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Certificate of Insurance This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder other than those provided by this policy. This ~ertificate does not amend, extend, or alter the coverage afforded by the policies described herein. ~amed Insured(s): Gevity HR, Inc and its wholly owned subsidiaries including but not limited to Gevity HR, LP; Gevity HR II, LP; Gevity HR III, LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; Gevity HR X, LP; Gevity HR Xl, LLC; Gevity HR XII Corp. 9000 Town Center Parkway MARSH Bradenton, Florida 34202 Insurer Affordine: Coveraee American Home Assurance Co., Coverages: Member of American International Group, Inc. (AIG) This is to certify that the policy(ies) of insurance described herein have been issued to the insured named herein for the policy period indicated. Notwithstanding any requirement, term or condition of any contract or other document with respect to which the Certificate may be issued or may pertain, the insurance afforded by the policy(ies)described herein is subject to all the terms, conditions and exclusions of such policy(ies). (Aggregate) Limits shown may have been reduced by paid claims. Type of Insurance Certificate Exp. Date Policy Number Limits Emnlovers Liability Workers' 1-1-2008 RMWC9719932 Bodily Injury By Accident Compensation RMWC9719957 $ 2,000,000 Each Accident Bodily Injury By Disease $ 2,000,000 Policy Limit Bodily Injury By Disease $ 2,000,000 Each Person Other: Employees Leased To: Effective Date: 1/1/07 9933 Petroleum Equipment Construction Inc ~f"'~DI..' ~.'iWrtr~.'~ "[111m I.' 'if"" The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other employer. Notice of Cancellation: Should any of the policies described herein be cancelled before the expiration date thereof, the insurer affording coverage will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. Certificate Holder: /Jr(~e. U/~ City of ZephyrhilIs Building Dept 5335 8th St Zephyrhills, FL 33542-4312 Michael C. Weiss Authorized Representative of Marsh USA Inc. (866) 443-8489 Phone 01/01/2007 Date Issued