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CERTIFICATE OF LIABILITY INSURANCE (10)
DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 05/10/2019 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 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 does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Sam Muradyan NAME: Liberty United Insurance Services, Inc FAX PHONE 81876188888882656889 (A/C, No): (A/C, No, Ext): 704 S Victory Blvd, Suite 204 E-MAIL sam@libertyunitedinsurance.com ADDRESS: Burbank, CA 91502 INSURER(S) AFFORDING COVERAGENAIC # License #: 0F89841 INSURER A : Admiral Insurance CompanyAdmiral Insurance Company INSURED INSURER B : Atlantic Specialty Insurance Co All Around Amusements, LLC INSURER C : DBA Big Event Slides INSURER D : 4001 Willow Hills Ct. INSURER E : Plano, TX 75024 INSURER F : COVERAGESCERTIFICATE NUMBER:00000000-435181 REVISION NUMBER:155 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ 03/16/201903/16/2020 1,000,000 AXYNCA000029992-02 DAMAGE TO RENTED CLAIMS-MADEOCCUR$ 50,000 X PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ 2,000,000 PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ 2,000,000 X JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 4,000,000 EACH OCCURRENCE$ 03/16/201903/16/2020 OCCUR AXGX000001187-02 EXCESS LIAB 4,000,000 CLAIMS-MADEAGGREGATE$ X $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below Inland Marine ins 05/10/201905/10/2020 BCommercial PropertyTBI25,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder Is An Additional Insured CERTIFICATE HOLDERCANCELLATION 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. 706 N Missouri Avenue AUTHORIZED REPRESENTATIVE Clearwater, FL 33755 (CER) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD Printed by CER on May 10, 2019 at 12:09PM DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 03/18/2019 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 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 does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER Sam Muradyan NAME: Liberty United Insurance Services, Inc FAX PHONE 81876188888882656889 (A/C, No): (A/C, No, Ext): 704 S Victory Blvd, Suite 204 E-MAIL Sam@libertyunitedinsurance.com ADDRESS: Burbank, CA 91502 INSURER(S) AFFORDING COVERAGENAIC # License #: 0F89841 INSURER A : Admiral Insurance CompanyAdmiral Insurance Company INSURED INSURER B : All Around Amusements, LLC INSURER C : DBA Big Event Slides INSURER D : 4001 Willow Hills Ct. INSURER E : Plano, TX 75024 INSURER F : COVERAGESCERTIFICATE NUMBER:00000000-0 REVISION NUMBER:150 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS 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. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ 03/16/201903/16/2020 1,000,000 AXYNCA000029992-02 DAMAGE TO RENTED CLAIMS-MADEOCCUR$ 50,000 X PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ 2,000,000 PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ 2,000,000 X JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY $ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB 4,000,000 EACH OCCURRENCE$ 03/16/201903/16/2020 OCCUR AXGX000001187-02 EXCESS LIAB 4,000,000 CLAIMS-MADEAGGREGATE$ X $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Certificate Holder Is An Additional Insured CERTIFICATE HOLDERCANCELLATION 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. 706 N Missouri Avenue, Clearwater, FL 33755 AUTHORIZED REPRESENTATIVE (SMS) © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD Printed by SMS on March 18, 2019 at 01:28PM