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CERTIFICATE OF LIABILITY INSURANCE (14) Client#: 22073RUTHECKE ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/31/2017 TM 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). CONTACT PRODUCER NAME: Bouchard Insurance (CLW) FAX PHONE 727 447-6481727 449-1267 (A/C, No): (A/C, No, Ext): 101 N Starcrest Dr. E-MAIL clcerts@bouchardinsurance.com ADDRESS: Clearwater, FL 33765 INSURER(S) AFFORDING COVERAGENAIC # 727 447-6481 16535 Zurich American Insurance Co INSURER A : 26247 INSURED American Guarantee & Liability INSURER B : Ruth Eckerd Hall, Inc. 10700 RetailFirst Insurance Company INSURER C : 1111 McMullen Booth Rd INSURER D : Clearwater, FL 33759 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD A GENERAL LIABILITY YYCPO01715680205/31/201705/31/20181,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X100,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurrence) X10,000 CLAIMS-MADEOCCURMED EXP (Any one person)$ XBI1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- $ POLICYLOC JECT COMBINED SINGLE LIMIT AYYCPO01715680205/31/201705/31/20181,000,000 AUTOMOBILE LIABILITY (Ea accident)$ X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNEDPROPERTY DAMAGE XX $ HIRED AUTOS (Per accident) AUTOS $ B X UMBRELLA LIAB XAUC96729410805/31/201705/31/201810,000,000 EACH OCCURRENCE$ OCCUR 10,000,000 EXCESS LIAB CLAIMS-MADEAGGREGATE$ X0 $ DEDRETENTION$ WC STATU-OTH- WORKERS COMPENSATION C05204622901/01/201701/01/2018X TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ Y N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below ALiquor LiabilityCPO01715680205/31/201705/31/2018$1,000,000/$2,000,000 AAbuse/MolestationGLC01715690205/31/201705/31/2018$1,000,000/$1,000,000 RETRO: 05/31/2013 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate holder is additional insured as respects General Liability only if required by written contract, and subject to the terms, conditions and exclusion as specified in the policy. Four parking spaces in #49-52 in City Owned Parking Lot Loc# 2 - 405 Cleveland Street; Clearwater, FL Building # 1 Capitol Theatre Loc# 4 - 112 Osceola Ave; Clearwater, FL CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CLEARWATER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)The ACORD name and logo are registered marks of ACORD 1of 1 #S684725/M684677KEVCO Client#: 22073RUTHECKE ACORD DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 5/31/2017 TM 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). CONTACT PRODUCER NAME: Bouchard Insurance (CLW) FAX PHONE 727 447-6481727 449-1267 (A/C, No): (A/C, No, Ext): 101 N Starcrest Dr. E-MAIL clcerts@bouchardinsurance.com ADDRESS: Clearwater, FL 33765 INSURER(S) AFFORDING COVERAGENAIC # 727 447-6481 16535 Zurich American Insurance Co INSURER A : 26247 INSURED American Guarantee & Liability INSURER B : Ruth Eckerd Hall, Inc. 10700 RetailFirst Insurance Company INSURER C : 1111 McMullen Booth Rd INSURER D : Clearwater, FL 33759 INSURER E : INSURER F : COVERAGESCERTIFICATE 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. INSRADDLSUBRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSRWVD A GENERAL LIABILITY YYCPO01715680205/31/201705/31/20181,000,000 EACH OCCURRENCE$ DAMAGE TO RENTED X100,000 COMMERCIAL GENERAL LIABILITY$ PREMISES (Ea occurrence) X10,000 CLAIMS-MADEOCCURMED EXP (Any one person)$ XBI1,000,000 PERSONAL & ADV INJURY$ 2,000,000 GENERAL AGGREGATE$ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:PRODUCTS - COMP/OP AGG$ PRO- $ POLICYLOC JECT COMBINED SINGLE LIMIT AYYCPO01715680205/31/201705/31/20181,000,000 AUTOMOBILE LIABILITY (Ea accident)$ X BODILY INJURY (Per person)$ ANY AUTO ALL OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOSAUTOS NON-OWNEDPROPERTY DAMAGE XX $ HIRED AUTOS (Per accident) AUTOS $ B X UMBRELLA LIAB XAUC96729410805/31/201705/31/201810,000,000 EACH OCCURRENCE$ OCCUR 10,000,000 EXCESS LIAB CLAIMS-MADEAGGREGATE$ X0 $ DEDRETENTION$ WC STATU-OTH- WORKERS COMPENSATION C05204622901/01/201701/01/2018X TORY LIMITSER AND EMPLOYERS' LIABILITY Y / N 1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ Y N / A OFFICER/MEMBER EXCLUDED? 1,000,000 (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under 1,000,000 E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below AAbuse/MolestationGLC01715690205/31/201705/31/2018$1,000,000/$1,000,000 RETRO: 05/31/2013 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) Certificate Holder is an additional insured with respect to general liability including ongoing and completed operations, where required by written contract and subject to the terms, conditions and exclusions of the policy. Owner of Land Loc# 1 - 1111 McMullen Booth Rd; Clearwater, FL (See Attached Descriptions) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF CLEARWATER THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05)The ACORD name and logo are registered marks of ACORD 1of 2 #S684711/M684679KEVCO DESCRIPTIONS (Continued from Page 1) Building # 1 Theatre & Education Wing Building # 2 HVAC Utility Building and (3) Cooling Towers including permanent mach. Building # 3 Studios (3 studios) SAGITTA 25.3 (2010/05)2of 2 #S684711/M684679