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CERTIFICATE OF LIABILITY INSURANCE (3)
Client#:26284 ALMNDR4 ACORD. CERTIFICATE OF LIABILITY INSURANCEDATE(MMIODNYYY) 1/16/2018 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(les)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 any rights to the certificate holder In lieu of such endorsement(s). PRODUCER Bouchard Insurance(CLW) PANNE Ezt;727 447-6481 atc No; 727 449-1267 Clearwater, N StarcreL 3 ADORE : cicerts@bouchardinsurance.com Clearwater,1 33765 INSURER(S)AFFORDING COVERAGE NAIC 0 727 447-6481 INSURER A:Rewwkzt r-ccmWY 10700 INSURED INSURER B Alexandra of Clearwater Beach dba Pier 60 Concessions INSURER C: PO Box 3337 INSURER D: Clearwater,FL 33767 INSURER E: COVERAGES CERTIFICATE 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. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR 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. NSR ADDL UB POLICY EFF POLICY EXP LTYPE OF INSURANCE LIMITS 1 D POLICYNUMBER MMID MMID COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CTCURRREENCE $ CLAIMS-MADE D OCCUR PREtytISS Ea�currertce $ MED EXP(Any ateperson) $ PERSONAL&ADV INJURY $ GEML AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY D JJEECT EILOC PRODUCTS-COMPIOP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea,c,derttt _ ANY AUTO BODILY INJURY(Pa person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Pa UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ A WORKERS COMPENSATION 052057049 1/04/2018 01/041201 X PER OTH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERIEXECUTIVE YIN E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? Q N I A (Mandatory in NH) E DISEASE-EA EMPLOYEE $1 000 000 If yes,descn'be under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 10,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS i VEHICLES(ACORD 101,Additional Remarks Sdkxhdo,may be attached H more space is required) **Workers Comp Information** Proprietors/Partners/Executive Officers/Members Excluded: Steve Chandler,President Use Chandler,Officer CERTIFICATE HOLDER CANCELLATION Ci of Clearwater SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016103) 1 of 1 The ACORD name and logo are registered marks of ACORD #87967821M796770 DANSU