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CERTIFICATE OF LIABILITY INSURANCE (880) Page 1 of 1 CERTIFICATE OF LIABILITY INSURANCE GATE(MM/2GI7 ACC]RL7 1211212 a17 ilt.�. 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 have ADDITIONAL.INSURED provisions or 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 CONTACT NAME: Willis Insurance Services of California, Inc. c/o 26 Century Blvd PHONE 1-877-445-737B�` ...... -f FAX 1-888-4fi7-2376 ALC.Iia Extk _._liAfc No}: E-MAIL certificates�w111i8.com P.O. Sox 305191 ADDRESS: .._..__._....._.. Nashville, TN 372305191 USA INSURER(S)AFFORDING COVERAGE NAICN INSURER A: Endurance Assurance Corporation 11551 INSURED INSURER B- State National Insurance Company Inc 12831 NS-TSR, LLC c/o Robert N. Currey & Associates, Inc. INSURER C. Allied World National Assurance Company 10690 One Beacon Street, 22nd. Floor INSURER D- Boston, MA 02108 INSURER E: - INSURER F: COVERAGES CERTIFICATE NUMBER.W4610989 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. INSR TYPE OF INSURANCfi AFInL SUER Y POLICY NUMBER MMIDD YY MM POLICY EXP LIMITS LTR2 X( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 11400,000 DAMAGE To RENTE13 CLAIMS-MADE FxI OCCUR PREMISES Ea occurrence $ 500,000 A ME EXP(Any one Person) $ Y GGR10011997500 10/27/2017 10/27/2016 PERSONAL&ADVINJURY $ 11000,000 G,EN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 21000,000 POLICY PRO JECr I LOC PRODUCTS-COMPIaPAGG $ 21000,000 OTHER: S AUTOMOBILE LIABILITY CEOa M aBINCCldED ent SINGLE LIMIT S 11000,000 X ANY AUTO BODILY INJURY(Per person) $ 13 CVVNED OSONLY AUTOSULED EDRGARD103800 10/27/2017 10/27/2018 BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY par acCid,t C X UMBRELLALIAB }'. OCCUR EACHOCCUR7tENCE $ 51000.000 £,YCESSLIA9 CLAIMS-MADE 0309-2216 10/27/2017 10/27/2018 AGGREGATE $ 51000,000 pED X'C RETENTIONS 10,000 g WORKERS COMPENSATION STATUTE ERH AND EMPLOYERS'LIABILITY YIN ...--._.. ANYPROPRIETORIPARTN I=RIEXECUTIVE E.L.EACH ACCIDENT $ OFFIOER1MEMSER EXCLUDED? N f A (Mandatory in NHJ E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLiCY LIMIT $ DESCRIPTION OF OPERATIONS I LOCAT{O NS 1 VEHICLES(ACORD 101,Additional Remarks Schedute,may be attached:if more space is required) RE: Starkey Ranch, 2500 Heart Pine Ave., Odessa, FL CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BC DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Clearwater AUTHORIZED REPRESENTATIVE Rick Osorio, Risk Manager PO a Clearwater,aterter,, 8L 33758-5520 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD sR rD- 15408911 RA-Tca: 539614