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<br />Certificate of Insurance <br />This certificate is issued as a matter of information only and confers no rights upon the Certificate Holder other than those provided by this policy. <br />This certificate does not amend, extend, or alter the coverage afforded by the policies described herein. <br /> <br />Named Insured(s): <br /> <br />Gevity HR, Inc; Gevity HR, LP; Gevity HR II, LP; Gevity HR III, <br />LP; Gevity HR IV, LP; Gevity HR V, LP; Gevity HR VI, LP; <br />Gevity HR VII, LP; Gevity HR VIII, LP; Gevity HR IX, LP; <br />Gevity HR X, LP; Gevity HR XI, LLC; Gevity HR XII Corp.; <br />Gevity XIV, LLC. <br />9000 Town Center Parkway <br /> <br />MARSH <br /> <br />Bradenton, Florida 34202 Insurer Affordine Coveraee <br />Coverages: American Home Assurance Company <br /> Member of American International Group, Ine. (AIG) <br />This is to certify that the policy(ies) of insurance described herein have been issued to the insured named herein for the policy period indicated. <br />Notwithstanding any requirement, term or condition of any contract or other document with respect to which the Certificate may be issued or may <br />pertain, the insurance afforded by the policy(ies)described herein is subject to all the terms, conditions and exclusions of such policy(ies). <br />(Aggregate) Limits shown may have been reduced by paid claims. <br />Type of Insurance Certificate Exp. Date Policy Number Limits <br /> Employers Liabilitv <br />Workers' 1-1-2009 RMWC4402574 Bodily InjllI)' By Accident <br />Compensation RMWC4275667 $ 2,000,000 Each Accident <br /> Bodily InjllI)' By Disease <br /> $ 2,000,000 Policy Limit <br /> Bodily InjllI)' By Disease <br /> $ 2,000,000 Each Person <br />Other: <br />Employees Leased To: Effective Date: 1/1/08 <br />12356 Florida Sign Company Inc. <br />The above referenced workers' compensation policy(ies) provide(s) statutory benefits only to the employees of the Named Insured(s) on such policy(ies), not to the employees of any other <br />employer. <br /> <br />Notice of Cancellation: Should any of the policies described herein be cancelled before the expiration date thereof, the insurer <br />affording coyeragewill endeavor. tomaiLJOJiayswrittennoticecto-the_certificate.holdernamed.hercin,but failure to mail such notice <br />shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives. <br /> <br />Certificate Holder: <br /> <br />-.... --...-- <br /> <br />/lY(~e. U/~ <br /> <br />Michael C. Weiss <br />Authorized Representative of Marsh USA Inc. <br /> <br />City of Zephyrhills <br />5335 8th St <br />Zephyrhills, FL 33542-4312 <br /> <br />(866) 443-8489 <br />Phone <br /> <br />0110112008 <br />Date Issued <br />