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CERTIFICATE OF LIABILITY INSURANCE (22) Client#: 22073 RUTHECKE ACORDT. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/02/2020 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 any rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Marsh &McLennan (CLW) PHONE 727 447-6481 FAX 727 449-1267 A/C,No,Ext: (A/C,No): 101 N Starcrest Dr. E-MAIL ADDRESS: cicerts@bouchardinsurance.com Clearwater, FL 33765 INSURER(S)AFFORDING COVERAGE NAIC# 727 447-6481 Arch Insurance Company 11150 INSURER A: p Y INSURED INSURER B: Retail First Insurance Company 10700 Ruth Eckerd Hall, Inc. INSURER c 1111 McMullen Booth Rd INSURER D: Clearwater, FL 33759 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 CONTRACT OR OTHER DOCUMENT WTH 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY SCGL1816100 05/31/2020 05/31/2021 EACHOCCURRENCE $1,000,000 CLAIMS-MADE ®OCCUR PREMISES(Ea olccurrDence) $1,000,000 MED EXP(Any one person) $0 PERSONAL&ADV INJURY $1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE x5,000,000 PRO- POLICY JECT LOC PRODUCTS-COMP/OPAGG x5,000,000 OTHER: $ A AUTOMOBILE LIABILITY SAUT0085500 05/31/2020 05/31/2021 CO(EaMBINED ccidentSINGLE LIMIT $1e 000e 000 a X ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY Per accident $ A UMBRELLA LIAB X OCCUR S F 50089900 05/31/2020 05/31/2021 EACH OCCURRENCE $10,000,000 Y EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000,000 DED X RETENTION$0 $ B WORKERS COMPENSATION 052046229 01/01/2020 01/01/2021 PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER YIN N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ® N/A (Mandatory in NH) E.L.DISEASE-EA E 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $190009000 A Abuse/Molestation SCGL1816100 05/31/2020 05/31/2021 $1,000,000/$2,000,000 A Liquor Liability SCGL1816100 05/31/2020 05/31/2021 $1,000,000/$2,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Loc#2-405 Cleveland Street; Clearwater, FL Building# 1 Capitol Theatre CERTIFICATE HOLDER CANCELLATION CITY OF CLAAT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 4748 ACCORDANCE WITH THE POLICY PROVISIONS. Clearwater, FL 33758-4748 AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #51275265/ 1275255 SHCA This page has been left blank intentionally.