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CERTIFICATE OF LIABILITY INSURANCE (4)�� �� GERTIFI�ATE QF LIABILlTY INSUR�►4NCE dA7E�MMlAp1YYYY} �� 3 � J.312 Q�.7 THIS CERiI�1CA1'�. IS 1551JE� .A5 A MATTER �� 13JF�RMRT{�N DNLY AH❑ C.pAiFEF2S N� RIGt�ITS. l3PON 3HE CERTfFlCA7� H�LbER. TH15. C�RTIFICAI'� p�ES NffT AFFIRMATIVELY aR NEGA7IVELY AiVI�NO, E3CTEHp QR ALTER THE COVERAGE AF�pR�H❑ BY TME P�LiC1E5 BELOW. iHIS CERTIFICATE .�F INSUl�ANCE Op�S NOT CbNST[TLJTE A G�NiRACT BETWEEN THE f5SlJ1NG. lNSURER{S], AlJTHORlZED R�PRESE.N.TATIVE QR PRAf3lJGER, AN� THE CERTIFICATE:H�Li7�R. IIVIP.DRTANT: ff the certifi�ate Eiolder is an AOD1TEpNAL 1HSLfRE�., tY�e policy{iesj.must be endorsed. [f SUBRDGATIQiV l5 WAIVEQ,. subjecY to the.terrr�s and c.onditions nf the: pfllicy, certain policies may require:a.n endvrsement,. A statem.ent vn this certificate iiaes noYconfer r'ights tv the ceitificate.ha[sler in lieu of sucfi endorsement s. PRDal10ER� S]lg�r pyril�� �NAME:�� Ir� %SI1C88�Br� S13SU�driCB PHDNE . _._.� f FA%� . �..��..�.._....� ta�c. rao. �.�;t: _{727 ] 4Si-3704 w. i Larc No1:. {�zz� aai-a?sa 5J.0 ]7ruid Rd E., S�e. #C npog�ess:sherzy�la.ncins.com � ^T..._ P O Bax 2 B 5 6 '------ �- _. _._..__�� � _�INSLIR@R{5] AFFORaING�COVERIIG� � NAIC # C�:eaxwater �� FL 33.757 �W � Er�su��Rn:Sauthern-Owners Insuran�e � 1019D 1NSUREp ENSUft£Ei B��: � ���� Clea.�vatier L3Wri BOW�.9 INSlfF2EEiC; � T.� .�..W 1 a 4 fl Galume t S� ..____. �........_..._ �.._.�...,M.._._...w.. INSi�RER 6: I . 11JSi3FiER.E : � ....�._._.._.W W �.mm..�.._..._.._._ Clearwa�er F�, 3.3TS5-1813 EfJ5UR5RF: � C�VERAGES CERTIFICA�E NLfMSER:CLi551.48572 ftEVl�laN NLIMBER: �HIS [5 T� CERTIFI' THAT TNE: PpL1C1E.5 �F IN5Ui2ANCE LlSTEE} SELOW HAV� BEEN 155[!ED T� THE INSLJREE3 NFiME� i4BpVE FOR THE P�LfCY P£R[QL7. ]�f�ICATEp_ Na7U1fEiH5`�AN�ING ANY REQUIREMENT, T�RM OR. CpNpIT1pN ❑F ANY CdNTRACT C}R .DTH�R ❑�CUM�NT INITH R�SPEGT TD 1'VHICH THlS GERTIFICATE MAY BE ISSUE❑ ❑R MAY PEF2T.AlIJ, THE fNS11FtAI�CE.AFF�RpEO BY THE POLfCIES L3ESCRIB�T] HER�[N 15 SLJ6J�CT TO ALL THE TERMS, EHCLUSIONS AND G�NDIT10�f5 QF SLJGH PQLICi�S. LIiNl75 SH�WIJ MAY HAVE eEEN REOLIEEp Bl' PAIO ELA[M5. fHSR � . .. . . ' ..�._.. :d�Sf'] i�Y1Bkj� � . � ; p ._:...�...._.... i PdLICY E7CP. i ...._ ...................._____._.. �7}Z : � TYP��OF�iHSl1RANCE OLiCY EFF � ,�_,___, „ � IN5❑ wLlo I POLICY NU__MSER_____ .. . LiMM1aQIVYNYi I iMM10�lYYYYi i �IMITS i:� l CQHifufERC117L:GENERAi� LIABELI71'•� I � I I � �_�_�—����•�����•-- l, D00, DOa EAGH OCC[JRR�NCE ' S A i. k � CLAItu15-MA�E L� QCCI]R � I ! oAMA E.