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<br />.. · 7/ 6/912008 10:54 Lion Insurance Lion Insurance Company-+-Apple Sign & Awning, LLC 1/1 <br />:. . <br />- <br />.- . CERTIFICATE OF LIABILITY INSURANCE Date <br />.11 6/912008 <br /> ,Jroducer: 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 /> the coverage afforded by the policies below. <br /> Holiday, FL 34691 <br /> Insurers Affording Coverage NAIC # <br /> Insured: South East Personnel Leasing, Inc. Insurer A: lion Insurance Company 11075 <br /> 2739 U.S. Highway 19 N. Insurer B: <br /> Holiday, FL 34691 Insurer c: <br /> Insurer 0: <br /> Insurer E: <br /> Coverages <br />The poliCies Of Insurance listed below have been Issued to the Insured named above for the pOlicy penod indicated. Notwlthstandlng any requirement, term or condibon of any contract or ott.lr document...th respect to which <br /> this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions, and condiborr:; of such policies. Aggregate limits shown may have been reduced by <br /> paid claims. <br /> INSR ADDL Type of Insurance Policy Number Policy Effective Policy Expiration Date Limits <br /> LTR INSRD Dale <br /> (MMIDDIYY) (MMIDDIYY) <br /> GENERAL LIABILITY Each Occurrence $ <br /> - Commercial General Liability Damage to rented premises (EA <br /> :: :J Claims Made 0 Occur occurrence) $ <br /> t- Med Exp $ <br /> I- Personal Adv Inpry $ <br /> General aggregate limit applies per: <br /> :J Policy o Project 0 General Aggregate $ <br /> LaC <br /> Products - ComplOp Agg $ <br /> AUTOMOBILE LIABILITY Combined Single Limit <br /> - (EA Accident) $ <br /> Any Auto <br /> ~ All Owned Autos Bodily Injury <br /> - (Per Person) $ <br /> Scheduled Autos <br /> ~ Hired Autos Bodi Iy InjUry <br /> ~ Non-Owned Autos (Per Accident) $ <br /> - Property Damage <br /> (Per Accident) $ <br /> EXCESS/UMBRELLA LIABILITY Each Occurrence <br /> i Occ~ o Claims Made Aggregate <br /> Deducbble <br /> A Workers Compensation and WC 71949 01/0112008 01/0 112009 X I we Statu- I 10TH- <br /> Employers' Liability tory Limits ER <br /> Any proprietorlpartner/executive officer/member E.L. Each Accident $1 ,000.000 <br /> excluded? E.L. Disease - Ea Employee $1,000,000 <br /> If Yes, describe under special provisions below. E.L. Disease - Policy Lim~s $1,000,000 <br /> other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 <br /> Descriptions ofOperatlons/LocatlonsNehlcles/Excluslons added by EndorsemenUSpeclal Provisions: Client 10: 29-66-299 <br /> Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company": <br /> Apple Sign" Awning, LLC <br /> Coverage only applies to inj.J1ies incurred by South East Personnel Leasing, Inc. active employee(s) , while working in Florida. <br /> Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or CIly other entity. <br /> A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562. <br /> FAX: 813-948-2403 & 813-780-0021/ISSUE 06-09-08 (TO) <br /> RE>nln Date 11 /22/2007 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS BUILDING DEPARTMENT Should any of the above described policies be cancelled before the expirabon date thereof. the issuing insurer will <br /> endeavor to mall 30 days written nODce to the certificate holder named to the len, but failure to do so shall impose no <br /> obllgabon or lIablily of an,' kind upon the insurer, Its agents or representabves <br /> 5335 8TH STREET JZ4 .../~ <br /> ZEPHYRHILLS FL 33542 <br /> ,~ <br />