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<br />10/11/2007 10:50
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<br />19043532647
<br />
<br />MEGD
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<br />PAGE 02
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<br />AC08P. CERTIFICATE OF LIABILITY INSURANCE
<br />FAX (770)447~83S3
<br />Agency
<br />
<br />I D^ TE (MMIDDIVVVVI
<br />10/09/2007
<br />
<br />THIS CERTIFICATE IS ISSUl!D AS A MATTER OF INFORMATION
<br />ONLY AND CONFERS 11IO RIGHTS UPON THE CERTIFICATE
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
<br />^LTER ,!!:!.~.g~~~~E~DED BVTHE POLICIES BELOW,
<br />
<br />ili!iilrl~~'Reco 'oniirth''FfoHdft,
<br />3~26 Phoenix Ave.
<br />JDr;ks"nvill e, Fl. 32206
<br />
<br />Inc.
<br />
<br />INSURERS AFFORDING COVERAGE NAIC ,
<br />. iNS\;;~l~ j{-;- Mi ii=Con'i:i nent-- C8sua 1 ty '~c~any .... ..-----,... _... ~ .__u
<br />;;"~~lli~i'R'ji-Na'ti onai"Trust-Insurafice Co. ....'... ~-..._---. ---
<br />~..~,..,. ,......-........".." .....,.. .-,_. .-.....--....--...,...,.,
<br />''''SLJlt1,RC American Alternative Ins Corp
<br />~~..'" .-. ,..--,-.--.--."....-,. .~.,..~...".__.__._- --.-...--....., ,.
<br />~~I~.~II~.?~. _~~!=~...~_'!~. '!.'::'~~~~..~!'2!:'.~... _____ .__> __._. _.._..___.
<br />INsunl R f
<br />
<br />COVERA~~$
<br />TJ~~ POLICIes Of IN~URANCE L1S"rEO BEI,OW HAVE BEeN ISSUED TO THE lNSUAlol) NAMED ABOVE fOR THE POLICY PE~100 It>lDICATED, NOTWITHSTANDING
<br />ANY REOUIREMENt, rF.RM OR CONDITION OF ANY CONTRACT OR OTHeR tJOCUMI;f'H WITH RESPfCT TO WHICH THIS CERTlfICATF. MAY BF. ISSUED OR
<br />M^Y f"Ef{ "'\IN, 1'H'= INSllMNCE AFFORDED BY THE POLICIES DESCRIBED HElU:lN IS SUBJECT TO ALL 'THE TERMS. EXCLUSION!; AND CONOITIONS OF SUC',H
<br />POl ICII~S AGGRE(~ATF t IMIT~ ~HOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
<br />iNsii 1l~.J - ".--, '~;;".' 0' r' r'N;;URhNC" .~.. .... . ., --I'tlI.I~-Y M::'~:;"-R -- r-poTrCY-EiFEcTiiie CPOLICY iii'iiiMlimi -- --- - -".P ..." ",- _n_._... -,~, -,~..~-,
<br />~TR. tl~rn .__.__..',.'~.......~.._,_._':... .L ",u"u", ....D1\1EJMMmQ/rfJ... LIMITS
<br />G!:NnRM UMIJ IT\' 04<iL679248 06/30/2007 06/30/2008 r,M:H OCCURRFNcr $ 1,000 I 00.9
<br />"Xl r;OMloIFRC:'hl (lHJr.lllIl 11.~","OD L INSURED IF REQUIRED IlliMAtihl'o RC,Nffi5"'" "," '.h.... '100 :000
<br />. _ n __:.I ~I lllfo\~ MAIlr L~I onC:\1Il BY WRITTEN CONTRACT.~3~;~~;.;;:~:;~~ i: . .___.!.~~I~dejj
<br />X ~~l1l1tion '~in_~n.._ $1,OOO,OOO/Z,OOO,OOO 06/30/Z007 06(3012008 ~~~~V~,~~~~._ _:.,._!.,~.OJl.IQQf
<br />, , . .___. ._. .. __ ___ WAIVER at SIJBROGATION ~~RI\l IIG(lR~Gl\lr: _,_,,_ ~_._b..<<1~,.9~~
<br />'~:'l~t. M;~:~r;~Jl F ""111 ^~rl:'I'F.1S rEn INCLUDED ~.I,l~~.!:.~~.: E~Gr, _ ..!..,.--L OOo..'..~,o.(J
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<br />hUTOMOlllllHlllnllm CA 0001716 4 06/30/Z007 06/l0/2008 COMnlNEO SrNGI.F.I.IM'"
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<br />1l00fl,Y INJtlHY
<br />(r~r ~~Int\n)
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<br />BOOll Y INJURy
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<br />f'I'lON. InY "^,MGI!
