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P , 0 �r ACORD' -- ------ CERTIFICATE OF LIABILITY INSURANCE UATE(MMIDDIYYYIr, ovo3/2o20 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 polil:y(ies)must"tie enddr6 d: 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). PRODUCER (COaNTA�:CT ` PHO E - - - - FAX- Baldwin Krystyn Sherman(iPEO) Arc"Ne: - 4010 W Boy Seoul Blvd ADnR1Ess. Suite 200 LNSURkSI AFFORDING COVERAGE _NAIC# Tampa,FL 33607 - -- - !INsur:Erta:Technology Insurance Company,Inc- 42376 INSURED - - -- - -- --- - 'INSURER B: - Choice Employer Solutions,Inc.dba Fourth HR and Choice Employer INSURER C: Solutions III,Inc.dba Fourth HR INSURERD o-- _- — 9007 Brittany Way -. - Tampa,FL 33619 INsuRER E o- - - - fINSURERF:. _ - - COVERAGF.S __---- _-------CERTIFICATENUMBER: 10.1.68_-- ____ ___—.__._.. _- __-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 OF F SUCH POLICIES.-LIMITS SHOWN MAY HAVE BEEN,REDUCED.BY PAID CLAIMS._ INSR -= -- -- L BR POLICY EFF- Polley EtP-. - - - - -- ------ --_ "LTR._--_-= TYPE OF-INSURANCE _---- -_--POLICY NUMBER-------MMIDO MMIDO ---- LIMITS UMTTS" _ { COMMERCIAL GENERALL_1A91UTY .Not Applicable .FACHOCCURRENCE-__.._— Y-_XXXXXX =. CLAIMS-MADE Q.00CUR !P�ISES,tC-accuureilceY - ` 1 _ MED EXP(M"one personi"-..,"S, XXXXXX TERSONAL&AUVINJURY S_ xxXXXX GEN'LAGGREGATE LIMIT APPLIES PER: j 'GENERAL AGGREGATE-__.S Xi000(X_ POLICY ECT LOC ;PRODUCTS-COMP/OPAGG S_ XXXXXX "OTHER:: S XXXXXX j AUTOMOBILE LIABILITY Not Appruable - - S xxxxxx -- ` F�alAaBie�nISINGL611M1. ANY AUTO 1 BODILY INJURY(Pot person) i$ XXXXXX IALL OWNED -- SCHEDULED `BODILY INJURY(Per_acrid f) S XXXXxX 1 AUTOS AUTOS - NON-0WNED "PROPERTY DAMAGE S xxxxxx i, !HIREDAUTOS AUTOS 1.1per,aorJdml UMBRELLA LIAR OCCUR" - - Not Applicable-- - - --- EACH OCCURRENCE S XXXXXX - EXCESS LIAB CLAIMS-MADE AGGREGATE --- S XXXXXX DED I .. RETENTIONS 's XXxxxx .,.WORKERS COMPENSATION - - - --- i' -" _- _ ---------------- - --- _-- -- - - ---- - PER——'-- OT}F"- ----- -—-- - - --- AND EMPLOYERS'LIABILITY TWC3850452 01/19/2020 01/19/2021 X STAil17E ER _ A Yra. --- ANY PROPRIETORIPARTNERIEXECUTrvE El-EACH ACCIDENT S 1,000,000.00 OFFICERIMEMBER EXCLUDED? a,NIA (Mandatory inNHI EL DISEASE-A.EMPLOY .$1,000,000.00 II es describe under POLC - 1.000,OQO:OODSCIPTIONOFOPERATIONSbelow EL LIMIT- L i i DESCRIPTION OF OPERA11ONS i LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may he attached if more space is required) THIS CERTIFICATE CONFERS NO ADDITIONAL INSURED RIGHTS UPON THE CERTIFICATE HOLDER.Coverage is extended to the leased employees,not subcontractors,of Alternate Employer.Acree Air Condifloning,Inc.(#CHR-895)at 3801 Corporex Park Drive#130 Tampa,FL 33619 effective 01/19/2020 as by contract. CERTIFICATE HOL-DEK CHR-895 '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 Zephyrhills - 5335 8th Street AUTHORIZED REPRESEAITATIVE Zephyrhills,FL 33542 ©1988-2014 ACORD-CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD