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<br />ACORD.
<br />
<br />CERTIFICATE OF LIABILITY INSURANCE
<br />
<br />OP'D KF I DATE (MM/DDIYYYY)
<br />KENNE-3 04/28/08
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
<br />ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
<br />ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
<br />
<br />INSURERS AFFORDING COVERAGE I NAIC #
<br />,
<br />24112
<br />02186
<br />
<br />westfi.ld Insurance COJllp..ny
<br />
<br />PRODUCER
<br />
<br />Greene-Hazel & Associates ,Inc.
<br />10739 Deerwood Park Blvd, #200
<br />Jacksonville FL 32256-2873
<br />Phone: 904-398-1234 Fax:904-396-7432
<br />
<br />INSURED
<br />
<br />i INSURER A
<br />! INSURER E
<br />
<br />CNA Insurance Companies
<br />
<br />Kennedy Contractors, Inc.
<br />Attn: Hr. Michael Carp'
<br />1495 Forest Hills Blv~ Ste A
<br />West Palm Beach FL 33406
<br />
<br />i IUSURER C
<br />,
<br />i INSi IRER 0
<br />~
<br />! INSUREFi:' E
<br />
<br />COVERAGES
<br />
<br /> THE POLICIES OF H'.lSURt:l!'.ICE LISTED BELeN'..' Ka.,VE BEH.J ISSUED TO THE InSUREC1I'-L,Q,MED,AECNE FOR lHE P()L!CY PERIOD Ir-.IOIC,c..TEO NOT'NIlH::iLt:lNDING
<br /> p.NY REOUIREt,!\EHT. TERM OR COi'lDlTlON OF ,o"NY CON'TRJI,CT OR OTHER OOCUt..1Er.rr ',I'./[TH RESPECT TO \/'/HICH THIS CERTIFIC;:.TE r~1.o:i BE ISSUED OR
<br /> Mil,,/" PERTAIN, THE H>JSURANCE AFFORDED 81 THE POLlC1ES DESCRIBED HEREIr>J fS SuBJECT TO P-.!...~ THE TERMS, !::)<:CLUSIONS AN[; COND~TION3 0F SUCH
<br /> POLlCIE:.:: A,G(:;REGATE LlI\rIlTS SHOWN M~,Y HAVE BEEN REDUCED BY PAID CLAIMS
<br />LTR NSRd TYPE OF INSURAt,CE POLICY NUMBER I DATE {MM/DD/YYI i r DATE' (MM/DD/YYI LIMITS
<br /> ,
<br /> i GENERAL LIABILITY EA:H (lCCURRENCE $1,000,000
<br />A ~~'1ERCIP.L ca.JERAL ""-BIL'TY CMM1642516 06/01/07 06/01/08 I PR~MI:;ES (Ea occur~nce) $150,000
<br /> I -LAII1'- W-E !XJ--.-u- r-rlEO E},'P (.A.n\l 0rli3 person) $ 10,000
<br /> i l.',.:J ....u '---.------- l.)l_l~ t"<
<br /> , I PERSON-A.L &. ADV INJURY ! 1,000,000
<br /> . ,
<br /> gJ'L AGGREGATE LIMIT APPLIES PER GEN:::RAL AGGREGATE $2,000,000
<br /> PRrJDUCTS COMPJOP AGG $2,000,000
<br /> n POLICY iXl :;~gT nLOC
<br /> I I AUTOMOBILE LIABILITY ! I COMBINED SINGLE. LIMIT 1..1,000,000
<br />A ~ AN! AUTO CMM1642516 I 06/01/07 06/01/08 i [Ea accident)
<br /> H""MC^~" I
<br /> , I $
<br /> 30DI~1- INJURY
<br /> SCHEDULED AUTOS (Per Derson) !
<br /> I HIRED I>,UTOS 80DIL Y INJUR'{ 1$
<br /> ~ ;~;:~ED P:;: (Pe: rKC-!dent) I
<br />A Damage CMM1642516 I 06/01/07 06/01/08 I PROPERTY D.AM.A.GE T
<br /> i I (Per accident) !$
<br /> I
<br /> I GARAGE LIABILITY I I AUTO Or'~L Y - EA ACCJDE.NT $
<br /> I H #,.,. ,".UTe I I E.A,.A.CC ! $
<br /> I I DTHER TJOt\N
<br /> , AUTO ONL Y ,LI.GG 1$
<br /> I I , ,
<br /> ~ESS/UMBRELLA LIABILITY EACH OCCURRENCE $5,000,000
<br />A X I O::CUR 0 CLAlr,AS tvLADE CMM1642516 06/01/07 06/01/08 AGGREG..o.,TE $5,000,000
<br /> ~ [ECUCTI8LE $
<br /> $
<br /> jX I RETErJTIOt J $0 , $
<br /> WORKERS COMPENSATION AND X ITC;~\tl':;ii5 I IOJ~. ,
<br />B EMPLOYERS' LIABILITY 2083385468 06/01/07 06/01/08
<br /> PJ,fT- PROPRJETClRJPARTNERJD<ECUTJVE t:._L... EACH .A.CClDENT i $ 500 ,000
<br /> OFFICEPJMEMBER EXCLUDED-' E.L DiSEASE - E.~ EMPLOYEE! $ 500 ,000
<br /> jlf ye~. describe under
<br /> I SPECIAL PROVISIONS below EL D'SEA.SE - POLICY LIMiT $500,000
<br /> I OTHER ! I I
<br /> I Leased/Rented , I
<br />B I 2083385437 I 06/01/07 06/01/08 , Rent/Leas 50,000
<br /> , Scheduled I
<br /> I I ! Scheduled 42,500
<br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS
<br />City of Zephyrhills is named additional insured.
<br />
<br />CERTIFICATE HOLDER CANCELLATION
<br />
<br />ZEPHYRH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
<br />
<br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAvOR TO MAIL 10
<br />
<br />DAYS WRITTEN
<br />
<br />City of Zephyrhills
<br />Fax: 813 7800005
<br />5335 8th Street
<br />Zephyrhills FL 33540-4312
<br />
<br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL
<br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
<br />REPRESENTATIVES.
<br />AUT ZE
<br />
<br />ACORD 25 (2001/OB)
<br />
<br />
<br />@ACORDCORPORATION19BB
<br />
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