Laserfiche WebLink
• <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCE SZP5YN4 D 0 4/ 2009 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Risk Transfer Holdings ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 301 E. Pine Street HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Suite 350 ALTER THE COVERAGE AFFORDED BYTHE POLICIES BELOW. <br /> Orlando, FL 32801 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA:Guarantee Ins. Co. <br /> C. Michael Brown DBA Advantage HR <br /> Dalton & Owens Electric Services, Inc. 1513 INSURER B. <br /> 4425 SW Martin Hwy. INSURER C• <br /> Palm City, FL 34990 <br /> USA INSURER D: <br /> INSURER E. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR AOD'L POUCY EFFECTIVE POUCY EXPIRATION <br /> LTR /NSRD TYPE OF INSURANCE POLICY NUMBER DATE (MIWDD /YYI DATF (MM/DDNYI LIMTS <br /> GENERAL UAW UTY EACH OCCURRENCE $ <br /> LAMM.E f HEN EU <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ <br /> CLAIMS MADE ❑ OCCUR MED EXP (My one person) $ <br /> PERSONAL 8 ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ <br /> 7 POLICY n JFs r n LOC <br /> AUTOMOBILE LIABI <br /> COMBINED SINGLE LIMIT <br /> _ ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> _ SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY <br /> NON -OWNED AUTOS (Per accident) $ <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABIUTY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN <br /> EA ACC $ <br /> AUTO ONLY. AGG $ <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR n CLAIMS MADE AGGREGATE <br /> DEDUCTIBLE _ $ <br /> RETENTION $ $ <br /> A WORKERS COMPENSATION AND GPE0195000001 -109 01/01/2009 01/01/2010 X I WCS I IOTH- <br /> EMPLOYERS' LIABILITY TORY I IMITS 1 1 FR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> E.L.DISEASE - EAEMPLOVEE $ 1,000,000 <br /> Ilyes describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br /> Coverage is extended to the leased employees of alternate employer (Florida Operations Only): Dalton & Owens Electric <br /> Services, Inc. 41513 (Effective 6/1/08) DISCLAIMER: The Certificate of Insurance does not constitute a contract between <br /> the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively <br /> or negatively amend, extend or alter the coverage afforded by the policies listed thereon. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAI L 30 DAYS WRITTEN NOTICETO <br /> THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURETO DO SO SHALL IMPOSE NO <br /> OBUGATION OR UABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> City Of Zephyrhills Building Dept. <br /> 5335 8th St. AUTHORIZED REPRESENTATIVE • <br /> 2eph <br /> 2ephyrhills, FL 33542 ..r'; � <br /> Page 1 of 1 <br /> ACORD 25 (2001!08) ® ACORD CORPORATION 1988 <br />