CERTIFICATE OF LIABILITY INSURANCE (3) OCEAPRO.29 TMILLER
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CERTIFICATE OF LIA13ILITY INSURANCE DATE(hsM€otaYYYY)
711612021
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).
PRODUCER CONTACT Terri Miller
NArx�:
The Loomis Company P&C Division PHONE _ FAX- _
850 N Park Road IArc No Extl (610)374-4040 2281 I,arc,Noy:
Wyomissing,PA 19810 E-MAIL tmillerlootmisco.com
ADDRESS
_.INSURER(S)AFFORDING COVERAGE NAiC#
_...._ _ INSURER A:The Cincinnati Specialty Underwriters insurance Company
13037
INSURED INSURER„B:Cincinnati Insurance Company _ ..__.... ,10677
Clearmar,LLC dlblal Opal Sands Resort INSURER c:Allied World Assurance Company 19489
430 Gulfview Boulevard INSURER p
Clearwater Beach,FL 33766 _
INSURER E::
._.,.._..,_.._ .�,,..,.._ INSURER F:.
COVERAGE ___... CERTIFICATE NUMBER: - � c
„ _rt_.... u N NUMBER:
THIS IS TO CERTIFY` THAI THE POLICIES OF INSURANCE FISTED BELOW DAVE BEEN ISSUED TO THE INSURED NAM EDI ABOVE FOR THE POI ICY PER 0D
INDICATED NOWATHSTANDING ANY REQUIREMENT "PERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO'vVH[CH`THIS
CERTIFICATE MAY BE ISSUED OR t.IAY 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 CLAINI-S.
pNSR
4 R TYPE OF INSElRANCE ADDL SUBR POOLICY EFF POLICY EXR _..
-- _.wv... m.-IN56 WVD ..,. POLICY NUMBER _.. ,,, h9MIDD/YYYY•l,u,jp,7 M,[}DTt`Y`"{1 .. LIMITS
,X COMMERCIAL GENERAL LIABILITY ."
UACH 3C1,'L,RR1L,%1iSP w 2,000,000
CLAIMS,MADE )( r, cuR CSU0089250 7115/2021 71`512022 D'A "� 0 RENTEtl 2,000,000
�tr31Cs w ry n,r-r�nc,�? 5 }
_.. PERSONAL&.ADV IN- U,7'k S 2000,000
GENT f REChTE LIMIT APPLIES PER: GE JERAI_AGGREGATE - _..._ 4,000,000
PC,LICY' XX
�^ 4 000,000
t'�Rs,[7IiCTS•� v�CP rz�U S
_._....
AUTOMOBILE LIABILITY CON!81 N L'SING E LIMIT m,,.-...
Eaac �en?i.._ 1,000,000
X ANY AUTO CAA5247199 711512021 711512022 PODILYIN,LRY,Parcerscn, s AUTOS ONLY nLTCS BODILY PI.;'iRY P i acci 3 rt; S
t.+AU�A E
�L ,�7 a;,r (�; acc,4r,r,:t,...
C X UMBRELLA LIAR X OCCUR 10,000,000
EXCESS LIAR LAI-is,>KADE 0309-1044 711512021 711512022 r,C._�r. nT u 10,000,000'
DFD X F ENITIONS _..-100,000 ....... _...... __. ._.....
WORKERS COMPENSATION �TTH �...
AND EMPLOYERS'LIABILITY Y 7 N '... '.... ... PSTATL;TE Eq
ER .. ...._
ANY ER0PRI TCR PR NEP EY_CU11VE _ ?-I ,�!yI�E:NT
ONFP;ER1MEMBER EXCL,LOEDi NIA E_L,I --.._... ...
(Mandatary in NH) '.. ......... _.... '..
I.L IS_ S���--_-E .`0YEL S
If yes,des .�Ce order n Eh�'PL _
LlLi(_RIP f N Or C ERA T It a8 beiem
E.L.
DESCRIPTION OF OPERATIONS;LOCATIONS 7VEHICLES (ACORD 141,Additional Remarks Schedule,may be attached if more space is required!
TRIA is included on the General Liability
City of Clearwater is noted as an additional insured on the General Liability as required by written contract and subject to the policy's tends,conditions and
exclusions.
CERTIFICATE BOLDER CANCELLATION --
i
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Clearwater THE. EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
Attn:Parks&Recreation Department
PO Box 4748
33758-4748 AUTHORIZED REPRESENTATIVE
I
James R. Loomis
_.. �. .... w_......
ACORD 25(2045103) �1988-2045 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD