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ago CERTIFICATE OF LIABILITY INSURANCE DATE TE(MM /DD/YYYY) <br /> 5/26/2009 <br /> PRODUCER Phone: (727)772 -7800 THIS CERTIFICATE 1S ISSUED AS A MATTER OF INFORMATION <br /> Fax: (727)797 -7310 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> AIM Insurance Group. Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 3607 Alt. 19 N. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> P.O. Box 860 <br /> Palm Harbor, Florida 34683 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: Bridgefield Casualty Insurance Company i 10335 <br /> Jack's Shore Breeze, Inc. _ <br /> 9604 SR 52 [ INSURER B: <br /> 7 — <br /> Hudson, FL 34669 INSURER C: <br /> 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 ADM- - - - - � POLICY EFFECTIVE POLICY EXPIRATION - - - -- <br /> LTR INSRO TYPE OF INSURANCE ! POLICY NUMBER DATE(MM /ODIYYYYI DATE (MMIDD/YYYY1 LIMITS <br /> I GENERAL LIABILITY EACH OCCURRENCE $ <br /> I <br /> COMMERCIAL GENERAL LIABILITY PRM TO aENTED <br /> f ■ - __ , ,,, PREMISES (Ea occurrence) $ <br /> CLAIMS MADE OCCUR I 1 ! MED EXP (Any one person) $ <br /> I I -- – PERSONAL & ADV INJURY 1 I $ <br /> I <br /> I - -- – — _ GENERAL AGGREGATE i $ <br /> ■ GEN'L AGGREGATE <br /> AUTOMOBILE LIABILITY PRO- APPLIES PER: PRODUCTS COMP /OP AGG j $ <br /> I POLICY I I JECT LOC <br /> ILITY <br /> `, ANY AUTO COMBINED SINGLE LIMIT $ <br /> (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> , HIRED AUTOS <br /> BODILY INJURY <br /> NON -OWNED AUTOS (Per accident) $ <br /> —~ - -- -- – PROPERTY DAMAGE $ <br /> I �� (Per accident) <br /> GARAGE LIABILITY <br /> AUTO ONLY - EA ACCIDENT $ <br /> --� ANY AUTO ' EA ACC $ <br /> OTHER THAN _ <br /> i AUTO ONLY: AGG $ <br /> i EXCESS / UMBRELLA LIABILITY <br /> i _ — EACH OCCURRENCE $ <br /> i i <br /> j OCCUR � CLAIMS MADE li AGGREGATE $ <br /> ____1 DEDUCTIBLE $ <br /> , [ R ETENTION $ I I $ <br /> A j WORKERS COMPENSATION i WC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY <br /> Y / N 01 9604534 6/29/2008 6/29/2009 TORY LIMITS 1 ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500,000 <br /> If yes, describe under 500,000 <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT j $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> Holders Nature of Interest : Certificate l lolder o SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> City of Zephyrhills NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> 5335 Ht}] St. IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Zephyrhills, FL 33542 <br /> THO T ENTATIVES. - <br /> IZED REPRES TA <br /> ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />