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<br />NOV-08-2007 THU 03:12 PM FIRST FINANCIAL
<br />
<br />FAX NO. 9418835852
<br />
<br />P. 01/01
<br />
<br />,ACORD CERTIFICATE OF LIABILITY INSURANCE I DAT" IMMlDllIVYYYI
<br />TIl SSTBF1CNl: 11/08/2007
<br />PRODUC~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />L19ncho~D=-~rogramB, I.LC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />301 ~. ~in= Scra~r. HOLDER. THIS CERTIFICATE:DOES NOT AMEND. EXTEND OR
<br />sun" ~~o ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />orJ.llllclo, rL 3:\"01-
<br /> INSURERS AFFORDING !=OVERAG~ NAIC#
<br /> .- ". -" -
<br />INSURED INSURER A: liD;" l"'Ulrance COlIl'pany
<br />I"h'Jlt Plnancilll Eu,ploy"e :1.....8105, .nc. -.." " --
<br />~74~ Tamiami Tr..i1 IN5UR~A ll: .- .. ~ .'
<br />fore cnar1ot~.., PL 3~,S2 -,"'
<br /> INSURER c:
<br /> --
<br /> INSURER 0:
<br /> ~.. -- '. ,
<br /> INSURgA /0,
<br />
<br />COVERAGES
<br />
<br />THE POl.lCIE:S OF INSURANCe L.ISTED BELOW HAVE BEEN ISSUED TO THE INSUREO NAMED ABOVE FOR THe POL.ICY pERIOO INOlCATEO, N01WlTHSTANDING
<br />ANY RE:QUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO \MilCH THIS CERTIFICATE MAY BE: ISSUED OR
<br />MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, EXCL.USIONS AND CONDITIONS OF SUCH
<br />POLICIES. AGGREGATE I.IMITS SHOWN MAY HAVE. BeeN REDUCED BY PAID CLAIMS, , _=" "'="'" .,,-
<br />
<br />I~ ~~~ ......." O~ INSURAOIC" . . POl-IcY NUMB~R p~rr ~jf'Ftc"VE I'OIoICVI!llPI'li'~c:" UMITS
<br />
<br />/OI<CH OCCURR/ONCf ~
<br />-oJglll'.I>~ .....RIO~..'
<br />PRIiMIS/OS.!.Es OCCIA'Iln"") $
<br />
<br />~':x.P (My 0"" p6(lcnl, S
<br />
<br />PER50NA~&flDVINJURY" ~': :"'_... ...0.'-"--'-
<br />
<br />~:~~~~::~~::"~G.:';<;;':-I,.'::~ ..-=
<br />
<br />", ...-
<br />
<br />~NtiRAL LlAfllUTY
<br />_ .,~~~MERCIf\L GENeRA~ LI"IlILITY
<br />
<br />_ -.J C\..I<llolS MADE 0 OCCUR
<br />
<br />," '..~. ,
<br />
<br />-_..
<br />
<br />~-,,, ..-
<br />q~~'L AClGl'te~ UMIT AP~ pER:
<br />I POUCy I I P'k'R;: I I I.OC
<br />~lOMDBILE UAIlILJ'lY
<br />~ ANY AUTO
<br />~ ALL OWNED AuTOS
<br />_ SCHi:DULED AUTOS
<br />_ HIRED AUTOS
<br />_ NON-Cll\lNED AWl'OS
<br />
<br />COM81NfD SINGLE LIMIT
<br />(/Oa ICCldsnU
<br />
<br />,--
<br />
<br />BOClILV INJURY
<br />(f'or per9Ol'll
<br />
<br />fI00lLY INJURY
<br />(Per !ll:dQenl)
<br />
<br />.-
<br />
<br />PROPeRTY OAM^Gi;:
<br />(Per ~dsnll ' _
<br />
<br />.. 5....., ...
