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10/30/2009 08:08 2399852122 PAGE 02
<br /> .... .. ; c@RTIFICATE NUMBER
<br /> . IR'I1FICATE.OF: INSURIANCE 628791
<br /> '
<br /> PRODUCER 'n11e CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AN0 CONFERS 140
<br /> RIGHTS VPON THE CERTIFICATE HOLDER OTHER THAN THOSE PROVIDED IN THE POUCY.
<br /> THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BV THE
<br /> POUCIES DESCRIBED HEREIN.
<br /> Marsh, Inc. COMPANIES AFFORDING COVERAGE
<br /> 1166 Avenue of the Americas
<br /> New York, NY 10036 COMPANY A: Al South Insurance Co.
<br /> Telephone (212) 345-5000 COMPANY 13: Commerce & Industry Ins Co
<br /> COMPANY C: Fireman's Fund Insurance Company
<br /> INSURED COMPANY D: Illinois National Insurance Co.
<br /> COMPANY E: Insurance Company of the State of PA
<br /> Master Protection. LLC COMPANY F: Nat'l Union Fire Ins Co of Pittsburgh, PA
<br /> dba FireMaster COMPANY G: New Hampshire Ins. Co,
<br /> 13050 Metro Parkway, Unit 1
<br /> Fort Myers, FL 33966
<br /> United States -
<br /> COVERAGES
<br /> THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE tNSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING
<br /> ANY REOUIRMENTS, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE
<br /> AFFORDED BY THE POLICIES USTED HEREIN IS SUBJECT TO ALL THE TERMS. CONDITIONS AND 6XCLUSIONB OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDuCEO BY
<br /> PAID CLAIMS, _ ..-
<br /> CO TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE POUCY LIMITS
<br /> LTR DATE (MMIDOIYY) EXPIRATION
<br /> G GENERAL LIABIU Y GL 09043 - 63 (Primary GL) 10/1/2009 10/1/2010 GENERAL AGGREGATE 54.000,000.00
<br /> X COMMERCIAL GENERAL, PRODUCTS - COMP/OP AGO $4,000,000.00
<br /> CLAIMS MADE L' J ocCU PERSONAL A AOV INJURY $2,,p00...0_00.00
<br /> OWNER'S & CONTRACTOR'S EACH OCCURRENCE $2,000,000.00
<br /> FIRE DAMAGE (My PAP No) $1.000,000.00
<br /> MED EXP (Any ono person) $10.000.00
<br /> F AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT
<br /> _AUTOMOBILE 091 (M A) 10!1/2009 10/1/2010 57,500,000.00
<br /> F X ANY AUTO CA 091 -93 -97 (VA) 10/1/2009 10/1/2010
<br /> F X HIRED AUTOS CA 091 -93-96 (AOS) 10/1/2009 10/1/2010
<br /> . X NON-OWNED AUTOS ii we sT
<br /> A WORKERS coMPENe XJ atuT7RV oTae ATION AND WC 060 - 113.8747 (CT,GA,PA,SC) 10/1/2009 10/1/2010 ccv A
<br /> B EMPLOYERS' LIABILITY WC 080-18-8741 (FL) 10/1/2009 10/1/2010 ' .
<br /> EL EACH ACCIDENT $2,000,000.00
<br /> D THE PROPRIETOR! WC 060.18.8744 (MI) 10/1/2009 10/1/2010 EL DISEASE-POLICY LIMIT $2,000,000,00
<br /> E PARTNERS/ExECUTWE WC 060-16 -8745 (AR,MA,VA) 10/1/2009 10/1/2010
<br /> F OFFICERS ARE: WC 060.16.8742 (OR) 10/1/2009 10/1/2010 ELDISEASE.EACH $2,000,000.00
<br /> F WC 060.16 -8740 (CA) 10/1/2009 10/12010
<br /> O wC 060 -16-8748 (AOS) 1011/2009 10/1/2010 —
<br /> 10/1/2009 10/1/2010
<br /> G WC 080 -1�6 -8743 (TX)
<br /> G WC 060168746 (ND,NY,OH,WA,WI,WY) 10/12009 ' 10/1t2010
<br /> ,
<br /> EXCESS LIABILITY GENERAL AGGREGATE $11,000,000.00
<br /> G X 0114ER THAN UMBRELLA FORM GL 090 - 73 - 84 (Excess GL) 10/1/2009 10/1/2010 PRODUCTS . COMP/OP AGO 511, 000,000.00
<br /> EACH OCCURRENCE $5,500,000.00
<br /> 71 UMBRELLA FORM _
<br /> pROPERTY
<br /> OTHER
<br /> C Bukdar'a Risk/netelIenon/ConlreCt WORM OC 9112960 5/1/2009 5/1/2010 Liar) $1,000,000,00 par /Obs4e
<br /> d Rental Equipment/Contractor's Equipment OC 9112660 5/1/2009 5/1/2010 USD 31.000,000.00 per/absile
<br /> C BIenKMt Tranos OC 9112960 5/1/2009 5/1/2010 USD 51,000,000.00 par common*,
<br /> ' DESCRIPTION OF OPERATIONS /LOCATIONSIVEHICLES/SPECIAL ITEMS
<br /> pre /Act: city of 2aphyrhilln
<br /> CERTIFICATE HOLDER , CANCELLATfON •
<br /> City of Zephyrhills SHOULD ANY OF TNa nOUCIEB OEBI.CO HEREIN BE CANCELLED BEF T H E EXPIRATION D
<br /> rA ATE THEREOr. THE
<br /> INSURER AFFOROINO COVERAGE WILL ENDEAVOR TO MAIL Zia OATS WRITTEN NOTIOE TO WIG CERTIFICATE NOLOCrt
<br /> 5335 Eighth Street BUT COVE RAGGE, BMW NONCE OR LABILITY
<br /> Zephyrhills, FL 33540-4312 REPRF_9 NTATIVEB, OR THE i$SUIROFTN B CERTIFICATE.
<br /> United States ( -.}--, ---.
<br /> MARSH USA INC, BY: FranNln HoNock, Global Matins
<br /> Davld KonO, CowAly ProgrAM Two Prepram
<br /> vduo"
<br /> AS OF :1/30/2009
<br /> L.Or qu,Aeiena renar"tag chin e,rtirioat.n eentnct: Mary vgge (Rmail: marm9e0rirnmaater mpc,CO' Clone: 230_ee0 1693(
<br />
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