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. A CORDTII CERTIFICA TE OF LIABILITY INSURANCE f DATE (MM/DDIYYYY) 10/16/07 PRODUCER LIC #A116633 1-407-260-1605 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Henricks & Associates, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1500 TOWIll Plaza Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW" Winter Springs, FL 32708 INSURERS AFFORDING COVERAGE NAIC# Scott E. Lugering INSURED INSURER A, Arch Insurance Company Lucas Automatic Fire Sprinklers, Inc. Thomas Lucas INSURERB, Progressive Express Ins Company 6!08 Boyette Road INSURER C: AmComp Incorporated Wesley Chapel, FL 33544 INSURER D, INSURER E, COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, II~:: ~I!~ POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS A J!I':NERAL LIABILITY MFGL06551601 12/30/06 12/30/07 EACH OCCURRENCE $1,000,000 _ X_~"RC'" G""","- U'.'''' ~~~~'SES lEa occurencel $100,000 1--- CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $10,000 1---- PERSONAL & ADV INJURY $1,000,000 1---- GENERAL AGGREGATE $ 2,000,000 ~N'lAGGRnE LIMIT APnS PER, PRODUCTS-COM~OPAGG $2,000,000 X 1 POLICY ~bW,: lOC B ~TOMOBILE LIABILITY 01787605-4 07/27/07 07/27/08 COMBINED SINGLE LIMIT $500,000 X ANY AUTO (Ea accident) -- - All OWNED AUTOS BODilY INJURY (Per person) $ I------ SCHEOUlED AUTOS X HIRED AUTOS f---- BODilY INJURY $ X NON-OWNED AUTOS (Per accident) f---- PROPERTY DAMAGE $ (Per accident) ~lAGE LIABILITY AUTO ONLY - EAACCIDENT $ ---1 ANY AUTO OTHER THAN EA ACC $ AUTO ONLY, AGG $ OESSlUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR D CLAIMS MADE AGGREGATE $ $ R DEDUCTIBLE $ RETENTION $ $ C WORKERS COMPENSATION AND WCV7064925 02/14/07 02/14/08 X I T~~IfrrN;, I I om- EMPLOYERS' LIABILITY $500,000 ANY PROPRIETORlPARTNER/EXECUTlVE E.l. EACH ACCIDENT OFFICER/MEMBER EXCLUDED? X E.l. DISEASE - EA EMPLOYEE $500,000 ~~~~:l'1>'~~~t~~NS below E.l. DISEASE - POLICY LIMIT $500,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS - CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Zephyrhi11s DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAlL ~ DAYS WRmEN Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL 5335 8th Stl~eet IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. Zephyrhills. FL 33542 AUTHORIZED REPRESENTATIVE USA SCOU E. LIIger;ng ACORD 25 (2001/08) a1asota 7282385 @ACORDCORPORATION 1988