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ACORD CERTIFICATE OF LIABILITY INSURANC~o~~~ MIl DATE (MMIDDIYY) -----.-.- '.. . ,- 04/07/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ILER WALL & SHONTER INS INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 800 49TH ST NORTH HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P.O. BOX 14448 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ST. PETERSBURG FL 33733 INSURERS AFFORDING COVERAGE Phone: 727-327-7070 Fax:727-328-2502 INSURED INSURER A: Old Dominion/National Grange INSURER B: Hanover Insurance Company Axon ElectricRRlnc. INSURER c: FCCI Mutual Insurance Co. JOHN VINCIGUE 2738 20th Avenue North INSURER D: St. Petersburg FL 33713 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 REQUIREMENT, 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. ~f~ TYPE OF INSURANCE POLICY NUMBER b~ff~'M;~BTJ~~E ~B~~~~\'6~m?N LIMITS GENERAL LIABILITY EACH OCCURRENCE $ $1,000,000 I-- B X COMMERCIAL GENERAL LIABILITY OHJ610231503 03/01/03 03/01/04 FIRE DAMAGE (Anyone fire) $ $300,000 I CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $$15,000 PERSONAL & ADV INJURY $ $1,000,000 GENERAL AGGREGATE $$2,000,000 1--' $ $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS, COMP/OP AGG --1 n PRO n -- POLICY JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 500,000 -i A ANY AUTO B1G42726 02/04/03 02/04/04 (Ea aceidenl) ~" ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - X HIRED AUTOS BODILY INJURY --. (Per aceident) $ X NON,OWNED AUTOS - 1--. PROPERTY DAMAGE $ (Per aceident) GARAG E LIABILITY AUTO ONLY, EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ tJ OCCUR l~ CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION .$ $. WORKERS COMPENSATION AND X I TORY L1Mrj-J IU~~' . C EMPLOYERS' LIABILITY 42670 04/01/03 04/01/04 E.L. EACH ACCIDENT $ $500,000 E.L. DISEASE, EA EMPLOYEE $ $500,000 E.L. DISEASE - POLICY LIMIT $ $500,000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER I N"f' ADDITIONAL INSURED; INSURER LE,TER: CANCELLATION ORANC-3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATlm DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN Orange County Building Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Contractor Licensing IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR P 0 Box 2687 Orlando FL 32802-2687 REPRESENTATIVES. AU./?p; REPRESENTATIVE ~O/ /) 1//;' /J ....-n-., I I'/J..II/~ ,- - ""r "-J ACORD 25-5 (7/97) @ACORDCORPORATION 1988