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<br /> <br />ADDITIONAL.. INFORMATION <br /> <br />CERTIFICATE NUMBER <br />404649 <br /> <br />PRODUCER <br /> <br />COMPANIES AFFORDING COVERAGE <br /> <br />Marsh, loc. <br />1166 Avenue of the Americas <br />New York, NY 10036 <br />Telephone (212) 345-5000 <br /> <br />INSURED <br /> <br />SimplexGrinnell, LP <br />4701 OAK FAIR BLVD <br />TAMPA, FL 33610 <br />United States <br /> <br /> <br /> <br /> <br />WORKERS COMPENSATION POLICIES <br /> Carrier Policy Number Eff. Date Exp. Date State <br />(B) American Home Assurance Co. WC 1616576 6/29/2007 6/29/2008 CA <br />(B) American Home Assurance Co. WC 1616584 6/29/2007 6/29/2008 AOS <br />(D) Illinois National Insurance Co. WC 1616577 6/29/2007 6/29/2008 MI <br />(C) Commerce & Industry Ins Co WC 1616582 6/29/2007 6/29/2008 FL <br />(B) American Home Assurance Co. WC 1616581 6/29/2007 6/29/2008 NJ <br />(A) AI South Insurance Co. WC 1616578 6/29/2007 6/29/2008 GA <br />(B) American Home Assurance Co. WC 1616579 6/29/2007 6/29/2008 PA <br />(F) New Hampshire Ins. Co. WC 1616580 6/29/2007 6/29/2008 NY,WI <br />(B) American Home Assurance Co. WC 1616585 6/29/2007 6/29/2008 OR <br />(E) Insurance Company of the State of PA WC 1616583 6/29/2007 6/29/2008 AR,MA,VA <br /> <br />LIABILITY PROGRAM <br /> <br />Project: City of Zephyrhi11s <br /> <br />If there is a question regarding this certificate please contact Ty10n Boyd <br />(Email: tyboyd@tycoint.com Phone: 813-626-5482) <br /> <br />CERTIFICATE HOLDER <br /> <br />City of Zephyrhills <br />5335 Eighth Street <br />Zephyrhills, FL 33542 <br /> <br /> <br /> <br /> <br /> <br />