE POLICIES DESCR3BED}FAIN IS SUBJECT TO ALL THE TERMS,
E=LUSIONS AND CONDIT]M OF SUCH POLICIES.LWATTS SHOWN MAY HAVE BEEN REDUCED BY PAIR CLAWS.
MR I TYPEaF ALiiAlIJrCE AooL 3UnR' PDL CYHUfrBF1k HuDn La[R3
L'M GENERAL UWLITY EA;H pc^„URRENCE t ,aOO,OflD
% CW.WERMAL GENERAL 1.AMITY ,x I PREASISES aoaw��m S 300,000
CLAIMS-UAJaS tE OCCUR f• F- NED EXP(A"ons pxson) $
A PL3843155 F02O286 07175l2616 47I15+2617 PrASCr+ALaarVlwurn s 1,000,040
GENERAL At'GREGRTIS S 2,000,000
QCNL Ar GS 41ATS LAV7 APPLIES MR: PR0auC7s-C0WA3PACC t 2,000,000
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AUTONOa7LE UASLn Y r kpdertl. INO1.E LI S
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AUTOS AUTOS ECDILY NLNRY(Per ardent) S
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OESORMTION OF QFERATM $ILOCATIONSI VEHNSES(RIIaW A00im 7a3,kWff.,w R*Pwks Sdwbile,Hmore apxe Is-**aril
Certsftcate haIderhad been added as additional insured regarding the above mentioned policy per aIlaChad
Add i Hon aI insured-Oesignated Parson or Organisation(CG20 26,ED.04 13)
CERTIFICATE HOLDER CANCELLATION
SHOULD AMY OF THE ASO"0S:=t 8W POWCIES BE CANCELLED V#F0R6
THE EXPIRATtON YKERWIF, NO
City of Clearwater ACCORDANCE NCE WITHDTiM POUCYPROMIQNrlSCE WILL BE DELIVERED IN
2998 Drew St.
Oearwater FL 33759 AUTHQR=REF-MENTATME
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0189"014 ACORD CORPORATION. All rights reserved
ACORD 25(2014Ibt) The ACORD natrle and logo are r"Istared marks of AGORCI
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