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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDNYYY)
<br /> TM 11/21/2005
<br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />Bauer & Associates ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />12210 US Highway 301 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />DADE CITY FL 33525 I
<br />93520 567-3702 - - -- ~ IN_~_~ERS AFFORDING COV~RAG~______ NAIC # ____
<br />------- ._-~--.~------..~--~~--
<br />INSURED CHRIS' AlC COMPANY INS_U".ER_A_ZU~.r~'i___ ,___, __n __ ______ _ __.__ _'__ _
<br /> P.O. BOX 1781 ""'''' BRIOGEFIELD t
<br /> ZEPHYRHILLS, FL 33539 ,
<br /> I IN~RER C__
<br /> 1_INSlillE:B_D~_--=--==---=_-==~=-~~~=-=::-=_=-=-~==~--
<br /> , INSURER E.
<br />
<br />COVERAGES
<br />
<br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TfiE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING
<br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OT'iER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
<br />POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />iiliS-R -DO' --------"------------T-...-;~L1CY NUMBER POLicy EFFECTIVE POLICY EXPIRATION
<br />
<br />
<br />LIMITS
<br />
<br />A
<br />
<br />GENERAL LIABILITY
<br />Kt,-" CO, ,~MERCIAL GENE,?", L ~IABILlTY
<br />_ _, I CLAIMS MADE I_~J OCCUR
<br />
<br />~-~,~ AG~R~~A;E L1M;T~~~;~P:
<br />
<br />POLICY I PRO. LOC
<br />AUTOMOBILE LIABILITY
<br />."j ANY AUTO
<br />ALL OWNED AUTOS
<br />L~-' SCHEDULED AUTOS
<br />I '
<br />I 1 HIRED AUTOS
<br />I'-l NON.OWNED AUTOS
<br />-,
<br />
<br />SCP0041955742
<br />
<br />! 03/07/05
<br />
<br />03/07/06
<br />
<br />EACH OCCURRENCE $ 500,000
<br />DAMAGE TO RENTED ~NA-'-
<br />
<br />:ED EXP=::~ i: 10,000-' -
<br />~SON~L & AD~-INJURY -1 ,$ 500,000 ,.=--_
<br />GENERAL AGGR,EGATE $ 1,000,000
<br />PRODUC~_: COMPIOP AGG $ 1,000,000
<br />
<br />!
<br />I', COMBINED SINGLE LIMIT I' $
<br />(Ea accident)
<br />~---I-------
<br />
<br />~ODIL Y INJURY _I' : $_
<br />(Per person)
<br />
<br />Up~~~LC~I~~~Vt"_____~____ _,
<br />
<br />I i
<br />I PROPERTY DAMAGE $
<br />I (Per aCCident)
<br />
<br />GARAGE LIABILITY
<br />,_=~ ANY AUTO
<br />
<br />~l!TO Q.NL Y . EA ACCIDENT $
<br />EA ACC $
<br />
<br />OTHER THAN
<br />AUTO ONLY
<br />
<br />B
<br />
<br />~! E, X, C, ESSIUMBRELLA,LIABILlTY
<br />_l OCCUR [J CLAIMS MADE
<br />
<br />-- i
<br />,. DEDUCTIBLE
<br />
<br />RETENTION $
<br />
<br />WORKERS COMPENSATION AND
<br />EMPLOYERS' LIABILITY
<br />ANY PROPRIETORIPARTNERIEXECUTlVE
<br />OFFICERIMEMBER EXCLUDED?
<br />If yes, deSCribe under
<br />, SPECIAL PROVISIONS below
<br />1 OTHER
<br />I
<br />I
<br />
<br />AGG $
<br />EACH OC(:t,)RREN~ _~____,
<br />I AGGREGATE i $
<br />f---====~-~ $ ~==
<br />
<br />I ________ I~________
<br />
<br />1
<br />[509700
<br />
<br />11/14/2005
<br />
<br />$
<br />i ",,/') X WC STATU. OTH.
<br />
<br />le~O_~oV 1-;;" EAC:~I~ENT~__j ~-100,~00==
<br />--0'-0 :_UJJJSEA~UA EMPLOYEE4.!..1 OO,~OO ,__
<br />EL DISEASE. POLICY LIMIT' $ 500,000
<br />
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
<br />
<br />AIR CONDITIONING REPAIR AND INSTALLATION
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />CITY OF ZEPHYRHILLS BLDG DEPT
<br />5335 8TH ST
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />
<br />ZEPHYRHILLS, FL 33540
<br />
<br />
<br />ACORD 25 (2001/08)
<br />
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