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� �i� � DATE(MMlDaYYYh <br /> �.�'��� CERTIFICATE OF AVIATION LIABILITY INSURANCE Ol/182016 <br /> �.--. <br /> . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAl10N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATNELY AMEND,IXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW.TFiIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED <br /> REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br />� IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subJect to � <br /> the terms and conditions of the pollcy,cerlain pollcles may requlre an endorsement A statement on thfs certificate does not confer rights to the j <br /> certificate�older In Ileu of such endorsemen s. <br /> CONTACT <br /> r�,oouc�r. I NAME. <br /> Falcon Insu ence Agency,If10. PHONE F� <br /> P O Box 291388 ac,No,e�c: ac,No: <br /> Kerrville,TX 78029 E-MAIL A�ORESS: <br /> RODUCER CUSTOMERIDNo. <br /> IfySURED INSURER(S)AFFORDING COVERAGE % NAIC No <br /> Skydive Cit , Inc. <br /> iNsuRERa,.0 S.SPECIALTY INSURANCE COMPANY ioo� <br /> 4241 Sky Dive Lane INSURER B <br /> Zephyrhills,FL 33542 INSURER C <br /> INSURER D <br /> INSURER E <br /> INSURER F <br /> THIS IS TO dERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED �JOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICAT�MAY BE ISSUED OR MAY PERTAIN,THE INSURANCEAFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> AIRPORT 8�F80 LIABILITY COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> INSURERLET�R POLICYNUMBER EFFECTIVEDATE EXPIRATIONDATE ADDITIONALINSURED9(Y/N) SUBROGATIONWAIVED?(Y/N) <br /> UA00167344-06 02/18/2016 02/18/2017 Y N <br /> COVERAGE il OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO <br /> $ 100,000 BI ea,PER $ PD <br /> �REidI�IS LIABI i ITY <br /> $ 1,000,000 �OCC $ 2,000,000 AGGR <br /> FRtM111SEShIE(�ICALPAfMENT $ EAPER $ EAOCC <br /> � $ BIEAPER $ AGGR <br /> PRODUCTS LIAi ILITY EXTENDED <br /> $ EA OCC <br /> COMPLETED $ BI EAPER $ AGGR <br /> OPERATIONS �(7ENDED <br /> LIABILITY $ EA OCC <br /> HANGERKEEPERS INCLUDI NG TAXI � I <br /> LEGALLIABILIT� INFLIGHT $ EAA�RCRPFT $ EAOCC <br /> I <br /> -- i � <br /> $ i � <br /> $ EA OCC $ AGGR <br /> - -- --- -------- $ EA OCC $ AGGR <br /> I INCLUDED EXCLUDED <br /> ICOVERAGE s - <br /> CODE I DESCRIPTION OPTIONS LIMIT APPLIESTO LIMIT APPLIESTO a <br /> I $ $ <br /> I <br /> I <br /> ----- I <br /> DESCRIPTION OF OPERATIONS!REMARKS(Attach ACORD 101,Additlonal Remarks Schedule,if more space is required) <br /> ZEPHYRHIL�S MUNI,ZEPHYRHILLS, FL <br /> Certificate H Ider is included as an Additional Insured. <br /> CERTIFICA E HOLDER CANCELLATION , <br /> Clty Of Ze hyrhills and Zephyrhills Municipal Airport SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i <br /> 39450 SO fh AVC. EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> Zephyfhills,FL 33542 CCORDANCE WITH THE POLICY PROVISIONS. <br /> AUTHORIZED REPRESENTATIVE , <br /> ���� ���'. II <br /> I O 2009 ACORD CORPORATION.All rfghts reserved. -I <br /> ACORD 20(2009112) The ACORD name and logo are reglstered marks of ACORD <br />