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CERTIFICATE OF LIABILITY INSURANCE (26)Client#: 706406 RUTHECKER AIL•LJ ` LJTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/01/2021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS POLICIES 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 Marsh & McLennan Agency Bouchard Re Ion g 101 N. Starcrest Drive Clearwater, FL 33765 CONTACT NAME: PHONE (A/C, No, Ext): 727 447-6481 (, No): AX 727 449-1267 E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC SI INSURER A : Arch Insurance Company 11150 INSURED Ruth Eckerd Hall, Inc. 1111 McMullen Booth Rd Clearwater, FL 33759 neves. a. a INSURER B : RetailFirst Insurance Company 10700 INSURER C OCCUR INSURER D $1,000,000 INSURER E : INSURER F : $ 0 CERTIFICATE NUMBER: 1.w,vs fa,mocs. 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. LTRR TYPE OF INSURANCE ADDL INSR SUER WVD P81I6101'L..CY N '1EI`��Nlln►�[yyyY) SNCGL181610 JUN04 OFFICIAL RECORDS LEGISLATIVE SRVCS POLICY EFF 021 2021 AND DEPT. ' P DY EXP 05/31/2022 LIMITS EACHOCCURRENCE$1,000,000 A X COMMERCIAL GENERAL LIABIUTY CLAIMS -MADE X OCCUR PREMISES(EaEoccurrence) $1,000,000 MED EXP (Any one person) $ 0 PERSONAL & ADV INJURY $1,000,000 GE 'L AGGREGATE POLICY OTHER: LIMIT APPLIES JRT O - PER: LOC GENERAL AGGREGATE $5,000,000 PRODUCTS-COMP/OPAGG $5,000,000 $ A AUTOMOBILE X X LIABIUTY ANY AUTO OWNED AUTOS ONLY AUTOS ONLY X SCHEDULED AUTOS AVON -O ONLDD SNAUT0085501 05/31/2021 05/31/2022 Ea acciden SINGLE LIMIT $1,000,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ A X UMBRELLA UAB EXCESS LIAB _ X OCCUR CLAIMS -MADE SNFXS0089901 05/31/2021 05/31/2022 EACH OCCURRENCE $10,000,000 AGGREGATE $10,000,000 DED X RETENTION $O $ B WORKERS COMPENSATION AND EMPLOYERS' UABIUTY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below Y / N Y N / A 052046229 01/01/2021 01/01/2022 XR STPEATUTE OTH- ER E.L. EACH ACCIDENT $1,000,000 E.L. DISEASE - EA EMPLOYEE $1,000,000 E.L. DISEASE - POLICY LIMIT $1,000,000 A A Abuse/Molestation Liquor Liability SNCGL1816101 SNLIQ0099201 05/31/2021 05/31/2021 05/31/2022 05/31/2022 $1,000,00042,000,000 $1,000,00042,000,000 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 CLEARWATER PO BOX 4748 Clearwater, FL 33758-4748 ACORD 25 (2016/03) 1 of 1 #S8337704/M8337645 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RCSRC