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ACORDr: CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYYYY) 10/31/2008 10/26/2007 PRODUCER LOCKTON COMP ANIES,LLC-K CHICAGO THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 525 W. Monroe, Suite 600 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR CHICAGO IL 60661 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (312) 669-6900 INSURERS AFFORDING COVERAGE NAIC# INSURED Windward Homes, Thomas Chad Home, INSURER A: ACE American Insurance ComDanv 22667 1025094 Thomas L. Spencer, & INSURER B: American Casualty Company of Reading, PA 20427 James G. Gambel (as Contractors) INSURER C: 110 West Front Street Red Bank NJ 07701 INSURER D: I INSURER E: COVERAGES HOVENOI Z THIS CERTIFICATE Of; INSWlANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER/SI. AUTHORIZEDREPRESENTATlVE OR PRODUCER AND THE CERTIFICATE HOLDER. THE POLICIES OF INSURANCE LISTED BElOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POliCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED 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 PAID CLAIMS. INSR DD'l ~~~:g8~ Pg~!fl{~"\;~,wr LIMITS LTR NSR[ TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY EACH OCCURRENCE $ 5 000 000 - ~~~J?~~6.;~cel A X COMMERCIAL GENERAL LIABILITY HDOG21722534 10/31/2007 10/31/2008 $ 1,000,000 - ~ o OCCUR CLAIMS MADE MED EXP (Any one person) $ XXXXXXX - PERSONAl. & ADV INJURY $ 5,000,000 - GENERAl AGGREGATE $ 5,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRO~-COM~OPAGG $ 5,000,000 --, n ,PRO- nLOC POLICY JECT ETOMOBILE L1ABIUTY COMBINED SINGLE LIMIT $ XXXXXXX ANY AUTO NOT APPLICABLE (Ea accident) - - ALL OWNED AUTOS BODILY INJURY (Per person) $ XXXXXXX - SCHEDULED AUTOS - HIRED AUTOS BODILY INJURY (Per accident) $ XXXXXXX - NON-OWNED AUTOS - PROPERTY DAMAGE $ XXXXXXX (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ XXXXXXX ~ ANY AUTO NOT APPLICABLE OTHER THAN EAACC $ XXXXXXX AUTO ONLY: AGG $ XXXXXXX EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ XXXXXXX ~ OCCUR D CLAIMS MADE NOT APPLICABLE AGGREGATE $ XXXXXXX $ XXXXXXX o UMBRELLA ~ DEDUCTIBLE FORM $ XXXXXXX RETENTION $ $ XXXXXXX WORKERS COMPENSATION AND X I VVC STATU- I IOTH- B WC2091214079 (AOS) 10/31/2007 10/31/2008 TORY LIMITS ER EMPLOYERS' L1ASIUTY B ANY PROPRIETORlPARTNERlEXECUTIVE WC209121411S (CALIFORNIA) 10/3112007 10/3112008 E.L. EACH ACCIDENT $ 2,000,000 OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 2,000,000 If yes, describe under NO SPECIAL PROVISIONS belOlN E.L. DISEASE - POLICY LIMIT $ 2,000,000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS / VEHIClES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS Windward Homes T. Chad Home & Thomas L Spencer & James G. Gambrel(as Constractors) are named as additional insured with respect to General Liability as required by written contract. Division: Tampa. CERTIFICATE HOLDER CANCELLATION 2713772 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City of Zephyrhills DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRmEN - Attn: Permitting Services NOTICE TO THE CERTIFICATE HOUlER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL 5335 8th Street IMPOSE NO OBUGA TION OR UASlUlY OF ANY KIND UPON THE INSURER, ITS AGENTS DR Zephyrhills FL 33542 REPRESENTATIVES. AUTH<.~ ~~.!{~EIlY,;lv'I:' - " .... .~:1. - / J ..- ) / ..., .' ( / - 4.- .~ - ACORD 25 (2001/08) For questions ~rdIntIlhl. l;ertlrh;ate. contact the number..... in the .Produc.... HCtion .bo...e.n~ity the client cod. "ItOVEN01'. @'AC6RD CORPORATION 1988