CERTIFICATE OF LIABILITY INSURANCE (3) �ADATE IMMC"R" CERTIFICATE OF LIABILITY INSURANCE ATElRRIYYYYI
iMM/2 19
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN01 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 CONTACT Susie Ricca _ _. ... ...
NAME:
Northeast Tlnderwriters Inc. {���Nt�u,E�t} E727)521-4253 �aA�,No} (727)^.27-9455
14,790 lst Street North E-MAIL srico@neu-ins.com
ADDRESS:
INSURER(S)AFFORDING COVERAGE _- NAIC id......
St. Petersburg FL 337013 INSURERA Seneca Specialty InsuranceCor�tpany 110729
INSURED .__. ...._.... _.. __ .._.. .. _._ INSURER B°Great American _ .. .. ..
Sunsets at pier 60 Society, Inc. INSURERC.
i c/o Craig West INSURER D
2007.. Central Aire INSURER E: ... _.
! St Petersburg FL 33701 INSURER F:
COVERAGES CERTIFICATE NUMBER;CL18102309727 REVISION NUMBER:
HIS IS I0 CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FLOP TETE POLICY PERIOD
INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERIA OR CONDiTI]N OF ANY CONTRACT OR OTHI.:R DOCUMENT TNI 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 ]'HE IERIVIS,
EXCLUSIONS ANIS CONDITIONS OF SUCH PO (CIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR I EAS"001SUBIR _. 1_.PMLICY EFF P.OLFCY EXP ,I...
LTR. TYPE Or INSURANCE � � POLICY NUMBER hSh31""YY MMII.7D"YYY ( LIMITS
COMMERCIAL GENERA.LIABILITY1,000,000.
I �
�.f AC H CICCURRE NCE
t 6AMAC E 10 RENT F G 1
A _ L;IAIM`S-MADE ,7I;C:UR }l?IMISfr S_IIaocurrruce; Dq+ Qf,.
i
f X BAI{....3382B--2 _x/7/2018 9/7/2014ML17EXP(Anyon��Isvrst�n) g 5,000
E
4_€i 16 NAI. &AIEV IN,J LJRY �;n 1,000,000
G N t P hi,E3EL:3A"I L I IMI;API L IP S PI.R GLNE.RAI.ACGRF CdAI L 2,000,000
1 )LICY .....i F'f2f5- I L.Oc _ i.PRODUCTS•COMPKA,AG( 5 Excluded
_.....i JF.G1 L
s I CI➢HER,
I_. ^r Bi LF LIAFi.ILITY ifCWHINE D SINC�I 1.L.IPAIT 5
fi IFIJII Y Ihd IURt per LF r�'on) $
i BOD ILY lNJE1RY IE'er a,cirler�r �
NO N O%NNtl 17 i PROP RIN DAM AU
I $
__. ALMUS i (Ier ar�tend
UMBRELLA LIAB4
OCCUR � I I E-At,lt FTt.,i;URRE NC:ES
EXCESS LIAB _. t CI AIMS-MADE,; ( ..
AC,I-,RI-GAIE.
DILI+ RETENTI(lNSY _. `
ER
W0RKEk`S COMPENSATION k3 f ATl1T E ER
_..
AND EMPLOYERS"LIABILITY I
YIN
r'r ^�:r RIETCIRdf'� Ttti h - t[,llIVF;: ( I i ? l'. I EACH ACCIDENT � %. _
Jh C.e R M MRE E Xt.t L,ttE i N r A
(Mandatary in NH) JL DISEASE LA E IAP OYFE $
vw oe r LF e under _ _.. ..
DES C,R'IF I10N OF 0 11 F PAT 10NS't. iTw E L DISEASE POLICY LIMIT
B Directors & Offi-cern I EPP4029486 Bf1B/27 T 8/18/2019 $1,000,000
i
& Employee Practices I, ab.
j DESCRIPTION OF OPERATIONS I LOCATIONS)VE=HICLES (ACORD 101,Additional Remarks Schedule,may be attached.if more 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 THE EXPIRATION [SATE THEREOF, NOTICE WILL BE DELIVERED IN
and Recreation Dept. ACCORDANCE WITH THE.POLICY PROVISIONS.
100 S. Myrtle Arae
Clearwater, FL 33755 AUTHORIZED REPRESENTATIVE
c 1988-2.0114 ACORD CORPORATION. All rights reserved
ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD
INS025 f2 14.01 s