CERTIFICATE OF LIABILITY INSURANCE (14) DATE(MWDD/YYYY)
ACOR" CERTIFICATE OF LIABILITY INSURANCE
ill 70"4/27/2022
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
NAME: Sam Muradyan
Liberty United Insurance Services, Inc PHONE FAX
704 S Victory Blvd, Suite 204 (AC,
/C,No,Ext: 8187618888 A/c No): 8882656889
Burbank, CA 91502 ADDRESS: Sam@libertyunitedinsurance.com
License #: OF89841 INSURER(S)AFFORDING COVERAGE NAIC#
INSURERA: Certain underwriters at Lloyds
INSURED INSURER B: HDI Global Specialty SE
Big Event Slides, LLC INSURERC: One Beacon America/atlantic specialty
4001 Willow Hills Ct. INSURER D:
Plano, TX 75024 INSURER E:
INSURER F:
COVERAGES CERTIFICATE NUMBER: 00000251-465534 REVISION NUMBER: 192
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.
INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS
LTR INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY
A X COMMERCIAL GENERAL LIABILITY Y N ZISMB1405 01 03/16/2022 03/16/2023 EACH OCCURRENCE $ 1,000,000
Am
X CLAIMS-MADE 1:1 OCCUR PREM SESOEa occurrence $ 300,000
MED EXP(Any one person) $
PERSONAL&ADV INJURY $ 1,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000
X POLICY D PRO-
JECT [::] LOC PRODUCTS-COMP/OP AGG $ 2,000,000
OTHER: $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $
Ea accident
ANY AUTO BODILY INJURY(Per person) $
OWNED SCHEDULED BODILY INJURY(Per accident) $
AUTOS ONLY AUTOS
HIRED NON-OWNED PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY Per accident
B UMBRELLA LAB OCCUR 18EX2781 03/31/2022 03/31/2023 EACH OCCURRENCE $ 4,000,000
X EXCESS LAB CLAIMS-MADE AGGREGATE $ 4,000,000
DED RETENTION$ $
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY Y/N STATUTE ER
ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $
OFFICER/MEMBER EXCLUDED? N/A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $
If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $
C Commercial Property 790011744-0009-75349 05/10/2022 05/10/2023 Inland Marine Ins $65,000
A Accident/Medical ZISMB1405 01 03/16/2022 03/16/2023 $10,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required)
Certificate Holder Is An Additional Insured
Claims made form: 36 month built in reporting clause included
CERTIFICATE HOLDER CANCELLATION
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.
705 N Missouri Avenue
Clearwater, FL 33755 AUTHORIZEDREPRESENTATIVE
'— " 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 04/27/2022 at 11:21AM