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~ - A.~..III.e CERTIFICATE OF INSURANCE ISSUE DATE (MM/DD/YYI 11-2!;-9;~ 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 PRODUCER Insurance Mart 37806 C.R. 54 West Zephyrhills, Florida 33541 COMPANIES AFFORDING COVERAGE ~~i'i~~NY A American Southern Insurance Co. CODE SUB-CODE ~~i'i~~NY B INSURED Douglas Battey 3!;805 Chancey Road Zephyrhills, Fl 33541 ~~T~~~NY C ~~T~~~~JY 0 ~~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 (MMIDD/YY) DATE (MM/DD/YY) ALL LIMITS IN THOUSANDS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR. OWNER'S & CONTRACTOR'S PROTo GENERAL AGGREGATE $ 100 100 GLA5 06 51 11-22-92 11-22-93 for Chris~mas Tree Lot. P19~U8TS.~crt'OPS 64J'm=~'H~ $ PERSONR & ADvJmslNG INJUii'y $ EACH OCCURRENCE FIRE DAMAGE (Anyone fire) $ MEDICAL EXPENSE (Anyone person) $ COMBINED SINGLE $ LIMIT BODILY INJURY $ (Per person) BODIL Y INJURY (Per accident) AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY PROPERTY DAMAGE $ EXCESS LIABILITY EACH AGGREGATE OCCURRENCE $ $ OTHER THAN UMBRELLA FORM STATUTORY WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY $ $ $ (EACH ACCIDENT) (DISEASE-POLICY LIMIT) (DISEASE-EACH EMPLOYEE) OTHER DESCRIPTION OF OPERA TIONS/LOCA TIONSIVEHICLES/RESTRICTlONS/SPECIAL ITEMS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~ 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. - ."---~-------_...., I I I I C I l.J~iRD__~c:lR~O!l~~~!:I.: 9881 CERTlFICA TEHCjI'DE'R--- .,-. ------.CANCELLATloN' - ~ORIZED REPRESENTATIVE .~ ~GVy~ ACORD 25-S (3/88)