CERTIFICATE OF LIABILITY INSURANCE (2) � RTC IIvIMIlRRIYYYYI
s�1C"R" CERTIFICATE OF LIABILITY INSURANCE DATE
(MM/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(ies) must 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 rights to the
certificate holder in lieu of such endorsement(s).
PRODUCER FCONTACT Susie Rico
l Northeast Underwriters Inc. PHONE (727)521-4253 FAX (727)52z -9455
p JNC No,..Ext): q.(AJC,No}
14,T9CI Ist Street North MAIL srico@neu-ins.com
ADDRESS:
_ _...INSURER($)AFFORDING COVERAGE _. NAkC�_....
St. Petersburg FL 33703 INSURERA Seneca Specialty InsuranceCompany 10729
ENSURED __ .... .. _._ INSURER B!Great American _ _. _.... .. ..
Sunsets at pier 60 Society, Inc. INSURERC.
i c/o Craig West INsuRERcr:
*0 Central Aire INSURER E _...
f St Petersburg FL 33701 INSURER F:
COVERAGES CERTIFICATE NUMBER.CL18102309727 REVISION NUMBER:
TI+IS IS 10 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMELY ABOVE FOP TT E POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WI LH RESPECT TO WHICH THIS
CI RTIFICATE MAY BE ISSUED OR MAY PERTAIN.. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THFIFRMS,
EXCLUSIONS AND CONDITIONS OF SUCH POUCIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR I A£OLTISUB13 i PMOLICY EFF PP%,10Y EXP 1... _...
LTR TYPE Or INSURANCE POLICY NUMBER Mh31[TDlYYYY MMII]D"YYY ( LIMITS
COMMERCIAL GENERAL LIABILITY1,000,000
f AC H t"ICCLII�RENt;1 ,�
RAMAL
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L„Pi RSUNAI. &ADV INJURY i$ 1,000,0010
I CzF N t AI f,I3E£3A"I E t IMI I A6zI L IF i Ia[.R GLNE.RAI.Af t,aRE£3A1 L $
2,000,000
II. x POLICY LC)C I E'HO[TL1CIi4•1:43PJII""iAAfiG 5 Excluded
0➢HER, _ S
- ^r I7B9LE LIARILITY I.i OMBINE D SINC�L 1.1 PAILT
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ANY Al IT4�
r dd I i RIXALINJURYleer pF r�uril $ _.
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_ RED AUTOS FALtIOS i {itra�r-deizl,r _.
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UMBRELLA LIAB I OCCUR C1 AIM5I I
FA(,',Ii f1?�#_i7RRt NC:FS a$
EXCESS LIAB r .111ADF .. .
AF,I-,ItFC3€IlE �
DE`I� RETE NTI£1N 5'
�WORKERSCOMPENSATION ( I k ��PER 015 1- r _
AND EMPLOY I=RS”LIABILITY f ;i f ATl1T E LR
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^� r E.'IET£1Rdp� TIti h u1[,I1Iv'F,: I I i 1 ! EACH At'H�4 C;ILa{Ni .%
Jh C€ P1 MIHE Xt.t LrttE I N A
(Mandatory in NH) JL DISEASE FA E IAPL OYFE $
It ye�, oe�mL�e under
DESCRIPTION OFUI'F RATIIJNS't.t iTw F L FJISFASE POL ICY E INFET is
S Directors & Offi-cern � �EPP4f2. 0486 i B,f1.Bj2t716 8/18/2019 S1,U+7.O..,CkITCS...
& Employee Practices I, ab.
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j DESCRIPTION OF OPERATIONS f LOCA nONS 1 VEHICLES (ACORD 101,Additional Re'narks Schedule,may be attachedif inure space Is required)
The certificate holder is hereby named as additional insured, as per written contract, in regards to the
genteral liability policy.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Clearwater Parks ACCORDANCE
EXPIRATION DATE THEREOF, NOTICE WILL E DELIVERED IN
and Recreation Dept. ACCORDANCEWITH THE POLICY PROVISIONS.
100 S. )Myrtle Arae
Clearwater, p1-. 33755 AUTHORIZED REPRESENTATIVE
c 1988-2014 ACORD CORPORATION. All rights reserved
ACORD 25(2414/01) The ACORD name and logo are registered marks of ACORD
INS025 f201401 s