<br />
<br />A
<br />
<br />~AOE LIABILITY
<br />_I flNv AUTO
<br />
<br />~l!SSlUMBREIoLA LIABIUTY
<br />---1 OCCUR D C\..I<lMS t.1ADt!
<br />
<br />
<br />-'1 OEouCTIBL/O
<br />
<br />I Mr/ONTlON I
<br />\IIlORKERSCOM"~SATlDNANg I'ISLTHT1lil 000066-02
<br />eMPLOVERS' UAIlIU'l'V
<br />ANY f'ROPflIETOfllPARTNERIIOXECUTIVE
<br />OffIOER/MEMBeR ~CLUI;l"P?
<br />II va;, QelC/lbe ill!d!l: ._, ,
<br />~';:CIf\L OROV'SION~ aelow
<br />OTHER
<br />
<br />AUTO ONLV - EA ACCIOENT ~
<br />,.
<br />EA ACC 5
<br />
<br />.'-
<br />
<br />OTHERT"""N
<br />AUTO ONLY:
<br />
<br />EACH OCCURReNCe
<br />AClGfiEG^TI<
<br />
<br />AGG $
<br />$
<br />$
<br />
<br />,,,-
<br />
<br />$
<br />
<br />12/31/2006
<br />
<br />01/01/2008
<br />
<br />$
<br />$
<br />I X I _'M= ST~,~<: I I 'fIlH-
<br />~RY._LI , .Ii
<br />#, EACH ACCIDI!NT, $
<br />~L. DISEASE. EA EMPLOVEE $
<br />10,". DIS/Ot\SE. POLICY LIMIT $
<br />
<br />1,090,000
<br />J.. 000, O~.~-
<br />:1.,000,000
<br />
<br />IlE:SCAlPTlON OF OPiAATlONS / LOCATIONS I \lEHIClES/ EXCl.USIDNS ADDIlD Ill' ,,"ODRSEMIiNT I SI"I!ClAl- Pft0\/l51ONS
<br />cover~9~ i~ excendc~ co ChB le~ued employeoD of alcern~te employer l~lorida Op~ration3 On~y): Southland Conatr~~tion
<br />Se~icee, Inc, client #26G9 (EffectivE: 1.01.20061 IlISCl.AlMBR: The Certificace of Irlliurance doe~ net conptitute i1 ....
<br />contra~c between tne issuing in~urerI31, ~~thorized representative or produoer, and the certifieace holder, nor does
<br />it affirmatively or negatively amend, extend or alter tho coverage attorded by the policiea listed thereon.
<br />Thi~ certificate only appli~~ co Licence Holder; Thomas LaMoilu.
<br />
<br />CERTIFICATE HOI.Ot=R
<br />
<br />CAIIICEI.LATION
<br />
<br /> SHOULD ANY OPTHIl Alave De5CRIIIEIl POWCE:! BE CANceLLIiO IIEfOfll!THI! EXPIRATION
<br /> DATE TH~flEtIf'. THE ISIUING INSURER Wll,l, I!NDI!AVDR TO MAIL 30 DAYII WRITTI!N NOTIC!: TO
<br /> THE C~llTl~ICI'TE HOUlf:II NAMEDTOTH~ 1ol!l"1', BUT FAILUlleTO 00 80 IHAW-IMPDSE NO
<br /> DIIl-_TION OR LIAII'IoITY ~ >>II' KIND Uf'ON THe INSURI!Il,I'l'S AGEN'B ~
<br /> REPRf:&5NYA'J'lVES.
<br /> ;
<br />City of Zephyrhille l'llclg Dept.
<br />813/'100-0021 AUTHORIZED REPIIl!SENTAnve ~
<br />5335 Sr.ll StreCl~
<br />:Z;t!ophyrh:l.lh, PL 33542 t'llg= 1 of. 1
<br />
<br />ACORD 2S (2001/08)
<br />
<br />(5) ACORD CORPORATION 1988
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