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May, 31. _2019 2:39PM GALAXY FIREWORKS No, 7025 P. 2 <br /> DATE(MMMDfYYM <br /> �'O, CERTIFICATE OF LIABILITY INSURANCE <br /> 5i2112019 <br /> THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: if the cartificate holder is an ADDITIONAL INSURED,the policy(ias)must be endorsed. if SUBROGATION 13 WAIVED,subject to <br /> the terms and conditions of the policy,cortain policies may require an endorsement A statement an this Cartifieate does not confer rights to the <br /> certificate holder in lieu ofsuch endomemen s. <br /> PRODUCER E; <br /> Britton Gallagher FAX <br /> One Cleveland Center,Floor 30 NC -71 <br /> 1375 East 9th Street <br /> Cleveland OH 44114 , u G COVMAGE NArc a <br /> INSURERAftl Surplus InsCompany <br /> INSURED INSURER 8: <br /> Galaxy Fireworks Inc. INSURER C: <br /> 204 E.Martin Luther King Blvd NSURERC: <br /> Tampa FL 336D3 <br /> INSURER E: <br /> i INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:1121001087 REVISION NUMBER: <br /> TK$IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TU THE INSURED WED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWTHSTANDINO ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED OY 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 /> AWL(NSR rmfOFINSURANCE POUCYNU taut WK CYEFF EPDMMD Ellp LIMITS <br /> B GENERALLIAmurf SISML00324.191 8170t2019 6110020 EACH OCCURRENCE $1,000,000 <br /> 5 C011MERCWL GENERAL LL461LITY P.EMIT t n° ir• S50D.000 <br /> CL NMS-MADE D OCCUR MED EXP(Aft one pow) $ <br /> PZR60NA4aAOVVLURY S1.000.000 <br /> i ! GENRRALAGGREGATE $2.000 000 <br /> GEN'LAGflREQATfi UMITAPPLIES PER: PRODUCTS-COMP10PA00 I>2.000.000 <br /> POLICY TA4 x LOC I <br /> C AU7OMMLEIJASIUIY I 518CA00081-191 all"019 a/1=020 „ 1000000 <br /> ANY AUTO 50D4Y INJURY(Perpemn) S <br /> Abl 0 0 PULED BODILY INJURY(Pereagon I <br /> X MREDAVTOS X �t� o PR aryl t <br /> 6 <br /> S <br /> A VMeRELLA uAe X OCCUR Exeess plAd�r 6M0l2019 8/1012020 EACH OCCURRENCE S4.000.000 <br /> X ECCESS16" CLAIMS-MADE AGGREGATE sa,000.000 <br /> OED RETEMION I I IS <br /> WORKERS COMPENSA119N ALL OTIi• <br /> ANC ENPLOYERT LIABILITY <br /> I YIN <br /> PPOPRIUMPARTNERlEXECUTIVE NIA M E.L.EACH ACCIDENT I <br /> OFFICOWEMBEREXCLUDED? i <br /> fMeedetm in NM E.L.DISEASE.EA FJAPLOYEE I <br /> If <br /> DES°B6W�PT ON ONF OPERATIONS be16x I EL D18EAse-POLICY LIMIT I <br /> DESCRIPT)ON OF OPERATIONS I LDDATONS r%THICLES(AkahACORD 101,AOORIDm Ramaam ftbewle.itmm 5pm is mq ittd) <br /> Additional Insured extension of coverage is provided by above referenced General Liability policy where required by written agreement <br /> Looation:5953 Gall Blvd,Zephythills <br /> Additional Insureds:City of Zephyrhills,Mark Ayer and all his agents,representatives and subsidiaries <br /> (Workmen Comp) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THEABOVE DESCRiBED POLICIES BE CANCELLED BEFORE <br /> City Of Zephyrhiils THE EXPIRATION DATE THEREOF, NOTICE VRLL BE DELWERM IN <br /> 6907 Dairy Rd ACCORDANCE WITH THE POUCY PROVISIONS, <br /> Zephyrh)ils FL 33542 <br /> AUMR0W REPRESMffAWX <br /> 0)9988-2010 ACORD CORPORATION. All tights reserved. <br /> ACORD 25(2010105) The ACORD name and logo are reglatered marks of ACORD <br /> I <br />