��R ���"�� S�, 0 0 a i i PREMi5E5 fEa occurrence] i S. .� � _.M._.._.........._._.._..__W....�._._..� ' � I � 206z4827 ""y '"' � .._._... �..�—. � I � G�N'L AGGR�GATE L3h1lT APpLI�S PER ' � ; �z. �� � � POLICY `��.� j� � ��. i LdC. � € � S .^ j fl71iFR: i € Ai37pMOHIL�.LIR81LlTY � f � 1 3 ^I AFtY �AL1TD � � � � ��I ALL flNM�� SCHEOULE6 ' ' ..__j AVTpS � i Al1TDS ! ? ': � � —� hON-0+7VNEQ � 1 ' HiRE� AUTOS All'F4S . = � � ;^ i j ? ! ; unrtaae�.w �fag i � occua ' i j _..._..; � s.�.{ ' . i EXCESS LIRB ; I I , I CLAlMS-MA6E � .._.._:....,... ...;.._....._I ------- 4 OEp �_. i�. _ � RETEIdF30N 5 _ _ _ � WORKERS COMPEHSATIaH I ANO EMPLOYERS' LIABILETY Y ��� I � AAtY pRpPFt]ETaRIPARTNERIF>fECLi.T1VE j""""'"' j ; QF�fCERIMEMBER EXCLLI�ED7� � �� N �A i �{Mandalor}i in NH} �"""""`f � � � I! yes, descrikia undAr � s iJESi:ft�F3�iGN i.}F :SREFLAI'l�NS�helaw . . � A/2fl�2�Z7 � 4�20�2018 lvSE� EXP tP�y one peisori] mm5 µ 5. a.6.0 PERSONRL 8 AdV iN;IURY � 5 1 � D d D, D 6 Q GENERALAGGREGA'FE ? S 2.000;96a rt._._._�........._._..�........... _ PRp0UCT5-COMPIOPAGG 5 2�4�fl..0�� ......... �...........__.___:.__ Premiseslpperatiaiis ! 5 � i� I�a accidenll.___�__...mm.�y.�......�....�...._._.__ .............. B�aILY IIJJl1RY tPer.persan} � 5 J�.._�._— ,. B4171LY ENJl1RY (Peracciden[} 5 _ PFtflPER'fY E7AMAGE� ,[Per accid_ent] _ __ � I S i �. EACH pCGURRENCE ! 3 ._ ._..�.__. _.__..._.____�.._............... AGGR�GAT� ;S E.L. EACFi ACCI!]EN7 ; � E..I.. AISEASE - EA.EMf'L[7YEE 5 ❑ESCRIPi[p[J OF �PEftATIaN5�7 LOCATlONS! VEFfICLES (ACOR��1G7; Acldltlonal Remarks.Schedule, may.4u aitached iS�moro space is�requfred] City ❑f Ciearwater Parks an.d.Recrea�iqn Departmezat i.s Zisted. as adfli�ianal insured with sespeGt to the general.Iiaba.�ity ii-�suzance per the terms, .condi�ians and exclusiqns vf �he poiiay. raymccartn.ey44Cgmaa.l:�om �ERTfFIGAT� HQLDER (727�552-4825 Mike,LvGltwood@my�learwater SHOULa AiJY OF 7H� AEIpN� AESGRIBEQ POLSCIES BE CAMC�LLEti.BEFpftE Gity of Cledzwa�e�C TH� EKPIRATI�iV DATE THEREOF, N071C�. WILL eE pEI:IVERE❑ IN Pa�ks and Re�reatibn. �ept : liCCa�tpANC�.W17H THL POLiCY PROVlslonl5. Attn: Mike I,vck�wood P O Bpx 47 �$ AE]THO}jIZEO REPRESEiJT17iIVE Clearwater, F'Ts 33755. _' � � � � � � �-. 1888-2�74AC�R0 C�RP�RAT[D.N, All righ#s reserved. AC�Ftb 25 [2a141fl1} The ACDF2a name and iogo are. registered marks. of ACORp. IN5625 t2osaai �