CERTIFICATE OF LIABILITY INSURANCE (7) C DATE I�IMtaDrvYYYI
� CERTIFICATELIABILITY INSURANCE
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 endorsements.
PRODUCER NAME cT Branda ICrepps
Christian-Baker Company PHONE PAx
PO Box 158 (AIC,xo,Ext).717-761-4712 (Adc,_No).717-761-5810
E-MAIL _
Camp Hill PIS 17001 ADDRESS. brand a k@ brandchristianbakerco.com
-INSURERIS),AFFORDING COVEAGEMAIC#
INSURER A:The Hartford 19682
INSURED T:AMPBAY-01 INSURER B
Tampa Bay Raptor Rescue
2750 Park Trail Large INSURER
Clearwater LL 33759 INSURER D:
INSURER E: .
INSURER F
COVERAGES CERTIFICATE NUMBER:560869286 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 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 IONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TNSR Tt[DDLISUBiEI _....._ ._ _. POLICY EFF POLICY EXP
LTR TYPE OF INSURANCE IN Lk Yu"Va POLICY NUMBER____ r(POLICY
EFF ,: POLICY
YVYM LIMITS
A X COMM:ERC IAL GEN ERAL LIABILITY Y 39SBMAR9HVT 61/112022 6/9!2023 EACH OCCURRENCE $1,000,000
CLAIMS-MADE ' OCCURDAMAGE TO RENTED
PR_F.MISFS(F:aOc['wrreracaj $1'000 000
_.. _..... ___-. MED EXP(Any One person) ':$10,000
......._ ...._.. -.... PERSO NAL.&ADV INJURY $1,000,000 ._..
GEN't AGGREGATE 1,1MIT APPI IFS PER GENERAL AGGREGATE---- $2,OOD,000 .....
X PRC/- ...... ... ,
POLICY JEC:T LOC PRODUCTS-COMPIOP AGG $2$$2,000.000
OTHER::. _.. -. ......
A .AUTOMOBILE LIABILITY �. .��. 39SBMAR9HVT 61112022 511/2023 COMBINED SINGLE LIMIT $1,000,000
(Ea aomdam)
ANY AUTO} : BODILY INJURY(Per ru?esOnl $ _--
O4NNEO _ SCHEDULED BODILY INJURY{Per accident)...S
AUTOS ON LY
_..,AUTOS __-..
rX HIRED X NON OVtINED ( PROPERTY DAMAGE $
AUTOS ONLY AUTOS ONLY (Per awdenll
5
UMBRELLA LIAB OCCUR EACH OCCURRENCE. $
EXCESS LIAB CL$,IMS-MADE'.. AGGREGATE...
DED HETENTION$ ... .... _.-.
WORKERS COMPENSATION _ -_... PER I OTH -
;AND EMPLOYERS'LIABILITY YIN ____ STATUTE, Ck2.
ANYP ROP RIETO MPARTN ER,+EXF.C UT IV E
OFFICERIMEMBEREXCLUDED? N I A I F.L.;EACH ACCIDENT
(Mandatory In NH) '., F..L..DISEASE-EA EMPLO'YE�'=..S
If yes,describes under t _... ....... _ ......... _._-.
DESCRIPTION OF OPERATIONS below E.L.DISEASE..POLICY L.IMlT S
i
DESCRIPTION OF OPERATIONS)LOCATIONS I VEHICLES (ACORO 101,Additional Ranarks Schedule,may be attached it morn space is required) -
Re;,lune 24,2422
City of Clearwater Is listed as additional insured With regard to the general liability When required by contract
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
City of Clearwater
100 S. MYRTLE AVE. AUTHORIZED REPRESENTATIVE
Clearwater FL 33756 Pa
1988-2015 ACCORD CORPORATION. All rights reserved.
AC RD 25(2€116103) The ACCRD Dame and logo are registered marks of ACORD