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<br />Oct. 1,7 20i15 9: 36AM
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<br />HP LASER JET FAX
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<br />!- ACO~0- C~RTIFICATE OF..LIABILITY IN URANCE i n/li~
<br />IP1tOIKicuA ~ed ~;pecialty Insurance, Inc THISCERTIPICATEISIS8UEOASAMAnEROF.HFORMA:10N i
<br />I 10451 Gtllf Blvd. ONLY AND CONFERS NORlGliTa VPONTHECERTlFlCATi ,
<br />Treasur€ Island FL 33106 HOLDER. TH~ CERTIFICATe DOES NOT AMeND, EXTeNDC~ ,
<br />" , FORoeD BtTHE POLI<;IEe aELC'W--.;
<br />800/237-3355 '
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<br />~'i~IIUREO ani verse--'Nc-ve-lty & Fi ~eworks
<br />Company, Inc.
<br />8820 US Highway 301 S
<br />Riverview FL 33569
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<br />, 'NSURE~AFFORDING COVERAGE '. '" : N....;, "
<br />-1 _E'; T. H.E:. Insu:r:"rice COmEany j_ _ ~ _
<br />INSVIU.~ B,
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<br />COVEAAOES _ . __
<br />I' THE F'OLICIESOF INSURANCE usreo BElCMI HAVE' BE.E~ ISS'JEO TO n-IE I~SUREO NAMEDA80VE FOR THE POLlCY PER:OO INDICATED NO"''\fT'''So1,',NOl,,;
<br />/>,HY REQUIFlEh.1ENT, TERM OR COHD!l1ON OF IWY '_~tm 1ACT OR OTiolE!:! OOCUiYE~n\t"TH RESPECT TO WHICH T1iIS CERTlFlCAlC WA.Y eE ISSUED C~
<br />~ MAY PeRTAIN, THE INSURANCE AFFOFlcec. BY 'Tl-IE ',:>0, LIC ~., oeSCRIBEO HEREIN IS SUBJ!CTTO AlL 1111:, TERM, S. ElCi, eLUSIONS ANO C, ONOlT'ONS OF ,UCH
<br />POLlC1E5. AGGREGATE UMITS SHOWN MAY '"AYE e"EN R:'\)UCeo BV PAID CLAIMS.
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<br />, EFFECTIVE FROM 12/10/05 THROUGH ~/03/06
<br />I ADDITIONAL INSURED: CITY OF ZEPHYRHI~LS
<br />I 5335 8TH ST, ZEPHYRHILLS, F.
<br />I AS RBSPECTS TO THE OPERATION OF THE NAMED INSUR.lD
<br />, RE: FIREWORKS STANDS SITUATED AT 5935 & 7~22 GALL
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<br />BLVD., ZEPHYRKILLS, FL
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<br />CITY OF ZEPHYRHILLS
<br />5335 8TH ST
<br />ZEPHYRHILLS FL 33540
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<br />tMOULD,."., Cf nta~. DIiIC_ED I'OUCIU 81 c.u.clEJ.l.iil) ..FOlIE THe UllU\11CIN
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<br />ACORD 2S C2001108)
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