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<br />08/20/2008 11: 08 FAX 8138753220 <br /> <br />HAMEROFF INSURANCE <br /> <br />III 002/002 <br /> <br />ACORD... CERTIFICATE OF LIABILITY INSURANCE DATECM~ <br /> 9/20/2008 <br />PRCXMICER (813)870-6284 FAX: (813)875-3220 THIS CERTlFlCA TE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Haaeroff Insurance AgBnc:y HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />PO Sox 270127 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />~1UIII:la FL 33689 INSURERS AFFORDING COVERAGE HAIC. <br />INSURED INSURER II: American States 19704 <br />~BCMAS Q LISNOCK ZU:CmI:CAL CO INSU",B: <br />22911 SnRLXNC MANOR LOOP INllURER c: <br /> INSIJR!iR D: <br />L'tnZ I'L 33549 INSURER E: <br />THE IIOLlC1ES OF INSURANCE USTED BilLOW HAVE BeEN ISSUED TO THE INSURED NAMED ABOVE FOA THE POLICY PERIOD INDICATED. "O'lWlHSTANDING ANY <br />REQUIREMENT. TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT \MTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HER~!.~_1S SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICIES. <br /> lTJ: <br />== lYPi OF IrcsURANCE PCLlCY NUMBER '>>Ir':~ '1ALfl,~N ~tTS <br /> ,!!Nl!IW.l.IAII.IlY . 1,000,ODO <br /> X COMMeRCIAl. GENERAL LIA8IlJTY I rWiAr.i! TQ ~ . 200,000 <br />A I ClAIMS MADE [!] OCCUR 01CB90002490 3/9/2008 3/9/2009 Ml!O EXP'_ one_I . 10,000 <br /> - ._.-.._~ I. 1,000,000 <br /> I-- OI!NEIW.. AGG~GAl1O . 2,000,000 <br /> @LA~n~;;AnS PE~ . .- . 2,000,000 <br /> X POLI~Y P LOC <br /> ~UTOM08ILlIJAIIL'T'l' COMBINED liNGLe LIMIT $ <br /> (Ea_1] <br /> - ANY AUTO <br /> "'- ALL OWNED AI1TOS 80DIL Y INJURY <br /> IP"~1 . <br /> - !lCHI!OtJLED AUTOS <br /> ...- HIRED AUTOS BODILY INJURY <br /> (per IllOlllenll e <br /> - NON.oWNED AIITOS <br /> PROPeRTY DAMAGe . <br /> IPer 8mlcMnl) <br /> GARAGE UAIIUT'l' "lITO ONLY. leA ACClDIiNT . <br /> ==i Atl't AUTO OTHI!R THAN ... ....". . <br /> AUTO ONLy: AM . <br /> E!XCesstU8IIIRELLA l.IA8lLlT1' <br /> tJ OCCUR 0 CLAIMS MADE '. <br /> e <br /> q DEDUCTIBLE . <br /> RETEN110N s ~I . <br /> WOAKERI COMPI!NlA11ON AND I~' <br /> EIII'l.OYERS' UA8lUT'l' <br /> IWY PROPRlE!TORIP~CUTlVE I!.L eACH ACCIDENT . <br /> Ol'F1CIiR/NIelllISR EXCLUDED? E-L DISeASe. eA EMPLOYEE . <br /> ~~,~Ile unGer ,_..... I'l 11111I'JlLOOl....D...."""',..... '. <br /> OTHefl <br />OIl8CAlP'nON OF OPI!RA'nONlll.OeA'nON.......Cl.B8lllXCLUSlON8 AGOEO "., SNDOMEMINTIlPECW. PROIIl.ONI <br />1.0 Day. Wl:Ltten MOC ~~ DOft-paytlell.t.. <br />CERTIFICATE HOLDER CAN~LATION <br />(813)780-0021 SHOULD ANY OF THE AlIOVE DEICAlIIED POuClI!8 IE CANCILLI!D II!FORI! 'TMI <br /> City Of Zepny:hi11a ElCf'8RAllON DA'T1!! THI!Ia!OP, THE IB8UING lN8UIU!R WILL ENDEAVOR TO ..... <br /> 5335 18th St. ~ DAY8 WRm8I NOllC8 TO 1M1I! CMTlFlCATI! HOLDI!R UAIIeIl m THE LEFT, BUT <br /> Zephyrhi11s, n. 33542-4312 FALU. TO 00 eo SHALL IMPOIE NO ClIlUGtlllON Oil UA8lLlTY OF ANY IlIND UPON 'TNB <br /> _"'R ms AGEHnI DR IlEPRElIENTA11IIES. <br /> AUTHORIZED REPRElENTA1lYE ~e- ~<:.r" e. v?7 <br /> Al.Hameroff/DEVIN <br /> <br />ACORD 25 (2001108) <br />...en.,,, ,n",., ...... <br /> <br />C ACORD CORPORATION 1981 <br /> <br />8......1 """, <br />