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06/02/2009 12:19 FAX 3526862891 WHITING AGENCY 8002 /002 <br /> CERTIFICATE OF INSURANCE <br /> The company indicated below certifies that the insurance afforded by the policy or policies numbered and <br /> described below is in force as of the effective date of this certificate. This Certificate of Insurance <br /> does not amend, extend. or otherwise alter the Terms and Conditions of Insurance coverage contained in any <br /> policy numbered and described below. <br /> CERTIFICATE HOLDER: INSURED: <br /> CITY OF ZEPHRYHILLS BUILDING WEST COAST ALUMINIUM AND <br /> DEPT SCREEN INC <br /> 5335 8TH ST 1451 ALAMEDA DR <br /> ZEPHRYHILLS, FL 33542 SPRING HILL, FL 34609 -5712 <br /> POLICY NUMBER POLICY POLICY LIMITS OF LIABILITY <br /> TYPE OF INSURANCE & ISSUING CO. EFF. DATE EXP. DATE ( *LIMITS AT INCEPTION) <br /> LIABILITY 77 -AC- 732952 -3001 10 -22 -08 10 -22 -09 <br /> [X] Liability and NATIONWIDE Any One Occurrence $ 300,000 <br /> Medical Expense MUTUAL <br /> [X] Personal and INSURANCE CO. Any Dne Person /Org $ 300,000 <br /> Advertising Injury <br /> [X] Medical Expenses ANY ONE PERSON S 5,000 <br /> fxl Fire Legal Any One Fire or Explosion $ 100,000 <br /> Liability <br /> General Aggregate* $ 600,000 <br /> Prod /Comp Ops Aggregate* _ $ 300,000 <br /> [ ] Other Liability <br /> AUTOMOBILE LIABILITY <br /> f 1 BUSINESS AUTO Bodily Injury <br /> (Each Person) E <br /> r 1 Owned (Each Accident) 3 <br /> [ ] Hired Property Damage <br /> r 1 Non-Owned (Each Accident) S <br /> Combined Single Limit $ <br /> EXCESS LIABILITY Each Occurrence <br /> Prod /Comp Ops /Disease <br /> [ 1 Umbrella Form Aggregate* <br /> STATUTORY LIMITS <br /> [ ] Workers' BODILY INJURY /ACCIDENT ._ $ <br /> Compensation Bodily Injury by Disease <br /> and EACH EMPLOYEE S <br /> [ 1 Employers' Bodily Injury by Disease <br /> Liability POLICY LIMIT S <br /> Should any of the above described policies be cancelled before the DESCRIPTION OF OPERATIONS /LOCATIONS <br /> expiration date. the insurance company will endeavor to mail 10 days VEHICLES /RESTRICTIONS /SPECIAL ITEMS <br /> written notice to the above named certificate holder, but failure to <br /> mail such notice shall Impose no obligation or liability upon the <br /> company, its agents, or representatives. <br /> Effective Date of Certificate: 10-22-2008 Authorised Representative: Whiting Agency Inc. <br /> Date Certificate Issued: 06-0Z-2009 Countersigned at: 11270 Spring Hill Drive <br /> Spring Hill, FL 34609 <br />