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<br />~ 1/16/2008 09:31 <br /> <br />LION INSURANCE COMPANY <br /> <br />Lion Insurance CompanY"'Air National. LLC <br /> <br />1/1 <br /> <br /> Date <br />:4 CORD TM CERTIFICATE OF LIABILITY INSURANCE 1/16/2008 <br />Producer: Lion Insurance Company This Certificate Is Issued as a matter of Information only and confers no rights <br /> 2739 u.s. Highway 19 N. upon the Certificate Holder. This Certificate does not amend, extend or alter <br /> Holiday, Fl 34691 the coverage afforded by the policies below, <br /> Phone: 727-938-5562 Fax: 727-937-2138 <br /> Insurers Affording Coverage NAIC# <br />Insured: South East Personnel Leasing, Inc. Insurer A Lion Insurance Company 11075 <br /> 2739 US. Highway 19 N. Insurer B: <br /> Holiday, FL 34691 Insurer C: <br /> Phone (727)936-5562 Insurer D. <br /> Insurer E: <br />Coverages <br />The poliCies of insurance listed below have been Issued to the Insured named above for the po~cy penod IndIcated Notwithstanding any reqUirement. term or condition of any contract or other document wth respect to which <br />this certifIcate may be Issued or may pertain, the insurance anorded 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 <br />paid claims <br />INSR ADDL Policy NlITlber Policy Effective Policy Expiration Date Limits <br />LTR INSRD Type of Insurance Date <br /> (MMIDDIYY) (MMIDDIYY) <br /> !:!.ENERAL LIABILITY Each Occurrence $ <br /> Commercial General Liability Damage to rented premIses (EA <br /> : :J Claims Made 0 Occur occurrence) $ <br /> - Med Exp $ <br /> - Personal Adv Injury $ <br /> General aggregate limit applies per: <br /> t:J Policy o Project 0 General Aggregate $ <br /> LOC <br /> Products. Comp/Op Agg $ <br /> ~UTOMOBILE LIABILITY Combined Single limit <br /> ~ (EA ACCident) $ <br /> Any Auto <br /> ~ Bodily InjUry <br /> All Owned Autos <br /> ~ (Per Person) $ <br /> Scheduled Autos <br /> ~ Bodily InjUry <br /> Hired Autos <br /> ~ Non-Owned Autos (Per ACCIdent) $ <br /> - Property Damage <br /> (Per ACCident) $ <br /> GARAGE LIABILITY Auto Only - Ea Accident $ <br /> ::J Any Auto Other Than EA Acc $ <br /> Autos Only AGG $ <br /> EXCESS/UMBRELLA LIABILITY Each Occurrence <br /> ~ o Claims Made <br /> Occur Aggregate <br /> ~ Deductible <br /> ~ Retention <br /> ~ <br />A Workers Compensation and X I WC Statu. I 10TH. <br /> WC 71949 01/0112008 01/0112009 tory Limits ER <br /> Employers' Liability <br /> Any proprietor/partner/execullve officer/member EL. Each Accident $1000000 <br /> excluded? E.L. Disease - Ea Employee $1000000 <br /> If Yes, describe under special provisions below <br /> E.L Disease - Policy Limits $1000000 <br /> Other 0665409 <br /> Air National, LLC COVERAGE APPLIES ONLY TO THOSE EMPLOYEES LEASED, NOT TO SUBCONTRACTORS. <br />Descriptions ofOperationslLocationsIV.hicl.slExclullons added by Endor.ementlSpecia' Provisions: ADD ON DATE: 8/14/2006 <br />COVERAGE APPLIES ONLY IN THE STATE OF FLORIDA TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF Air National, LLC . FAX: 813.514-6458 <br />& 813-780-0021I1SSUE 11-21-07 (SO) / REISSUE 01-14-08 (JOY)/ REISSUE 01-16-08 (NM) <br /> Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 <br />CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS Should any of the above descnbed polICies be canceUed before the expiration date thereof, the Issuing insurer will <br /> endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose I'K) <br /> BUILDING DEPARTMENT obligation or liabHiry of any kind upon the insurer, its agents or representatives <br /> 5335 8TH ST ~ ~--- <br /> ZEPHYRHILLS FL 33542 <br /> <br />ACORD 25 ( 001108) <br /> <br />ACORD CORPORATION 1988 <br />