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EVIDENCE OF PROPERTY INSURANCE (3) 72/1/2018 E(MM/DDYYY) A�" EVIDENCE OF PROPERTY INSURANCE /Y THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW.THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE ADDITIONAL INTEREST. AGENCY PHONE COMPANY vc No Ext):727-461-6044 National Casualty Company Brown&Brown Insurance-Clearwater 83 Park Place Blvd.,Suite 101 Clearwater, FL 33759-3925 A/c No):727-442-7695 A"Ess:Iwaldorf@bbpinellas.com CODE: SUB CODE: AGENCY CUSTOMER ID#: INSURED LOAN NUMBER POLICY NUMBER Chi Chi Rodriguez Youth Foundation, Inc. KK00000007253300 3030 McMullen Booth Rd. Clearwater, FL 33761 EFFECTIVE DATE EXPIRATION DATE CONTINUED UNTIL 02/01/2018 02/01/2019 El TERM INATEDIFCHECKED THIS REPLACES PRIOR EVIDENCE DATED: PROPERTY INFORMATION LOCATION/DESCRIPTION 3030 McMullenbooth Rd.,Clearwater, FL 33761 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION PERILS INSURED I I BASIC BROAD SPECIAL COVERAGE/PERILS/FORMS AMOUNT OF INSURANCE DEDUCTIBLE Scheduled Equipment 831,510 1,000 REMARKS(including Special Conditions CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ADDITIONAL INTEREST NAME AND ADDRESS ADDITIONAL INSURED H LENDER'S LOSS PAYABLE LOSS PAYEE MORTGAGEE LOAN# City of Clearwater P.O. Box 4748 AUTHORIZED REPRESENTATIVE Clearwater FL 33756-5520 ACORD 27(2016/03) @ 1993-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD