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Oct 23 09 09:57a Lg Edwards Ins 3525676766 p. ipti5iii]br CERTIFICATE OF LIABILITY INSURANCE OP ID RE DATE(MNMDD/YYYY) GAVIN -1 10/23/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE L . G. Edwards Insurance Agency HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P . O . Box 1548 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Dade City FL 33526 -1548 Phone : 352 - 567 -6751 Fax: 352 - 567 -6766 INSURERS AFFORDING COVERAGE NAIC # INSURED INSURER A: Atlantic Casualty Ins Co INSURER B: Gavin Roofing Rick Gavin dba: INSURER C: P 0 Box 1363 INSURER D: Dade City FL 33526 1 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MK AWL' POLICY EFFECTIVE POUCY EXPIRATION LTR INSRD TYPE OF INSURANCE POUCY NUMBER DATE (MMIDD/YYYY) DATE (MMIDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE S 300,000 A X COMMERCIAL GENERAL LIABILITY L0830047240 08/04/09 08/04/10 PREMISES( Ea $ 50,000 CLAIMS MADE X I OCCUR MEO EXP (Any one person) $5,000 ^_ PERSONAL & AOV INJURY S 300,000 GENERAL AGGREGATE _ S 300,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG S 300,000 POLICY n 1.;EC7 7 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY NON -OWNED AUTOS (Per accident) $ - PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN - EA ACC S AUTO ONLY: AGG S EXCESS /UMBRELLAUABIUTY • EACH OCCURRENCE _ $ 7 OCCUR 1 CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ $ ND EMPLOYERS' LIABILITY Y / N ITORY S I lOER ANY PROPRIETOR/PARTNER/EXECUTIVEE OFFICERIMEMBER EXCLUDED? E.L. EACH ACCIDENT S (Mandatory In NH) EL. DISEASE - EA EMPLOYEE $ X yes, describe under SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT _ $ OTHER DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITYOFZ DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL CITY OF ZEPHYRHILLS IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR 813- 780 -0021 5335 8TH STREET REPRESENTATIVES. ZEPHYRHILLS FL 33541 Au REPR ryNTATIVE ACORD 25 (2009/01) ® 1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD