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RSKCo 5/15/00 10:14 PAGE 2/2 RightFAX Certificate of Insurance This cer~ficate is issued as a matter of information only and confers no rigtts upon you the oertificate holder. This oertificate is not an insuralC8 policy ald does not amend, extend, or alter the ooverage afforded by the policies listed bel~. Named Insured(s): TAFF LEASING, L.P., BY STAFF ACQUISITION, INC., THE NERAL PARTNER, AND THE AFFILIATED UMITED ARTNERSHIPS OF WHICH STAFF ACQUISITION, INC. IS THE NERAL PARTNER AND STAFF LEASING, INC IS THE LIMITED ARTNER. 00 301 BOULEVARD WEST, SUITE 202 RADENTON, FL 34205 C'NA RISK MANAGEMENT I Insurer Affording Coverage Coverages: I Continental Casualty Company The policy(ies) of insurance listed below have been issued to the insured named above for the policy period indicated. The insurance afforded by the policyCies) described herein is subject to all the terms, exdusions and conditions of such policyCies). Certlflcate Exp. Date Type of Insurance o CO\lTINUruS Policy Number Limits o EXTENDED IIi P{1ICV TERM //1-1-20V we 189165165 Employers Liability Workers' Bodily Injury By Acddent Compensation we 189165182 $1,000,000 Eadl Accident "--- Bodily Injury By Disease $1,000,000 Policy Limit Bodily Injury By Disease $1,000,000 Eadl Person Other: Employees Leased To: Effective Date: Ol.-JAN-2000 8396.Jacks Beating & Air Conditioning Inc The above referenced workers' compensation policy provides statutory benefits only to employfl8S d the Named Insured(s) on the policy, not 10 employees d alY other employer. .If the certificate expiration date is continuous or extended term, you will be notified if coverage is terminated or reduced before the certificate expiration date, However, you will not be notified annually of the continuation of coverage, Notice of Cancellation: (Not applicable unless a number of days are entered below) Before the stated expiration date the company will not cancel or reduce the insurance afforded under the above policYCies) until at least 30 days notice of such ciYlcellation has been mailed to: I/J- at/.~~~ -- Certificate Holder 5335 8TH STREET Zeohvrhills, FL 33540 51 Lwis, MO (877]427-5567 Office Phone Martin Oosterba., Authorized Repres...tative 1.5-MAY-2000 CITY OF ZEPHYRHILLS Date Issued