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<br />, 11/8/2007 10:59 <br /> <br />(813-909-8743 <br /> <br />Paragon RIsk Management <br /> <br />Jean Shuff-'Southland Const Serv <br /> <br />1/2 <br /> <br />ACORD", CERTIFICATE OF LIABILITY INSURANCE T DATE (M1olJ:lD/l'YVYI <br />11/08/2007 <br />PRODUCER (813) 949-8636 THIS CERnFICATE IS ISSUED AS A MATTER OF INFORMAnON <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERnFICATE <br />Paragon Risk Management, :Inc. HOLDER. THIS CERnFICATE DOES NOT AMEND, EXTEND OR <br />P.O. Box 119 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Lutz I'L 33548- INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Clarendon America <br />Southland Construction SeZ:Vices, :Inc. INSURER Et .zurich <br />Thomas LaKeau INSURER C: <br />9605 E US Hwy 92 INSURER 0: <br />TaDlD8 I'L 3361.0- 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, NOTWITHSTANDNG ANY <br />REClUIREMENT, 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 />I~ ...~.J: TYPE OF INSURANCE POlICV NUMBER IP~4i~MIolIOOIVV) DATE (MMJ:l"&VY)" LIMITS <br />A ~I9ERAL LIABILITY CA0900000152 01/1212007 01/12/2008 EACH OCCURRENCE $ 1,000,000 <br /> ~ =rMERCIAL GENERAl LIABILITY I ~~~~~~YE~~JuEJ'ence\ $ 100,000 <br /> ~ ClAlMSMADE [!J OCCUR 1 1 1 1 MED EXPIAnu one !lArsonl S 5,000 <br /> PERSONAL &. ADV IN-lJRY S 1,000,000 <br /> / 1 1 1 GENERAL AGGREGATE $ 2,000,000 <br /> ~l AGGREn ~IMI: AnS PER: PRODUCTS - COMPIOP AGG $ 2,000,000 <br /> POUCY ~T LOC / / 1 1 <br />A ~TOMOBILE LIABILITY CH0900000247 01/12/2007 01/12/2008 COMBINED SINGLE LIMIT 500,000 <br /> (Ea occldent) S <br /> ANY AUTO <br /> - 1 1 1 1 <br /> ~ ALL OWNED AUTDS BODIL Y INJURY <br /> (Per person) S <br /> .!.. SCHEDULED AUTOS <br /> .!.. HIRED AUTOS 1 1 1 1 BODILY INJURY <br /> (Per accldent) $ <br /> ..!. NON-OWNED AUTOS <br /> / / 1 1 PROPERTY DAMAGE <br /> (Per ecddent) S <br /> RRAGE L1ABlLllY AUTO ONL Y - EA ACCIOENT S <br /> ANY AUTO / / / / OTHER THAN EAACC S <br /> AUTO ONL Y: AGG $ <br /> :=JE8S~M~LAL~BLnv / 1 I 1 EACH OCCURRENCE $ <br /> OCCUR 0 CLAIMS MADE AGGREGATE $ <br /> $ <br /> q DEDUCTIBLE / / 1 / $ <br /> RETENTION S $ <br /> WOR~COMpagAnONAND I / I I I T~1r,1J,y~ I IOl~: <br /> EMPLOVERS' LIABILITY <br /> ANY PROPRIETORIPARTNER/EXECUTlVE E ,L. EACH ACCIDENT $ <br /> OFFICERIMEMBER EXClUDED? / / I / E,L, DISEASE - EA EMPLOYEE S <br /> "yes, desalbe under E.L. DISEASE - POLICY LIMIT S <br /> SPECIAL PROVISIONS below <br />B OTHER Inland Marine I:C65575385 01/12/2007 01/12/2008 r.nted or l....d 100,000 <br /> / / / / <br /> 1 / / 1 <br />DESCRIPTION OF OPERAnON8A.OCAnONS/VEHCLESIEIlCLUSIONS ADDeD BV ENOORSEMENTISPECIAL PROVISIONS <br /> <br />CERnFICATE HOLDER <br /> <br />CANCELLA nON <br /> <br />(813) 780-0020 (813) 780-0021 SHOULD ANY OF THE ABOVE DeSCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISIUNG INSURER WILL ENDEAVOR TO MAIL <br /> ~ DAYS M1nEN NOnCE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> City of .zephyrhills - Building FAILURE TO DO so SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> 5335 8th St.z:eet INSURa ITS AGENTS OR REPRESENTATIVES, <br /> AUTHORIZED REPRESENTATIVE ...i;fL v-~ <br /> .z8Dhvrhills I'L 33542- ~ <br /> <br />ACORD 25 (2001/08) <br />It.... -INS025 (0108),05 <br /> <br />ELECTRO NIC LASER FORMS,INC:. _ (800)327-0545 <br /> <br />CJ ACORD CORPORAnON 1988 <br />Pogo I or 2 <br />