|
<br />! ACDB.Il. CERTIFICATE OF
<br />I'~;:;~et~ c~vera~, Inc. .
<br />
<br />, PO :Box 906
<br />I Palm Harbor, ~L 34682
<br />727-216-3509
<br />INSUReo Ace Alumi.num & Construction, LLC. '
<br />Richa~d Shaffer
<br />4926 Airport Ro::a.d , IN~IIRFR C
<br />Zephyrhills, Fl 33542 Ir.$UFlER D ._____
<br />i ,813-782-2616 'iNSURER S i
<br />COVERAGES : I
<br />! THE POLICIES OF INS!JRANCE LISTED BEI.OW HAVE BEEN iSSUED TO THE INSURED /liAMEO ABOVE FOR THE POLlCY PERIOD INCICATEO. NO'1\NITHSTAND1Nr-1
<br />! ANY REQUIREMENT, TERM OR CONDiTION OF ANY CONT~CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIfICAT! MAY 6e ISSUED 0'1 '
<br />MAY /"1!1'l;"AIN, TI;E IN$uAANCI! ArrO~OCD ov THIlt I'OI"IOIl:S DESCRIBED HEREIN IS SuBJECT TO I1U THI! TERMS.. FXr.ll ,:l;,ON!li AND CONDrTlONS CF SUC'tl
<br />POLICIES. AGGREG.I.,TE liMITS SHOWN MAY HAVE SEEN REDUCE;O IY PAlO Cl-1IMS , I
<br />INII" "'DO'L [ ..' .. I PO~ Y ~i'FEj<;W'" I P8,UCYEXPIRAT~. l---...J,
<br />i LT" IINaRO tyPI! O~ INSI!AA~CF. I POLICY NU~BER MMIDO TF- 'MM/DDIYY LIMITS I
<br />I 'I ~~.eML ~'ABILlty i i E^CII oee\JMtl~CC: -!, 1.000~ OO~L'
<br />'---1 I ' DAMI'\l:i1:: I \) KIM" I ~u
<br />j X I CO~E~C!AI. GENE~i'Aelllty , ~MISES lEi Q~<;.:;r~""'o} i $ SO I 000 I
<br />. f---l--.i CLAIMSMAoe L-, OCCUR i I MEOeXF':AnYQn"p,,,son) : $ 5 ~_OOO
<br />Ai Li [Binder 5/17/2009 iPERSONAl&/lDVI~JUf'\Y 2-L.Q.OO}000:
<br />
<br />I II; ! OEN5'lAl AGGREGATE : G 1.-...._0j)0 i 000 i
<br />I i !;:;N.L A~GREQAT" LIMIT APPLlea PER I .! ! "~onl.Ir.T!': _ t.('}MFi0P AC'..G I s 1. 0001 000 'I'
<br />'~I ~I F'RO r--"I , I ...-. ,. . -
<br />l.---i--.J X I POliCY I 'JEcl I I :,oc I I I I ~:
<br />
<br />! I ~OMOBILELiABI~lty i '" i COMBINEO SINGI,I, LIMIT i i II. 00 : 000 I
<br />I LI ANVAUTO: '. i lIl:loouU.",I' ,----1--..::> r __._,
<br />
<br />: l--: ALLOWNEOAUTOS I I MCtLVIIIIJUR1 ' S I
<br />I I X I OCII r.OULEO AUTOS i I' (Per pereon)
<br />
<br />A: r-: ioIlRED AUTOS ! Binder 5/17/20e8 ! 5/17/2009 , BOOILYINJUflY 1$
<br />!-I NON.OWNEDAIJ'iOl; : (Perec.:lden'.) I
<br />
<br />f-.--i: ! F'IlC"eRTY DAMAGE I s
<br />I I 1 \Peracclden'l
<br />, , 'i I
<br />L.:~r;U~F IIAl.llLllY A'JTOONL't'-EAACCIOENT !
