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U':;;J/U':;;J/UL I,J U Ill: l. .nll1'l tn~ - / .LO.L~/OUUUL.L 1:-'g L/~ ACORD.. CERTIFICATE OF LIABILITY INSURANCE I DATE (IIIIIIIIDDIYV) 09/09/02 PRODUCER 1-407-481-9363 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Risk Transfer, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 315 East Robinson Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Suite 580 Orlando, FL 32801 INSURERS AFFORDING COVERAGE INSURED INSURER A: First CCllllDercial Mutual Canpanv Sun_lOt PEO of Florida II, Inc. 18-12-728 INSURER B: 221 Hobbs Street INSURER C: Suite 101 Tampa, FL 33619 INSURER D: I INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REOUIREMENT, 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .I.N~ TYPE OF INSURANCE POUCY NUMBER POUCY EFFECTNE POUCY EXPIRATION UMITS ~Nt:KAL UA1IIUI Y ~CH OCCUKH1::NCt: $ COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone tire) $ l CLAIMS MADE 0 OCCUR MED EXP (AllY Uflt;t: Vt1llSllll) $ - PERSONAL & I'DV INJURY $ I-- GENEnALAGGnEGATE $ n1.. AGGREnE LIMIT APPlS PER: PRODUCTS. COMP/OP AGG $ POLICY ~~.9.: LOC ~OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AIITO (Ea accident) f-- e-- ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Par person) e-- f-- HIRED AUTOS BODILY INJURY (Par accident) $ f-- NON-DWNED AUTOS PROPERTY DAMAGE $ (Par accident) RGE UABUTY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS UABIUTY EACH OCCURRENCE $ D' OCCUR 0 CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ "', $ A WORKERS COMPENSATION AND 15648-00 05/16/02 I/~/ X I WC STATU- I IO,J~- EMPLOYERS' UABLrTY $ 1,000,000 E.L EACH ACCIDENT 1'--. -'- . E.L DISEASE - EA EMPLOYEE $ 1,000,000 -- E.L DISEASE. POLICY LIMIT $ 1,000,000 OTHER DESCRIPTION OF OPERATIONSlLOCATlONSlVEHICLESlEXCLUSIONS ADDED BY ENDORSENENTISPECIAL PROVISIONS Coverage is extended to the leased employees of alternate employer (Florida Operation Only): Coverage does not apply to subcontractors: Gator Transport, 9073 Wire Rd, Zephyrhi11.., FL 33541 - '171 ~o t ~o:?'~ . CERTIFICATE HOLDER I I ADDmONAL INSURED: INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRlBEDPOUCIES BE CANCELLED BEFORE THE EXPIRATION Ciey of Zephyrh.i11.. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRIlTEN NOTICE TO THE CERTIFICATE HOLDER NAIlED TO THE LEFT, BUT FAlWRE TO DO SO SHALL Zephyrh.i11.. IMPOSE NO OBUGATtON OR UABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhills, FL 33540 AUTHORIZED REPRESENTATIVE ~?~~" I ACORD 25-S (7197) Missy 764028 GlACORD CORPORATION 1988