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I A4~.tlll.~ \\. ,.., . ... .,...., -....., . .. . . -_. . CERT FICA TE OF INSURANCE ISSUE DATE (MM/DD/YY) 11-19-92 PRODUCER Insurande Mart 37806 C.R. 54 West Zephyrhills, Florida 33541 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAGE f~T~~NY A American Southern Insurance Company CODE SUB,CODE INSURED f~T~~NY B Douglas Battey 35805 Chancey Road Zephyrhills, Fl 33541 f~~~~NY C f~T~~~NY D f~T~~NY E .COVERAGES-".". .,.'-, ~_. .... . "'.., ~.-.... ._".,. ...-....---'-..--...- .. ,. 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 SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE (MMIOD/YY) DATE (MMIDD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY 11 - 2 2 - 9 2 11- 2 2 - 9 3 GENERAL AGGREGATE $ 100 AX COMMERCIAL GENERAL LIABILITY G L A 5065 1 OWNER'S & CONTRACTOR'S PROT, Christmas Tree Lot N/W Corner ~f U.8.301 Zephyrhills, Fl 33541 PRODUCTS.COMP/OPS AGGREGATE $ PERSONAL & ADVERTISING INJURY $ EACH OCCURRENCE CLAIMS MADE OCCUR, AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON.OWNED AUTOS GARAGE LIABILITY FIRE DAMAGE (Anyone fire) MEDICAL EXPENSE (Anyone person) $ COMBINED SINGLE LIMIT BODIL Y INJURY (Per person) $ BODIL Y INJURY (Per accident) $ PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION STATUTORY AND $ (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE EMPLOYERS' LIABILITY .. $ $ OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEHICLES/RESTRICTIDNS/SPECIAL ITEMS . CER'rIF'ICATE HOLDER CANCELLATION Concire Centers,Inc. Townview Square 7252 Gall Blvd. #2. Zephyrhills, Florida 33541 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Lt r,- DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES, AYTHORIZED RE~RESENTATIV~ \ ') \ ''\."...... '.' . ..' c. .._~,X~...;O-> \,..... t. .,. , " Ll., I I I I : '1'l "-, I bACORD CORPORATIOr:-' 1988/ ACORD 25.8 (3/88)