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<br />1J~/Zll/ZOOll FRI ll: 00 FAX 561 :n3 1747 ......... CHRIS TAMPA IlQ01orOl <br />A.CDRQ. CERTIFICATE OF LIABILITY INSURANCE I CIRTlI'lc:ATE NO./DATE <br /> ACOQ. '2G04G2. ~0?U6 <br /> OJ/25(20n 01:31 PI <br />,"~DUCER THIS CI!JmFICATE IS ISSUED AS A MATTEA OF INFORM4T1ON <br />Highpoint lli~k Service~ L~C ONLY AND CONP.R. NO RIGHTS UPON THE CER11FICATB <br />14160 DallaD Parkway 1t500 HOLDIR. THIS CBmFICATI! DOI!S NOT AMI!ND, I!XTI!ND E.!! <br />D_11iLli, 'rx 75254 <br />(800) 632-5096 INSURERS AFFORDING COVERAGE <br />IIN!IllIiI!D!"II ';(Ms" "'ti aN r IN!URER ^' Can"an1on PronQrtv and CaliuiL1tv InliuranClI;I C <br />J " C CARPENTRY, INC. INSURER B; <br />13461 79 CT, NOR~R INSURER 0; <br />WEST PALM BEACH, FL 33412 INSURiR D; <br />(5&1) 333 -7-'04 Fax: ( Stil) 333-7747 INSURO'II:: <br />THli POLICIES OF INSURANCE USTED BELOW HAVE ElEeN ISSUED TO THi INlURiD NAMiD AiOVE FOR THE ..OLlCY PERIOD INDICATeD. <br />NOTWITHSTANDING <br />A~~.~~~~RI!MENT, TllRr.1 OR CONOmON OF ANY CONTRACT OR O'I'HER DOCUMENT WITtl RESPECT TO WHIc:t1 THIS CERllFICATE MAY E1E <br />~ lYpeOl'INSUMNCf POLICYNUMll!ft ~~ UMITS <br /> ~I!NI!:AAL UAI!1LllY I!"'CH OCCUAA!NCI! S <br /> 10- O""MERCIAL CENI!/W. L'A!lIUTY I'IRI: DAM!\GI: (My 011' "re, , <br /> I- CLAIMS M!\DE 0 OCCUM MI:D I:lCP 1M, 0", 1II1I0n) S <br /> 10- PI&ASONAl. , AlN INJURY S <br /> - GeN~ML AGGrteGAu S <br /> ~N1. AQQ~En ~rMIT "nS peR: I'I'IO~. OOMP'lO"!\GO $ <br /> I'QUCV F,.fl~ LOO <br /> ~UTOM081~; UA8ILITY OOMIIINIOD $INGLIO LIMIT , <br /> AN'( AIITO (fa acddenU <br /> - <br /> AlL OWNED AVTOS IiOPI!,V IN,jUl'l'f <br /> f- a <br /> SCHI:OULl!:D AUTOS (Ptr pelton) <br /> - <br /> WI"'O AUTOS BODlLT INUI'IV <br /> - $ <br /> - NON.()WI';EO AUTOS (PW .Cl:id.n1) <br /> - PROPERTY DAMAGE S <br /> (Per accicIonl) <br /> ~RAG' l.I,lIlI~ITY AUTO ONLY .I!'" ACCIDENT $ <br /> !\N'f AUTO OTHliR THo\N I:...ACC S <br /> AUTO ONLY: AGG i <br /> ~I!CS UABlLITY eACH OOOVIIIII!NOI! s <br /> '"- OCCUR 0 CLAIMS hti\Dl: AGOIII!CilTI! . <br /> S <br /> I- OEPUCTIIlLE <br /> $ <br /> ~ <br /> 1Il!T!r-mON S S <br /> WOAKllRI <:OMPIiNSATlON ANll x f'''''!OTATU.. I 10J:lt <br /> I!M'LOVeAS' LlA~LITY WC77779990601 04/01/2008 04/01/2009 s 1000000 <br /> l!.L I!ACH ACCIDI!,," <br />A E.L D18I:A8l! - EA EMPLOYEE S 1000000 <br /> ".1- 0l8I!AS~. "OUCY LiMIT , 1000000 <br /> :rIA LIWITS S <br /> UWITS S <br />olSCAlPTlON 0,. OP1!IIATlDNSlLOCATIONSlVIIMlCl.QIEXc;I.U510NI IIPPIP .., PfElOMEMENTlSPECIAL PAOVICICltfS <br />1. Insured is afforded Occupational Accident Coverage as . co-employer under the policy for employeell <br />lea~ed from ANS Staff Lca.ing. Inc. 2. 'mi. c.r~ifica~e remains in cffoct, providod tho cliont's <br />account ili in good stiLnding with AMS. COver~go i. not provided for any employee for which the c1i~t <br />~.s not repor~ing wagee to AHS. Applies to lOot of the employees o( AMS lea~ed to J & C CARPENTRY, <br />INC., effective 04/01/2008 <br /> "''''8 I I ADIlITIONAL INSUAI!D: INSUAIIA L;TTCJl: .... ...."'. ........., <br /> SHOULD ANY OF TMIi AIIQVIji DACIIIRiD POLlCIIilIiIi CoIi/t4C;SI.LliD R"FOR" na;: IiXPlllAllOii <br /> DoIiT1: 'Tlfl:llrol'. TH!! ISSUING INSUReR WILL eNDeAVOR TO MAIL 30 DAYS WAITTIN <br /> CITY 01-' ZIOPHYRJfILLS NOnCE TO 'Tlfa e'RTII'lCAft HOLDIUI _ID 'to 'tHI lU't. ell'l' ,&11.1I... TO DO 10 'HALL <br />fiJJ5 8 TII STREET IMPOS. NO ORLIlIA110NOII UARIUTT OPANT KIND UPON TltIINl..-, I7WA_O~ <br /> b~: 813-760-0021 AGPIICJ:IWTATlVIiI- <br />ZEPRYRRrL~S. FL 33542 AUlJ10rua:o AI:P11IlSINTAl1VJ: l -. ", <br />ACORD 25.S \TI9TJ o ACORD CORPORATION 19 I <br /> <br />, <br />