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<br />Nov 18 2005 3:54PM <br /> <br />HP LASERJET 3200 <br /> <br />p. 1 <br /> <br />. ACQRQ.. CERTIFICATE OF LIABILITY INSURANCE I DATe [MMlDDIVYVY) <br />11/18/2005 <br />PRODUCER (813) 788- 5715 FAX (813)782-6445 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Accwrate Insurance Mart ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />38232 - 5th Avenue HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. <br />Zephyrhil15, Fl 33542 <br />Walter Everton INSU RERS AFFORDING COVERAGE NAlCII <br />INSOR!O Terry Palnter - N-surance Outlets <br /> INSURER A. <br />DBA: Terry Painter Mobilehome Setup" Repair INSURER B. <br />35030 Chancey Rd INSURER c. <br />Zephyr-hills, Fl 33541 INSURER 0: <br /> INSURER E: <br /> <br />THE POLICIES OF INSURANCE LISTE[) BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE F'OUCY PERIOD INDICATED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAV 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 />I~~ I'm.~ TYPI! OF INSURANCE POlICY NOMBE R POLICY EFFECTIVE '~lfeY EXPIRATION LIMITS <br /> GENERAL LIABILITY 1961000225 03/05/2005 03/05/2006 EACH OCCURRENCE 5 1,000,000 <br /> - OAMAGnC?, RENTED 50,000 <br /> COMMERCIAL GeNERAL LIASILrTY s <br /> --1 ClAIMSMAOE W OCCUR MED EXP (A"y one pe..on) 5 1000 <br />A X F'ERSONAL a AnV ,NJURY $ 1,000,000 <br /> f-- 2,000,000 <br /> GENERAlAOGREGATE 5 <br /> -- <br /> GEN"L A.GGREGATE LIMIT APPLiES PER. PRODUCTS - COMPIOP AGG $ 300,000 <br /> J POlICY n rG& n l,OC <br /> AUTOMOSILe UA8lUTY COM B1NED SINGLE LIMIT <br /> - (Ea accidtlnt) 5 <br /> ANY AUTO <br /> - <br /> ALL OWNED AUTOS BOOIL Y INJURY <br /> - 5 <br /> SCHEDULED AUTOS (Per peracln) <br /> I-- <br /> HIRED AUTOS BOOll V INJURY <br /> I-- $ <br /> NON.OWNED AlITOS (Per iloc:ident) <br /> - <br /> - -- PROPERTY [)AMAGE 5 <br /> (Per acciden1) <br /> GARAGE LIABILITY AUTO ONL V . EA ACCIDENT 5 <br /> R A",'Y AUTO OTHER THAN EA I'CC 5 <br /> AUTO ONLY: AGG S <br /> EXCESs/UMBRELLA LIABILITY EACH OCCURRENCE S <br /> tJ OCCUR 0 CLAIMS MADE AGGREGATE S <br /> $ <br /> q DEDUCTIBLE $ <br /> RETENTION S S <br /> WORKERS COMPENSATION AND I ~5;~~~ J IO~- <br /> EMPLOYERS' LIABILITY e,L EACH ACCIDENT <br /> ANY PROPRIETORIPARTNERIEXECUTlVE $ <br /> OFFICER/MEMBER EXClUDED? El, DISEASE. EA EMPLOYEE $ <br /> ~~~I~k'O~~OOS bel..., E ,L DiseASE. POLICY LIMIT S <br /> . <br /> OTHER <br />OESCRlPTION OF OPERATIONS I LOCATIONS I VE".HICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Zephyrhills <br />Permit department <br />5335 8th St <br />Zephyrhills, FL J3S4n-4~12 <br /> <br />CE <br />SHOULD ANY OF THE ~\fE DESCRIBED POLICIES BE CANCELLED BEFME THE <br />eXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />...19..-- DAYS WRlrTEN NOTICE TO THE CERTI~ICI\TE HOlDI!R NAMED TO THe lEFT, <br />IIUT FAILURE TO MAIL SUCH I'lOTlC MPO OBLIOA TION OR LIABILITY <br />C~AN" KIND UPON THE ESEHTATlVES <br />AUTHORIZE) REP~ <br /> <br /> <br />@ACORDCORPORATION19U <br /> <br />'CORD 25 (2001/08) FAX: (813)7&0-OOZl <br />