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~l ~ERT~FICATE OF INSURANCE I I?ROOUCER ':':':':':':':':':.:':I:I:'~I:':':':':':':'.'Z.:.:.~':I;.:.:.:.:.:.:..:.:..:..:.:.:.:.:.:..:..:..:.:.:.~.:..:.:.....=,,:.: ...,.......,.................................iII.......lII.a .. 6/11/ 02 1_ 11IIII1 COMPANIES AFFORDING COVERAG~.J~ 11CO~~ANY A: ST. PAUL REINSURANCE I~ Policy #: SPBS03021702 . Eff. Date; 02/17/02 Exp. Date: O~J.J1J.Q~._ ~ICOM~ANY B: I~ POllCY #~ Eff. Date; II COMPANY C; Policy #: Eff. Date: _ICOMPANY D: policy #: Eff. Date: ~ester Xalmanson Agency, Ino. ~. o. Box 940008 ~aitland, FL 32794-0008 (407) 645-5000 INSURED l ~IVERSE NOVELTY & FIREWORKS k ~. 0 . BOX 1862 RIVERVIEW, FL. 33569 / / Exp. Date: l~ l~ / / Exp. Date: / / I / Exp. Date: rHIS CERTIFICATE IS ISSUED AS INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE IT DOES NOT AMEND, EXTEND OR ALTER COVERAGE BY POLICIES HEREIN. I COVERAGES I This is to certify that policies of insurance listed below have been i~~ued ~o ~he inn~rOQ ~rno~ ~bovc {Q. ~hc policy period indicated, notwithstanding any requirement, term or condition of any contract or other document wit~ re$pcce to whtcn t~i~ certificate may be issued or may pertain, the inaurance afforded by the policies described herein is Q~bject to ~11 the term~. exclusions and conditions of such policies. Limits ahovn may have been reduced by paid elaims. :;:::::::::::::::::::::::::::;:::::::::::::::::~::::::::::;:::::::::::::::::::::::::::~::.::::::::::::::::::~:~~::::::~::::::.::: Co TYPE OF INSURANCE GENERAL LIABILITY [Xl Comm. General Liability [Xl Occurrence [] Claims Made [ ] Owners/Contractor Protective [x] 0, L & T FORM [ ] 1,000 o o 1,000 50 o EXCESS LIABILITY [ ] Umbrella Form [ ] Other than Umbrella $ $ $ $ $ $ $ $ $ A SEE ATTACHED ADDENDUM II A" FOR FURTHER DETAILS: All limits in THOUSANDS General Aggregate Products/Compops Aggregate Personal/Advertising Injury Each Occurrence Fire Damage (anyone fire) Medical Expense (one person) Each Occurrence Aggre~ate Self-lnsured retention ====m=~~=============.===~~=~~~~~======_;;;=~=~============~~~~~~=~~~ DATE OF EVENTS: 6/14/02 THRU 7/7/02 ==========a=======;=~~~=======~==============~~~===~================: ADDITIONAL INSURED{S): CERTIPICATE HOLDRR IS HEREBY ADDED AS ADDITIONAL INSURED ONLY AS THEIR INTEREST MAY APPEAR IN RESPECTS TO THE OPERATION(S) PERFORMED THE NAMED INSURED <<lOR ITIS EMPLOYEE(S) ONLY. ~~===~=~=======~===:=====:=;~~=============~~=====;~~~=========~~~~~~~ LOCATION(S) :ZEP'~ Description of operations/locations/vehicles/other --i CERTIFICATE HOLDER JAMBS STONE 39200 5TH AVENUE ZEPHYRHILLS, FL 33542 CANCELLATION I-- 1 cancelled prior to expiration date, issuing any will endeavor to send 00 daysw~' en notice to cart. holder.