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<br />; 11/8/2007 10:57 <br /> <br />(813-909-8743 <br /> <br />Paragon Risk Management <br /> <br />Jean Shuff-+City of Zephyrhills <br /> <br />1/2 <br /> <br />ACORDfM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDI'fYVY) <br />11/08/2007 <br />PItODUCER (813) 949-8636 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Paragon Risk Management, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 119 AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Lutz FL 33548- INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A Clarendon America <br />Southland Construction Services, Inc. INSURER B Zurich <br />Thomas LaMeau INSURER C <br />9605 E US Hwy 92 INSURER D <br />Tampa FL 33610- INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO \MilCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, <br />AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br />INSR ADD'L POLICY EFFECTIVE POLICY EXPIRATION <br />LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIODIYY) DATE (MM'()DIYY) LI MITS <br />A GENERAL LIABILITY CA0900000152 01/12/2007 01/12/2008 EACH OCCURRENCE $ 1,000,000 <br /> - ~~~~~~~9E~~~~;.?en ce \ <br /> ~ ==rMERCIAL GENERAL LIABILITY $ 100,000 <br /> CLAIMS MADE [!] OCCUR / / / / MED EXP IAnv one personl $ 5,000 <br /> - <br /> PERSONAL & ADV INJURY $ 1,000,000 <br /> / / / / GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT AnS PER PRODUCTS. COMPIOP AGG $ 2,000,000 <br /> I POLICY n ~~8T LOC / / / / <br />A AUTOMOBILE LIABILITY CN0900000247 01/12/2007 01/12/2008 COMBINED SINGLE LIMIT 500,000 <br /> - (Ea accident) $ <br /> - ANY AUTO <br /> ALL OWNED AUTOS / / / / BODIL Y INJURY <br /> - (Per person) $ <br /> X SCHEDULED AUTOS <br /> - / / / / <br /> X HIRED AUTOS BODIL Y INJURY <br /> - (per accident) $ <br /> X NON-OWNED AUTOS <br /> - / <br /> - / / / PROPERTY DAMAGE <br /> (Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY. EA ACCIDENT $ <br /> ===j ANY AUTO / / / / OTHER TH AN EA ACC $ <br /> AUTO ONLY $ <br /> AGG <br /> EXCESSIUMBRELLA LIABILITY / / / / EACH OCCURRENCE $ <br /> :=J OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE / / / / $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND / / / / I T~~1If;JNs I 10TH. <br /> EMPLOYERS' LIABILITY ER <br /> ANY PROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $ <br /> O~~ICERIMEMBER EXCLUDED? / / / / E L DISEASE. EA EMPL OYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below EL DISEASE. POLICY LIMIT $ <br />B OTHER Inl and Marine EC65575385 01/12/2007 01/12/2008 rented or leased 100,000 <br /> / / / / <br /> / / / / <br />DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLA TlON <br /> <br />(81.3 ) 780-0020 (813) 780-0021. SHOULD At('( OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> - <br /> City of Zephyrhills - Building FAILURE TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF At('( KIND UPON THE <br /> 5335 8th Street INSURER, ITS AGENTS OR REPRESENTATIVES, <br /> AUTHORIZED REPRESENTA TlVE -M..r~_~ <br /> Zephvrhills FL 33542- <br /> <br />ACORD 25 (2001/08) <br />ft_.,-INS025 (0108)05 <br /> <br />ELECTRONIC LASER ~ORMS,INC, -1800)327-0545 <br /> <br />@ACORD CORPORATION 1988 <br />Page 1 of 2 <br />