CERTIFICATE OF LIABILITY INSURANCE (15) AC C7,RE0 DATE(MMrQDNYYYI
CERTIFICATE LIABILITY INSURANCE 0712412018
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 be endorsed, It SUBROGATION 15 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
NAME: FLIP Program Support
Veracity Insurance Sfllutions,LLC. "RHONE FAx
(844)-520-6992 rare NdI:
260 South 2500 VVesk,Suite 34?3 ErdAli �.
Pleasant Grove UT 84052 A[1DREs8_.___.Info@f program com
-- --
INSURE SAFFORDING COVERAGE NAIL e
INsuI:ED
INsuRERR... GreatAmerican Alliance-Insurance Csa.—.._ 1..._.._.25832 ......
;
Joe IDonoughe,DBA Bug-Eyed Entertainment INSURER Ira
321'Washington ave MAuReRc.._
—m ��
Lake MaINSUR€R D
ry FL 32746 -- __
eISURIM E
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HA mNsuRE F,
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
VE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
CERTIFICATE
NOTWITHSTANDING BE ISSUE NOy ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAYO CONDITIONS
OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBER} HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND OONDRTIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR; _ TYPE OF INSURANCE leER 060CY EFF ?°'pNDLbCYR�
POLICY Nue
GENERAL LIABILITY Mft,D ffYYYOMIT
I 1,{I 00,0 0 0
EACH OCCURRENCE
F�GOMIVIERCIAL GENERA,a,LIAR€CITY 300,000
PREMISES Ee Pocurren�) $
CLAIMS MADE X OCCUR
A MED EXP(Anyone per.on) $ 5,000
PL1744427-FO40464 63101/201a 1)3161/2019
---- ---
PERSONAL&ADV INJURY s 1,000,000
--°- GENERAL AGGREGATE. $ 2,000,8700
HN1.AGGREGATE LIMITAPPLIES PIuR PRODUCTS-COMPFOPAGG S 2,000,000
POLICY: PRO,
LCC ANIMAL BAILEE $
AUTOMOBILE LIABILITY I I"; rrFBIN SINGLE I R
I I Ea accede n
ANY AUTO BODILY INJURY(Per person) $ .
ALL Q'4M1RdED -"I SCHEDULED
„w.....�AUTOS u AUTOS _ BODILY INJURY(Per occident) $
HIRED AUTOS NON OWNED
AUTOS �PROPEFITY DAMAGE -_..... _..�.... _.._.�__._
' (Per accetlnntl __ $
UMBRELLA UAS $
F.I5ESS LIA �� EACH OCCURRENCE._ T—.,..,.DEO _. ....
...—....e
WORKERS COMPENSATION $
AND EMPLOYERS"LIABILITY WC STATU fl _
ANY PROPRIETORIPARTNER/EXECU1`IVE
OF FIC,E;'MEMBER EXCLUDED? N r A F E L EACH ACCIDENT $
ta
(Mandary In NR) t.. .—•�—
IfYee,deecrlbe under E L DISEASE mnA.EMPLOYEE,.$4—�'__
.._
E.L.DISEASE•PflLICY LIMIT $
DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Atlach ACORD 101,AddMonal Remarks Schedula,H more space is required)
Certificate holder had been added as additional insured regarding the above mentioned policy per attached
Additional Insured-Designated Person or Organization(CG 20 26 Ed.04 13)
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
P.O.box 4748 ACCORDANCE WITH THE PO7LICY PROaVISIO7NS.
Clearwater,FL 33788 :::JALFTHORt=ZED
REPRESENTATIVE
Q 1968-2014 ACORD CORPORATION, All rights reserved.
ACORD 251 (2014101) The ACORD name and logo are registered marks of ACORD
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