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<br />60A2UB0002680-00 06/30/2007
<br />
<br />06j30/Z008
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<br />AGG $
<br />
<br />"ACH OCCIIRRr:NCl' S 4,000,000
<br />^;:;GRt-G^;~'" '...--.....-s-....... 4:00(r;OO~
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<br />OTHI1R mllN
<br />hl1TO ONLY
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<br />t-- - ...:'X .I\E1ENTrON_ ..-.!...,~.~!.oJ(]
<br />WORKm9 CnM"F.N!IJl'nON I\N(I
<br />QMrLOYI'Il!' 1,,'II"flJTY
<br />D IINY PR\lr!'tll;,10rlIrIlRTNfRIr:.Xr CI JTIVr.
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<br />m~lt'w~Vt~rO~s hnt"",
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<br />B ~qu'''llIP.nt Rented from
<br />pthers
<br />
<br />010WC07A56Sg9 06/30/2007
<br />
<br />06/30/2008
<br />
<br />$
<br />}. "b~ijirrPlNsC.J~~W: , ._.._._.._____...~.
<br />H EliCH /lCI:IU(;N'T $ 1 , Q.OO , ~~Q
<br />(~I:: 'o;seiiSF.: ':~';;~MPLo';;riii '$"" ,. . 1;.000 ~oog
<br />7'~;ISr;;;:~;~~~.~;,;. s"'---'1';'oo'O;ooo
<br />$ 200.000
<br />$ 1,000 deductible
<br />
<br />CPP0002662630 06/3017.007
<br />
<br />06/30/2008
<br />
<br />OE:SCRI~l1('1N Of /)PERI\11ONr.1 L n~ noNS / vtrH!CI,F.5/UClUSlONS IIDOl!IlIlY IiNIlORSEMF.NT / ~p"'Cll\l PROVISIONS
<br />
<br />~'..
<br />~lEIAAT,e.H9.1..Q.e
<br />
<br />City of Zephyrhills
<br />Attn= Ru11d1ng Dept.
<br />~335 8th St.
<br />Zephyrhi11s. FL 33S42
<br />
<br />C LAlO
<br />SHOULD ANY OF TWE /laDVIl DESCR'''F.D rouelEI DE CIINCE~lF.D llEFDRE TWE
<br />CXPlRIITION DIITI! THEREOf'. TUl! ISSlJINO INSURF.II WLl ENDfIIVOIl TO ""/IlL
<br />_~.L DhVS WRITTEN NOTICE TO TIlE CF.IIT1I'1CIlTe HOI.OEII NIIMED TO Tile Llln,
<br />I1ur FIIJlUIU: TO "'II". 3UCH N(1tlr:r.. $liAl,I, IMI>O!lE NO OBl.'GJI"'ON OR I,'MII,IN
<br />ITS AGeNTS OR 11F.l'~I;SENTI\T1VQS.
<br />
<br />ACORD 2S {?0011l)1l) r:AX: (813) 780-0021
<br />
<br />
<br />@ACORDCORPORATION 1908
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