CERTIFICATE OF LIABILITY INSURANCE (1105) AC<>RL> CERTIFICATE Q LIABILITY IN URANC ®ATE�MM��IYYYY,
8/18/2022
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 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).
CONTACT
PRODUCER NAME: _ Linda Codnick
Prince aztce A88cciate8 Inc. PHONE 1518}822-6550 FAX Sxslaz,x-55e4
Exth AIC,No))
270 Duffy Avenue ADDRESS:
Suite D INSURERJSI AFFORDING COVERAGE NAiC 8
Hicksville NY 11801 INSURERA:Arch Insurance Comnpany 11.150
INSURED INSURER 8:
Suncoast Animal League INSURER G:
1030 Pennsylvania Ave., INSURERD:
INSURER E
Palm Harbor FL 348B3 INSURER F;
COVERAGES CERTIFICATE NUMBER:city of Clearwater 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 CONTRACTOR OTHER DOCUMENT WTH RESPECT TO WHICH THIS
CERTIFICATE MAYBE 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.
TYPE OF INSURANCE POLICY NUMBER —_-- MMIDOlYYYY MMIO YYY
INSR ADDL BUSH POLICY EFF POLICY EXP
LTR LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
MA'
A CLAIMS-MADE Ul OCCUR PREMISE(E.oeeurcene� $
1,000,000.-.
MKPX09568303 9/3/202.2 4(3/2023 MED EXP(Any one person) S 10,000
PERSONAL i£ADV INJURY '......5.. 11000,000
GENL AGGREGATE LIMITAPPLIES PER GENERAL AGGREGATE S 2,000,000
POLICY
PRO-JECT 0 LOC PRODUCTS-COMPIOPAGG 5 2,000,400
OTHER:.
ProfessionalLlabildy S 1,000,000
AUTOMOBILE LIABILITY COMBI0i
NEC SINGLE LIMIT S
Ea aedenf
I
AN'YAUTO BODILY INJURY(Per person) S
ALL OWNED SCHEDULED BODILY INJURY(Per accident), S
AUTOS AUTOSPROPERTY DAMAGENON OWNED Psr PERRY l
HIREDAUTpS AUTOS S
UMBRELLALIAB OCCUR EACH OCCURRENCE S
EXCESS LiAB HCLAIMS-MADE AGGREGATE S
DED I RETENTION$ S
WORKERS COMPENSATION PER OTH-
AND EMPLOYERS'LIABILITY' Y t N STATUTE ER
ANY PRC}PRIETORIPARTN:EwEXECUTIVE N f A E1 EACH ACCIDENT $
OFFICERIMEMBER EXCLUDED? El
(Mandatory in NH) E.L.DISEASE.EA EMPLOYEE S
If yes desenbe under
DESCRIPTION OF OPERATIONS Wow E.L DISEASE-POLICY LIMIT $
DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES(ACORD 1'...01,Additional Remarks Schedule,may be attached if more space is requited)
City of Clearwater is included Additional Insured only as agreed to by a signed written contract or
agreement.
CERTIFICATE HOLDER CANCELLATION -
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
City of Clearwater THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
P.O. Box 4748 ACCORDANCE WITH THE POLICY PROVISIONS.
Clearwater, FL 33758
AUTHORIZED REPRESENTATIVE
Linda Godnick/LINDA �'ivrea°ax cry r8t
U 1988-2014 ACORD CORPORATION. All rights reserves/.
ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD
INS025 1201401)