CERTIFICATE OF LIABILITY INSURANCE (11) ACC>R CERTIFICATE OF LIABILITY INC RA CEDAT`(" '° ,
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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 PC?L-[CIEs
BELOW. THIS CERTIFICATE OF INSURANCE DUES NOT CONSTT UTE,A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT, it the cortifiicasls holder Is an A06MONAL.INSURED,the Policy(les)must have ADDITIONAL INSURED provislons or be endorsed,
N SUBROGATION IS WAIVED,subject to the terms and conditions of the polfcycertain Pof[cFes may require an endomemenL A statement an
this ccartl#lcate dO05 not confer Nghts to the certificate holder in lieu of such vndorsenment(s}.
PRODUCER CONTACT .Ilei Paranti
Sandy Wasson sson andAssoclatea Ira±s,Inc dila ARCW Insur PHONE727
7 Bei rea RdE-MAILvx ( )5"-8811 Ira 827]544-8842
ADDRESS: JImCarcwinsuranoe.00m _.
awsURERI6 AFFORIANGCOVER"E rIAIC■
Pfnellas Parts FL 33782 INSURER A; PhOWel hia Indomnify Ins Co
MORED WSURERS; Progresslvs Eapnass 1D193
Artz 4 Life Academy Inc *4URER C
"IM N.HighfandAve INSURER n
INS'r7RER E,
Clearwater FL 33755 INSURER F.-
COVERAGES
:COVERAGES CERTIFICATE NUMBER: Updated Master Cart REVISION NUMBER,.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTE I BELOW HAVE BEEN ISSUED TO THE WSURED 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 DE=MSED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.1,HITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAJMS.
ASR TR TYPE OFINSURAKE ut WVD POI YNUMSER PNArD
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COMMERCIAL GENERAL LIARLrrk" EACH O=RRENCE 1, towow
Cr.111 OCCUR PRkIA':I'SES S 300.000
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A PHPK1697511 10/0112017 10101¢22018 PERSDrdALdAOVINJURY s 1, ,8
N'L.AG IREGATELIM17A6PLIE5PER: r AG'GRE'flATE S 3,000
FoLicy 0 Jam- 0 LOC PRODUCTS-COMPaYkPAGw S 3,000400
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B IgDWNED ONLY ;AUTDS 033$53173 3 121011 17IM112A18 BODILYINJURY(Prr deM) 3
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UMBREMtratifea!payments s 5A000
EXCES ALk!4� _FACE!OCCURRENCEEXC 35 LEAscL.Uala-MADE AG REGATE....
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DESCRIPTION OF OPEXAT[ONS below E.L DISEASE_POUCY LOXT $
Directors A Offir dts Eaoh Occurrence 1,000,11110
A PHS01273061 10101/2017 1013112016
DE&CmFnow OF WPERA1iYM4s I 1 Aril S t vEwwLsS yACORO ia1,Adddk^W Rwv*m,t Schednk,rely be*ftctwd If mw &""M rte*d_dl
CodMwls Holder is Additional Insured Location. 1761 Khp Hlghway,Clearwater,FL 33755
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ASM DESCRISM POLICES SE CANFCELLECO BEFc#aE
THE EXPIRATION DATE THEREOF NOTICE WILL BE DELIVERED IN
Clay of Clearwater ACCORDANCE VATH THE POLICY PROVISIONS.
100 S.MtyrdeAvenue
AUTMOPJZED UPREWNTATME
Clearwater Fl. 33756 ,i r
O INS-2015 ACORD CORPORATION. All rights raeaerved.
ACORD 25(201 SX3) The ACORD name and logo are registered marks of ACORD
A44�C"Ra CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DD/YYYY)
THIS CERTIFICATE IS ISSUED ASA 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 certlticate holder is an ADDITIONAL INSURED,the(ioficy(les)must have ADDITIONAL INSURED provisions or tae endorsed
If SUBROGATION IS WAIVED,subject to the Berms and conditions Of the policy,certain Policies may require an endorsement A statement an
this certificate does not confer rights to the tortlffcats holder in lieu of such endorsemeM(s).
PRODUCER JA
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AME;
CertiSure,Inc [8@3J 293 4I35 Nu. (883)2II8 5862
Ste.
AYErIIJe C SW DaRe sr adrnln@certipaycom
Ste.1tatINSUR ISI AFFORDING COVERAGE NA=lV41int>r Halleaa FL 33880suwERA Associated Inalustties In$U'2 CD Inc. 2314D
INSURED _.
INSURER B:
Ariz 4 Life AcsdeM,InCL INsuRER c
1751 itlligs Highway
INSURER a
INSURER E
Clearwater FL 33755 INSURER F.
COVERAGES CERTIFICATE NUMBER: 2018 COI REVISION NUMBER-
THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUEYa TO THE INSURED NAME-D ABOVE FOR THE POLICY PERIOO
INDICATED, NOTVATHSTANDING ANY REQUIREMENT,,TEFW OR CCNMTIONr OF ANY CONTRACTOR OTHER DOCCLWENT WITH RESPECT TO VvRICH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS,
EXCLUSIONS AND CONDITION'S OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'TYPE: INSURANCE POLICY NUMraER P _...
MM M7A[o LIMITS
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AND EMPLOYE13rr
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A ANY GER ER EXCLUDER ECUn4E Y iNIA AWC1104905 0410EV2018 0410MO19 E.LEACIACCIEDENT S 100,000
ry in NH
IFym RdI�P"W Nur -TIONS below
I E.L DI&F.ASE-EA EMPLOYEE S 1.000 E'DD i.
IIS, wsdar ,IHSS
E.LDI'BEASE-POLIOYUMIT S �,ODO,{I00
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DESGRIPn NI OF OPERATIONS LOCATIONS YEm LEs(ACORD I01,AddWonal Rmmoft SchedWa, �rf�te
may he Aman age Is required)
CERTIFICATE HOLDER CANCELLATION
�i
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
City Of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS.
too S Myrtle Avenue
RUTH47R12ED REPRESENTATIVE .
Clearwater FL 33756 i
@ 1588-2015 ACORD CORPORATION. All rights reserved.
ACORD 26(2016103) The ACORD name and logo vire registered marks of ACORD