<br />~I ANY AUTC : i I OTHEFl THAN EAACC i $
<br />I AUTO ONlY: AGG: S
<br />I
<br />I
<br />ill
<br />
<br />LIABILITY INSURANCE
<br />
<br />DATE!MMIDDIY"IWY)
<br />
<br />I 6/19/2008
<br />THIS CERTIFICATE IS ISSUED A~ A MAHeR OF INFO~MATIO'"
<br />ONL.Y AND CONFERS NO RIGHTS UPON THE CERTIFICA1'e
<br />HOLDER. THIS CERTIFICATE DOES NOT AMEiNO, EXTEND OR
<br />AL. TER THE. COVERAGF AFFORDED BY THE POI..ICIES BEL~
<br />
<br />...J
<br />I
<br />
<br />I
<br />, INSURERS AFFORDING COVERAGE
<br />
<br />I NAIC#
<br />I
<br />
<br />IN5uREIIl A. F:l.rse Commercia.l .LnsuraflC;;t Co
<br />r;;UR~Fl B
<br />
<br />~-,..,____-i
<br />I !
<br />
<br />,_I
<br />
<br />I
<br />I
<br />I
<br />~
<br />!
<br />
<br />---,
<br />I
<br />,
<br />
<br />~I EX~ES5IUMaIllELLA UA~!~II y
<br />\ r--l
<br />_I OCCuR LI CtAlMSMAOE
<br />
<br />, .
<br />_._~
<br />
<br />1
<br />II
<br />
<br />I
<br />~C~ OCCURR&~E
<br />~GGReGATE
<br />
<br />:516883
<br />I
<br />I
<br />I '
<br />~ I: I
<br />I OESCi'lIPTlON OF OI"EFlAT10NSI LOCATIONS I VEHICLES I EXCLUSION$ADOEO ev ENDOflS"f1ENT i SPECiAl Pi'lOVIS10NS
<br />Coverage includes Richard Shaffer License# caCl329266
<br />
<br />, i 6/17/2008
<br />I
<br />I
<br />
<br />!
<br />i
<br />i
<br />I
<br />:
<br />I
<br />, 6n 7 /.2009
<br />!
<br />I
<br />
<br />1$
<br />Is
<br />r---- I
<br />! $
<br />I I
<br />i~
<br />I Wl,;~ ATU. I !OlH~ I
<br />I X I TonVCIMITS I .-J_~!Li
<br />I E L. EACH ACCIOENT I $
<br />~ '--r
<br />c!~':. o SEASE - Ell. EM"LOYE~ $
<br />E.l. O'SEME. POLICY LIMIT I S
<br />
<br />I
<br />~,'i----,
<br />-+-----1
<br />~..-._,
<br />: I
<br />. --.I
<br />I .
<br />. I
<br />1001 000-:
<br />1.'--
<br />.5~QOjl 000 I
<br />lQO~, 000 :
<br />
<br />i:
<br />
<br />~-
<br />I ,
<br />. ! L-! DEDUCTIBLE
<br />
<br />H I I RETENTION $
<br />I ' If'ORKE.f(~COMP~N:r.ATION''NO
<br />I ! EMPLOYERS' LIABILITY
<br />, I' f\NV P~Ol'l\iETO~I~ARTN'E"'EX!eVTIVe
<br />, A OFFQ"'",EMBEI'I EXC.\JDEO'
<br />
<br />~~~c~r;~ov~5\'ONS belOW
<br />OtHeR
<br />
<br />, i
<br />
<br />j I
<br />I.
<br />I
<br />
<br />L
<br />GE~TIf'ICATr: HOL.DI!I\
<br />
<br />.--4--__._
<br />
<br />J
<br />
<br />i
<br />ACORD2512001/08)
<br />
<br />CAN<:ELLA TION
<br />I SHOULO ANV OF THE A30ve DESC~leE:> PO~lC',ES 8li CANCELL,," eeFORE THE E)(~IRATION
<br />DATE THERI!OF. THE IMulNG INSURER W1-~ EN~"'V"R TO MAIl.!.L DAYS t'll."EN
<br />NUnCf:: TO T>-lE CERTir:IC!ITE HOLDER NilMriD TO THE lEFT BUT FIIIUJRE 1'0 1)0 ~o SI-IALL
<br />IMPOSE NO OElLIGATlON 01'1. LlABILICV or: ANY KIN;:) uF'ON THE INSl.'RI!R res ".G~NTS OR
<br />h "EPR~ SENT A T1VF';
<br />I ,\UTHOl'l.lZeO RePRESENTO,TIVE
<br />
<br />......
<br />
<br />
<br />~AOO~D OORF'OI'tATlotiI1900
<br />!
<br />
<br />
<br />City of Zephyrhills
<br />:133.5 8th $l:.
<br />Zephyrhills, Fl 33542
<br />
|