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<br />Nov 17 98 08:28a
<br />
<br />MRRTY PRULEN
<br />
<br />(904J 532-7169
<br />
<br />p.2
<br />
<br />11-17-98
<br />
<br />09:23
<br />
<br />P'iROTECt; I CO
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<br />I D"
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<br />f A CORD,CERJIFiC'A:fe QPIIABIl;rtyi NS;iJR~i\lttlf; --- - P:) ::tl~'g8'''.'' ~
<br />
<br />P-CI)\:CfR 216.248471' ! THIS C~RTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />. ONLY AND CONF~RS NO fliGHTS UPON THE CERTIFICATE
<br />HOlDER. THIS CERTIFICATE DOES NOI AMEND. EXTeND OR
<br />L ALTER TH~ COVERAGE AFFORDED BV THE POLICIES aELOW.
<br />
<br />COM?ANIES AFFORDING CO\l'Efl~G~.
<br />
<br />Brrtton.Gallagher & Assoc.
<br />6240 SOM Center Rd.
<br />Cleveland.OH 44139.2985
<br />
<br />COMSI...t~.1"
<br />A
<br />
<br />Nobel InsL;rance Co.
<br />
<br />tIliISUR(:;)
<br />
<br />Pyro!ecnico
<br />P.O. Box 149
<br />New Castle PA
<br />
<br />::CM?A~-JY
<br />a
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<br />~mer;ca" if'\lerst3t8 1'1&. Cc.
<br />
<br />16103
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<br />C:J~1rA."~Y
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<br />COMF-..HJy
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<br />
<br />'C.QVERA,GES:;.' :...
<br />'1"1-11515 TO CERTIFV THAT THE ?Cl..ICleS O~ .NSURANCE LISTED BELOW ~&VE BEEN ISSUED TO lME INSURED NAMED ABOV~ ,~OR THE POLICY PERIOD
<br />iNDICATED. NOTWITHSTANDING A'IY REaUIReME~JT TEilM OR CON;)ITION OF UJY COr-.;,HAC, OR OTMfR OOCUM~NT WITH RESPECT 10 WHICH THIS
<br />CERTiFICATE MAY Be 15SuEC Of'. MAV FERT AIN. TJo!E INS'.)f<ANU A~l-lJHDED IlY T~f POLICiES DESCRIBED ~!;l'IeIN IS SUBJECT TO All T~e TERMS.
<br />e)(C~iJSIONS AND CONDITIONS OF SI.'C~ POLICIES liMITS SI'IOWN MA.Y HAVE BEEr~ REDUCEO sr PAID CLAIMS.
<br />
<br />C) I TYPt Of '''$UIIANCE 'OLley :"'u~ PQ,t<;y VfE~;NE ~OLlCY EXPIII.TIO.,
<br />lTR! OAY,,"'''';OOIVYi DATE IIoIMIDO/\"V,
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<br />fXPA000606
<br />
<br />3/29f9a
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<br />3/29199 I ~~E;;Al A(jGP.~GAH: 200GOCO
<br /> : rQOOvCTS . t;O~P.'O. ....~O ! , .2,000000
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<br /> ' pe.~S.:r""'L &. ADY !N..!<JfW ..) 000000
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<br /> EAC" OCC~!RE"CE . . 1000000
<br /> i ;:IAE OAMAGE eArlY on. '..'e, ; . 50.0 00
<br /> I M~O EX!) (Any Q^~ t)~,.'01'\I ! 5000
<br />3i~9199 'OM6INl.o S,\:\IGlf: lIM:T i I
<br /> 100CJOO
<br /> 180~IL y 'NN~Y
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<br /> : 01'Hffll ,.......Iu..: AU'!C ONl'y';
<br /> ~ EACH oIll.C':IOENT ,
<br /> AG(jl'HiATE ,
<br />3.'29/99 I I. .;ocoooo
<br /> f floC" OCCWPPWCE I
<br /> ; "'GG~fGATE 400:000
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<br />5/27 !99 we Sl,rdl,J-
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<br /> f.. EACrl ...CC:IO~N-r 1000000
<br /> i iL OIS;~ SE 1I'Ol..iCV 1..1~"'\IT . I 1000000
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<br /> EL OI~e:~~E . e... cMPLOY!~ 1000000
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<br />)~ ~C~O..lf UAIIILlTY
<br />~ A"'" "UTO
<br />..Ll OWNC:O A<.JTOS
<br />
<br />EXPA00015C5
<br />
<br />3.29/98
<br />
<br />SCHi'DuLEO ....UTQS
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<br />~"~CN-OWNEO ..Vl',';
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<br />X ' OTHER Tl-(AN UMe~fLLA ~ORM
<br />
<br />H ...ORXElIS COMl't"lSATION A"O
<br />, E.'IlP\DYOS' LIABILITY
<br />
<br />EXP.c.000607
<br />
<br />3/29:98
<br />
<br />98WCPA125Z58
<br />
<br />5l27I~8
<br />
<br />~ME PPOP~IE.O~I
<br />~. JilTNERSJEx E CUTI\jE
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<br />PC'CI'I.:"TrOIlll OF O"EMTIC:'S'lOCA~IQN..{\Jf"'ICL.eS;$pC:CfAL ITeMS
<br />
<br />Fireworks Dispiaj: Dec€mber 6, 1998
<br />Location: East Pasco Medica' Center
<br />Additional Insured: City of Zephyr
<br />iC.amFlC~T~: HOLDeR.' ; '; : ".' ...
<br />cdst Pasco Medical Center
<br />7050 Gall BlVd
<br />Zephyr Hills, FL
<br />
<br />Hi 11 s
<br />
<br />33541-1399
<br />
<br />CANCE.ltA:rlor;~:,,, . .,'. '::'....':.,
<br />I 5HC\110 AI'I1 OF THIi AeOv, OUCllliED POLICIU 1I~ CASCEl.J.EO 8E10~t l"f
<br />EXPIRATIO'l OAT~ TIIEllfCf H'~ "'VINe COM'.I<Y WILL ENOtAVOll TO ,.,.AlL
<br />_].Q. OAY& W~'TTEN NOTIC. TO T "f crATt'leATE HO.P~M NAMEO TO n,f .UT.
<br />BUT I'AJLUA~ TO MAIL, SUCH "-OTtCl: $HAU. ,'-'POSE h'O oaLIOATIQN OR lI....H.IT't
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<br />CO....PAN'. 'TS
<br />
<br />2.:40
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