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<br />ACORDTII CERTIFICATE OF LIABILITY INSURANCE I DATI! (1IIIIIIDD1YYYY) <br />IPU34IVP 01/21/2008 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Lighthouse-Programs, LLC ONLY AND CONFERS NO RIGHlS UPON THE CERTIFICATE <br />301 E. Pine Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />Suite 350 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOIN. <br />Orlando, FL 32801 <br /> INSURERS AFFORDING COVERAGE NAIC" <br />INSURED INSURER A: SUA Insurance Company <br />Southeastern Companies, Inc. INSURER B: <br />3350 Bushwood Park Drive <br />Suite 200 INSURER C <br />Tampa, FL 33618 <br /> INSURER 0 <br /> INSURER E: <br /> <br />COVERAGES <br /> <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> =ES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BV ~ID CLAIMS. <br />:=: rl POLICY NUMBER POUCY EPl'ECTIVE POLICY !XPIRATION UIIIT8 <br /> ~E.RAL UABlUTY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL lIABILllY PREMISES (E':.I:~::';:ncel $ <br /> I CLAIMS MADE 0 OCCUR M ED EXP (Anyone pefllon) $ <br /> - PERSONAL & AfN II\IJURY $ <br /> GENERAL AGGREGATE $ <br /> - <br /> GEN'LAGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ <br /> I POLICY n ~PRT n LOC <br /> AUTOMOBILE. UABILITY COMBINED SINGLE LIMIT <br /> - $ <br /> A lIlY AUTO (Ea accidenl) <br /> I-- <br /> I-- ALL OWNED AUTOS BOOILY INJURY <br /> SCHEDULED AUTOS (Perpel1lOn) $ <br /> - <br /> - HIREO AUTOS BODILY INJURY <br /> NON-OI/VNED AUTOS (Per acciden1) $ <br /> - <br /> - PROPERTY OAlMGE $ <br /> (Per sccidenl) <br /> RRAOE. UABlUTY AUTO ONLY - EA ACCIDENT $ <br /> AIIIY AUTO OTHER THAN EA ACe $ <br /> AUTO ONLY: AGG $ <br /> EXCE8SIUIIIBRE.LLA UABlUTY EACH OCCURRENCE $ <br /> :J. OCCUR 0 CLAIMS MADE AGG REGATE $ <br /> $ <br /> ~ DEDUCTIBLE $ <br /> RETENTION $ $ <br />A WORKE.. COIIIPI!NSATION AND WSLTHPE 000082 04 12131/2007 01/01/2009 X I I~TJi- <br /> ~LCl'fERlr UABILITY $ 1,000,000 <br /> ANY PROPRIETORlPAATNERlEXECUTIVE EL. EACH ACCIDENT <br /> OFFICERlMEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1,000,000 <br /> ~~CI~~ribe ~~r $ 1,000,000 <br /> I PROVI I I EL. DISEASE - POLICY LIMIT <br /> OTHER <br />DESCRIP110N OF OPERATIONS I LClCATlONII fYEHICLEB f EXCLU8lOHS ADDE.D BY I!NDOMEMENr f 8PECIAL PIIOVIlIIONS <br />Coverage is extended to the leased employees of alternate employer (Alabama, Florida, Georgia, Indiana, Mississippi, <br />Texas and Michigan Operations Only): G.L. Steve Construction f 0203268 (Effective 08-01-02) <br />DISCLAIMER: The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized <br />representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or <br />alter the coverage afforded by the policies listed thereon. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br /> SHOULD /W'( OFTHE. ABOVI! DESCRIBED POUQES BE. CANCE.LLED BEPOREll1E EXPIRAllON <br /> DATEll1EREOF.THEIUUlNG MURERWlLL ENDl!AVOR'IOMAlLIlI DAY8WRlTTEN NCmCE.'IO <br /> ll1E CElmFICATE HOLDER NAME.D'IOll1E. LEFT, BUT FAlWRI!.'IO DO SO 8HALL IMPOlIENO <br /> OBUCMTION OR UABlUTYOF /W'( KIND UPONll1E.INlRJRER,ITlI AaEN'nII OR <br /> RI!PRESEN1lImVES. <br />City of Zephyrhills Building Department .....[IIM <br />AUTHOIlZED Rl!PRE.SENrAnVE. ........................................-. c....... <br /> ....... .. ..... <br />5335 8th Street . ~t:i~;:..:...::...:.:.:.;:;:..:. '.:~~.?:: <br />ZeDhvrhills FL 33540 Page 1 of 1 <br /> <br />ACORD 25 (2001/08) <br /> <br />C ACORD CORPORATION 1988 <br />