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10/13/2006 03:28 8638750703 BIG_DADDYS PAGE 03/03 <br /> ACOR CERTIFICATE OF LIABILITY INSURANCE DArs e0^ I <br /> 04/02/09 <br /> moms THIS CERTIFICATE IB ISSUED AS A MATTER OF INFORMATION <br /> Omega Insurance Solutions ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 199 Menus K Se ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Winter Haven, FL 33880 <br /> Winter Haven FL 33980 1 INSURERS AFTOPDING COVERAGE NAIL a <br /> F191ER9C Omega Business Solutions Inc R A: GuiranteU Nrsularic 11398 <br /> 199 Ave K SE INI9UR Se Names Indemnet f �At AM Beef 20097 <br /> Minter Haven FL 33880 IN&URER C -- - ......... <br /> I INSURER 0;, .,.... _ <br /> COVERAGES '- <br /> THE POLICIES OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURE° NAMED ABOVE FOIL ;HE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> APR' RCOUIRIMSNT, TOW OR CONDITION OF ANY CONTRACT OR OTHER DOCIPAINT WITN RESPD.T 'I'n EAMICH rpMS CERTIFICATE MAY BE IS9UEO OR <br /> MAY PERTAIN. THE INSURANCE APPOROEO eY T'1 t POMP ORSCRINSO HEREIN is SUBJECT TO Aid 1 1.II: TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> 1 DOLICi8& AOCREGATE LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID OLAIM& <br /> j� WOW AP Nmasarn PODGY NtM 19g ll;Ifl�l%L •- � �� Mme. LIMITS — <br /> dIIIIRAL MAMMY Er <br /> ' . itI <br /> CO ERCIAL 0 MLI T .11t A ROCIPIP el_..0 -.- - <br /> .� CLAIMI MAD OCCUR ,�la EIO' perm i $ <br /> PEREINAL& AOV_jMURY S <br /> _,■ ORAL tlfjl�lRaeATB !� <br /> Nt Ts LIMIT APPLIES P9N; P�t�IP/�TS�fgMP/pPAGO 0 <br /> AUTOMDIELE LIABILITY • <br /> _ ANY AUTO trOMI INELE LIMIT <br /> ALL OWNEOAUTOS '— ' <br /> BOOST INJURY <br /> SCHEDULED ALTOS (( *r 1 --- <br /> _ HIRED AUTOS INJURY <br /> NON -OWN WI AUTOS NOMMES .......�� S <br /> •..— �— . .. PRCIPERTYDAMAGE s <br /> (Per i. duW) <br /> OBI LMeILITc , OATS ONLY - EA ACCIDENT 1 <br /> ANT AUTO OTINRTNAN EA ACC <br /> AUTO ONLY: AEG , 6 <br /> E R !IMIINIIIIOI.IA UANUTY , e,Gfi OCCURRENCE 1$ <br /> OCCUR ❑ cues MADE .6 1 <br /> 1 <br /> 1 DODUOTIBLE .. 1 <br /> RETENTION 1 $ <br /> WORKIlle COMPENIM110N AND "x L WO_ bTATLL p ry <br /> YJ.IIAttS.l. ,. .ER, . <br /> A pgp O ruA GPEO0193000001.109 01/0112009 01/01/3010 ,pS,I I� *cciDGNT x1,000000 <br /> A NY OI M E EARRLTu0EA E;CU1rvE <br /> .M. 0664@6•64 10AM S.. 1 , 00 0 000 <br /> r .IA t� NeENwelr <br /> C. DEMME- POI,ICY 1 1,000,000 . <br /> oTNER EL Each Acre 1,000,000 <br /> B Employers Liability RA•39$9 01/01/1009 01101/3010 EL Disease Ea Emp 1,000,000 <br /> _ EL Disease Pol Um 1,000,000 <br /> B$3 P110N OP OPENATIONI 1 LOCM1ONS ) mecums r sitcLumONE ADDED RT ENDORSEME NT f SPEOEAL PRO i W$ <br /> Jackie Peterson license 111110000937 <br /> Coverage Is extended to the leased employees of alternate employer (AL, FL, and GA Oniyl DIG DADDY'S SET UP SERVICE, LLC. <br /> (Effective 01/01/ 2009). DISCLAIMER The Certificate of Insurance does not constitute Et contract between the issuing ineu er(s), <br /> authorized representative or producer, and the certificate holder, nor dote it affirmatively or nagatlwly amend, extend or alter <br /> Dove .. e • • • .. the • • tales listed thereon. Covers • B Ben . . Uabii . • viand by National Indemnity (dRA -2389) . <br /> GERTI] ICATE HOLDER CANCILLATION <br /> City of Zephyrfiilla <br /> IN0UTAANYREF 1IE 0 B DN$c O0I PCU0NEDROANcIL 6OWORETHE E1fOMRJ1TRfN <br /> DATE Tourer, me snow IMJUNgR WILL ENDEAVOR TO MAIL 1 Q tors warren <br /> 53:15 91h 8R NOTICE TO NE GENT1NCA r F Mouses T AMIDTO TN[ LMT, MUT FAILURE TO DO SO SHALL <br /> IMPOSE NO °®EMOTION c•R maul OP ANY ICMO UPON he MUREX ITS AGSM Olt <br /> ZEE1phyrhllls, PL 33642 IsEEMIMEri <br /> AUTN01zIxap,s6e grrTA - are E.- e.ITs <br /> ACORP as (mum a • ACORD CORPORATION 1908 <br />