CERTIFICATE OF LIABILITY INSURANCE OCEAPRO-29 TIMIL
' + ... '► CERTIFICATE OF LIABILITY INSURANCE DA 03/2 F�8
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THIS CERTIFICATE IS ISSUED AS A MATTED. 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),AUTHORIZER
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 dues not confer rights to the certificate holder in lieu of such endorsement(s).
PRODUCER SnAR_I cL TeM ? _r_i.M.
Tiler
The Loomis Pan P8C Division H
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PHONE FAX N Park Road (618)374-4040 2281 ' wc,N_a.
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Wyomissing,PA 19610 mlllerloom'sco.co .
_
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1 INSURER A:The Cincinnati Specialty Underwriters Insurance Company
INSURED INSURER B:Cincinnati Insurance Cornny__.. _ 10677
Clearmar,LLC d#btal Opal Sands Resort 1NsuREwt_c„Allied World,Specialty Insurance Company 1662.4
430 Gulfview Boulevard INSURER D: ——
Clearwater Beach,FL 33765
INSURER E
INSURER F: ,
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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICHTHIS
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 LTR 1 TYPE OF INSURANCE IA6DLiSUBR POLICY NUMBER ... POLICY EF;F POLICY EXP
COMMERCIAL GENERAL LIABILITY
'N � IdIM1 ( LIMITS
A X a ( EACt1OCCURItENOE 1,000,000
r
. CLAIMS-MADE X
OCCUR 1 iCSU0089250 0711512017 0711512015 DAMAGE TO RENTED f 1,000,000
- PREMISES iEar=urrencq ,5 ..._
r „ .._ .._.._. _..... -MED EXP lAny,onepersdn5_ _..... --
PERSONLAL&ADV I,Nit)RY 15 1,000 000
GEN L AGGREGATE LIMIT&PPLIES PER GENERAL AGGREGATE j$ 0005000
POLICY X Pcrt X LOC 2,000,000'
. PRODUCTS COMPIOPAGG J S
X 1 OTHER,Includes Terrorism jLi-quor Liab, $ 1,000,000
B AUTOMOBILE LIABILITY (COMBINED SINGLE LIMIT ...._
1Ea.IIdenl] _. ._$ .. .._
X ANY AUTO CAP5247199 10711512017 0711512018 BODILY INJL RY�Aerpe can) f 5
CANED scHEDULE7 I TW 1,000,000
AUTOS ONLY �AUTOS 1 FBODILY INJURY{Per accadeM,,,$
- _......... _
HIREp NON{'�Vt4a? ( PROPERTY DAMAGE
j AUTOS ONLY AIITtDS OY i .{Per accydert} $
" X UMBRELLA LIAR F X OCCUR EAC
OCCURRErJCE *$ 25,000,000
EXCESS LIAs �cLAIMS-MADE 0309-1044 0711512017'0711512018 _.
.— - _ ........,_ _.. .. .. ,
AGGREGATE 25,
._ 5
DED X RET ENTION$ 10,000! 000,000
— Is
'WORKERS COMPENSATION I I PER O'rH-
AND EMPLOYERS'LIABILITY YIN j - $TAI IITE.. ER—y. ...,, ....._.._
ANY PROPRIETORIPARTNE:WEXECUTIVE 1
OFFICER�MEMBEREXCLIJDEfl? INIA E_L_EACHACCIDENT ....._.1 S_......_ ..____.. .........._
tory
If yes,descrin and �'` E.l..01 SEAS E-EA EPA PLOY E EJ S
If yes.describe under ( - ........_ ,.,.,..
DESCRIPTION.OF OPERATIONS belaw C---- ._..._.
E,L.❑ISEASE-E'>i3LICYL9MIT 1$
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DESCRIPTION OF OPERATIONS I LOCATIONS)VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space IS required)
City of Clearwater is noted as an additional insured on the General Liability as required by written contract and subject to the policy's terms,conditions and
exclusions,
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City Of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Atte:Parks&Recreation Department ACCORDANCE WITH THE POLICY PROVISIONS.
PO Box 4748
33758-4748 AUTHORIZED REPRESENTATIVE
James R.Loomis
ACORD 25(2016103) C 1988-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD
EARLIER NOTICE OF CANCELLATION OR NONRENEWAL BY US TO A
DESIGNATED ENTITY
This endorsement modifies insurance provided under the following:
COMMERICAL GENERAL LIABILITY COVERAGE PART
COMMERCIAL PROPERTY COVERAGE PART
POLLUTION LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS COVERAGE PART
SCHEDULE
Designated Entity:
Any additional insured requiring early notification by written contract.
Mailing Address:
Cancellation Notification - Number of Days: 60
The following notice of cancellation condition is added only for the person or
organization designated in the Schedule above.
If we cancel or nonrenew this policy for any statutorily permitted reason other than
nonpayment of premium we will endeavor to mail notice to the person or organization
shown in the Schedule above. We will endeavor to mail such notice at least the number
of days shown in the Schedule before the effective date of the cancellation or
nonrenewal.
If we cancel this policy for nonpayment of premium, we will endeavor to mail notice to
the person or organization shown in the schedule above. We will endeavor to mail such
notice for nonpayment of premium at least 10 days before the effective date of
cancellation.
When notice is mailed, proof of mailing to the mailing address shown in the Schedule
will be sufficient proof of notice.
In no event will coverage extend beyond the actual expiration, termination or
cancellation of the policy.
Includes copyrighted material of Insurance
Services Office, Inc., with its permission.
COMMERCIAL GENERAL LIABILITY
CG 20 01 04 13
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.
PRIMARY AND NONCONTRIBUTORY -
OTHER INSURANCE CONDITION
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART
PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART
The following is added to the Other Insurance (1) The additional insured is a Named
Condition and supersedes any provision to the Insured under such other insurance:
contrary: and
Primary And Noncontributory Insurance (2) You have agreed in writing in a
This insurance is primary to and will not contract or agreement that this
seek contribution from any other insurance insurance would be primary and would
available to an additional insured under not seek contribution from any other
your policy provided that: insurance available to the additional
insured.
CG 20 0104 13 0 Insurance Services Office, Inc.,2012 Page 1 of 1