CERTIFICATE OF LIABILITY INSURANCE OCEAPRO-29 TMILLER
CERTIFICATE OF LIABILITY INSURANCE QATE(MMIDDrYYYY}
_..._._ .711812022
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDEN 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 INSURERS),AUTHORIZED
REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy lies)must have ADDITIONAL INSURED provisions or be endorsed.
If SUBROGATfON 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 CONTACT Terri Miller
NAME:
T-heLoomis Company P&C Division PHONE FAX
S 60 N Park Load (AIC,No Ext) (610)374-4040 2281 [Arc,No).
V1Iyomissing,PA 19610 E-MAIL ss.Ss,tmiller@loomisco.com
..._.WSURERISI AFFORDING COVERAGE NAIL
INSURER A The Cincinnati Specialty Underwriters Insurance Company 13037
INSURED irsURE:R_B:Cinc I nnati_I_nsurance Company }10677
The Sandpearl Resort LLC INSURERC:Allied World Specialty Insurance Company 16624
200 Sable Oaks Drive INSURES n
South Portland,ME 04106
INSURER E
..M---..., .w_. .�,,.,�.... INSURER I.
COVERAGES
CERTIFICATE NUMBER IEVI5lt7hl NUMBER----.-----.._
UMBER .d _
I HIS IS IU CLRTIFY 'IHA I TFIL. 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
IMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
CERTIFICATE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, L
MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POIJCIES DESCRIBED HEREIN IS SUBJECT TO ALL'1'HE TERMS,
ILTR TYPE OF INSURANCE ._.. ADDL SUBR .......POLICY NUMBER -.... POLICY EFF POLICY EXP _._.
QTR .....LL _,�....�,_..__ . IMI QanY,Y,Y3 lMtsMrQQiYYYYIm„..........- _ LIM67Sv.,,._ Y.LL
A !( COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 3 2,000,000
t ,i IJY CSU0089250 7115120227115!2023 DAMAE
I ,�tREIN 2,000,000
ew�'I
MEDEXP Ary cre cersrir�, S ...
,_PERSONAE&ADV INJURY ... 2,00Q,000
GENT AGGREGATE LIMIT APPLIES PER. GENERAL AGGREGATE LL$. .._._4,000,000
POLICY , JII-CT X L „f7L` PRODUCTS CONIP;OP AGG ......_4„000,000
THEIR
B AUTOM083LE LIABILITY COMBINED SINGLE I IFMET
I accident
1 111
X ANYAk) O EBA0582308 711512022 711512023 QODILYi'.NE, SCHEDULED NJO
Y,Per remsur' .._. {.
_. ...__ __. ...�
AUTOS ONLY AUTOS BODILY INJURY Per acc dents .S.,
X HIRED X NON i7VJNF 7 PROPERTY DAMAGE
AUTOS ONLY AI,J COS C3NEY accjdentY S
C X tIMBRELLA LTA6 X OCCUR E:'ACIlOCCURPLNCE x 10,000,000
ExCDSS LIAR t".I Alms MADE,, 0309-1044 711512022 711512023 - ..10,t 0,000.
AGGREGATE 3
QED X RETENT ION$ 10,000'
WORKERS COMPENSATION'_. .,....�.41. PER OTI-1- '.
AND EMPLOYERS'LIABILITY YIN .. STATUTE ._ER ... ....... _ '......
fiaY aROPRIE l'ORtPAR NERIEiXECi.:t-VE ...-
N i A E'Ll EACH ACCIDENT
utas.deoryscribe
in and E r DISEASE FA EMPLOYEE= G. ._ .......
f yes �escr�e under ',,. ',, '.
DESC.,RIPT ION OF OPERA Ii()NS Ceio'ra iJ`( ICY LIM t
DESCRIPTION OF OPERATIONS i LOCATIONS i VEHICLES (ACORD 191 Additional Remarks Schedule,may be attached it more space is required)
Insured Location. Sandpearl Resort,500 Mandalay Ave,Clearwater,FL.
The following are noted as additional insureds under the General Liability as required by a written contract subject to the policy's terrpis Conditions and
exclusions:
City of Clearwater&Florida Capital Assets Group,Inc.,2086 CR 753 South,Webster,FL 33537
I
.... w
CERTIFICATE HOLDER .. _CANCELLATION ,
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
City of Clearwater
PO Box 4746 ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater,FL 33755
AUTHORIZED REPRESENTATIVE
James R. LoomisI
ACORD 25(2016103) _ 1968-2015 ACORD CORPORATION. All rights reserved.
The ACORD name and logo are registered marks of ACORD