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<br /> <br />CERTIFICATE NUMBER <br />393523 <br /> <br />PRODUCER <br /> <br />COMPANIES AFFORDING COVERAGE <br /> <br />Marsh, Inc, <br />1166 Avenue of the Americas <br />New York, NY 10036 <br />Telephone (212) 345-5000 <br /> <br />INSURED <br /> <br />ADT Security Services, Inc. <br />32100 US Hwy 19 N <br />Palm Harbor, FL 34684-3727 <br />United States <br /> <br /> <br />WORKERS COMPENSATION POLICIES <br /> Carrier Policy Number Eft. Date Exp. Date State <br />(B) American Home Assurance Co. WC 1616576 6/29/2007 6/29/2008 CA <br />(B) American Home Assurance Co. WC 1616584 6/29/2007 6/29/2008 AOS <br />(D) Illinois National Insurance Co. WC 1616577 6/29/2007 6/29/2008 MI <br />(C) Commerce & Industry Ins Co WC 1616582 6/29/2007 6/29/2008 FL <br />(B) American Home Assurance Co. WC 1616581 6/29/2007 6/29/2008 NJ <br />(A) AI South Insurance Co. WC 1616578 6/29/201:17 6/29/2008 GA <br />(B) funerican Home Assurance Co. WC 1616579 6/29/2007 6/29/2008 PA <br />(F) New Hampshire Ins. Co. WC 1616580 6/29/2007 6/29/2008 NY,WI <br />(B) funerican Home Assurance Co. WC 1616585 6/29/2007 6/29/2008 OR <br />(E) Insurance Company of the State of PA WC 1616583 6/29/2007 6/29/2008 AR,MA,VA <br /> <br />Project: town 174 <br /> <br />If ther<= is a question regarding this certificate please contact Marilyn Zimmerman <br />(Email: mzimmerman@adt.com Phone: 813-806-7141) <br /> <br /> <br />City of Zephyrhills <br />5335 Eighth Street <br />Zephyrhills, FL 33540-4312 <br /> <br />