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Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon you the certificate holder. This certificate is not an insurance policy and dDes not amend, extend, or alter the coverage afforded by the policies listed below. .00 Insured(s): Staff Leasing, LP, By Staff Acquisition, Inc., The General Partner, And The Affiliated Limited Partnerships Of Which Staff Acquisition, Inc. Is The General Partner And Staff Leasing, Inc. Is The Limited Partner including Staff Leasing of Texas, LP, Staff Leasing of Texas II, LP, Staff Leasing IV, LP 600 301 Boulevard West, Suite 202 Bradenton, Rorida 34205 C'NA RISK MANACEMENT - Insurer Affording Coverage Coverages: Continental Casualty Company The policy(ies) of insurance listed below have been issued to the insured named above for the policy period indildted. The insurance afforded by the pDlicy(ies) described herein is subject to all the terms, exclusions and conditions of such policy(ies). Certificate Exp. Date Type of Insurance o ContinuDus Policy Number Limits o Extended * ~ Policy Term Workers' 1-1-2002 we 189165165 Employer's Liability Compensation we 189165182 Bodily Injury By Accident we 247848874 $1,000,000 Each Accident we 247848888 Bodily Injury By Disease $1,000,000 Policy Limit l~ Bodily Injury By Disease $1,000,000 Each PersDn - Other: Employees Leased To: Effective Date: 1/1/01 2464 Cox Fire Protection Inc Cox Fire Protection Inc The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(les), not to the employees of any 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 policy(ies) until at least 30 days notice of such cancellation has been mailed to: Certificate Holder: l. " l . J City of Zephyrhills Building Department 5335 8th St Zephyrhills, Fl 33540-4312 ~ a/.~~ ~ Martin Oosterbaan Authorized Representative Office: S1. Louis, MO 12/15/00 Phone: (877) 427-5567 Date Issued