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<br />A,CORD,. CERTIFICATE OF LIABILITY INSURANCE I OATECIIIWO#YYYY) <br />0310112007 <br />PROOlICER THIS CERTlRCATE IS ISSUED AS A MATTER OF INFORMATION <br />J. Smith Lanier & Company ONLY AND CONFERS NO RIGHTS, UPON THE CERTIFICATE <br />HOLDER. THIS CERTFICATE DOES NOT AMEND, EXTEND OR <br />11330 lakefiekl Drive ALTER THE COVERAGE AFFORDED BY THE POlICIES BELOW. <br />Building 1; Suite 100 <br />Duluth, GA 30097 INSURERS AFFORDING COVERAGE NAIe" <br />I8IIlED INSURER A: Zurich-Amerlcan Insurance Company <br />Staffing Concepts International, Inc., e1a1 All Emp: Steve Wood dba: Woods INSURER B: <br />Propane INSURERC: <br />4224 West Henderson Blvd. <br />Tampa , Fl33629 INSURER 0: <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />TtE POlICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POlICY PERIOD INDICATED. NOlWrTHSTANDING <br />AN'( REQUIREMENT, TERM OR CONDmoN OF ANY CONTRACT OR OTHER 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 UMrrs SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />== POlICY_ POlICYEFFECmIE POUCYEllPIRATION LIIIfTS <br /> ~LIABlUTY EACH OCCURRENCE $ <br /> COMMERCIAL GENERALLWlILITY PREMISES Ea!JCCUnlnCel $ <br /> '- U ClAIMSMADE 0 OCCUR MEDEXP{Anyone_} $ <br /> PERSONAL & Af:1V INJURY $ <br /> GENERAL AGGREGATE $ <br /> ~'lAGGnUMfTnSPER: PRODUCTS -COMPIOP AGG $ <br /> POUCY ~ lOC <br /> ~LIAIlIUTY COM8INEo SINGlE UMfT $ <br /> AMY AUTO (Ea llCddenl) <br /> - <br /> - ALl OWNEDAUTOS BOOll Y INJURY <br /> $ <br /> SCHEDUlEO AUTOS (Per person} <br /> - <br /> f-- HIRED AUTOS BODILY INJURY <br /> $ <br /> NON-OWNEDAUTOS {Pen..:idenl} <br /> f-- <br /> - PROPERTY DAMAGE $ <br /> (Per aa:idenI) <br /> GARAGE LIA8LfTY AUTO ONlY - EAACClDENT $ <br /> =l-ANY AUTO OTHER THAN EA ACe $ <br /> AUTO ONlY: AGG $ <br /> ElI~_LAUA8lUTY EACH OCCURRENCE $ <br /> o OCCUR 0 ClAIMS MADE AGGREGATE $ <br /> R=e $ <br /> $ <br /> $ $ <br /> WORKERSOO. "-J&t:.TIONAND X WCSTATU-,I IOJr' <br /> a.t.O\'BtS'lIA8lUTY <br />A ANY PROPRIETOlwARTNERlEXECunve we 45-57-044-03 0310112007 0310112008 EL EACH ACCIDENT $ 1.000.000 <br /> OFFICERRIIEMBER EXClllDED? E.l. DISEASE - EAEMPlOYEE $ 1,000,000 <br /> ~ desc:rlbe under <br /> ffiQYISIONs below E.L. DISEASE - POUCY lIMIT $ 1,000,000 <br /> 011IeR <br /> LocatIon Coverage Period: 0310112007 0310112008 Certlficatet#: 07FL103757429 <br /> Clientt#: 314610 <br />onc-..ONOFOPERAT1ONSfLOCATIONSfVEfIICLES fEXCI.USIONS ADDEOBYENIlOR8EMENT /SPECIAl.PROVlSION8 <br />Cowlrage 'is provided for only Steve Wood dba: Woods Propane <br />those~ leased to 15229 US Hwy 301 <br />but not sutlCOnlracfors of: North Dade City, Fl33523 <br /> , <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SfIOUUl Nl'f OF TIE A80VE DEiSC-.o:u POUClES BE CANCEl.LED BEFORETHEEllPIRA.. <br />City of ZephyrtJills DATE lllEREOF. TIE ISSUING INSUIER WIL1. ENDEAVOR TO IIAIL ~ DAYS WNITBI <br />5335 8th Street NOTICE TO THE CERTlFlCATE HOUlER NAIlED TO THE lEFT, BUT FAIlURE TO DO so SIUW. <br /> .-ose NO OBUGI'iT1QN OR UA8lUTY OF Nl'f KIIID UPON TIE INSURER. rTlI MEImi OR <br />ZephymiHs. Fl 33542 REI'RElIEIITATIVES. <br /> AUTHORIzEDREI'RElIEIITATlVE A ~ ~.- <br />A : <br /> <br />CORD 25 (2001108) <br /> <br />CACORD CORPORATION 1988 <br />