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JUL- 29- 200901E0) 09:00 P.001 /001 <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID EIM 1]ATE (MM/DDIYYYY) <br /> 9HINM -1 07/29/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Fairchild, Addison & MoKone HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR <br /> P <br /> P. 0 . Box 1030 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Brandon FL 33509 -1030 <br /> Phone: 813 -681 -4893 Fax: 813- 685 -8610 INSURERS AFFORDING COVERAGE NAIC f! <br /> INSURED <br /> INSURER A Hemritaga Insuranr.4 Company <br /> INS(IRFR R: <br /> Shingle Masters Roofing & <br /> Construction Svcs, Inc. INSURER C. <br /> 2502 Culbre th Cove Ct <br /> INSURER D <br /> Valrico FL 33594 .. _ <br /> INEI IRF.R F. — <br /> COVERAGES <br /> TI IC POLICIES OT INSURANCE LISTED OCLOW UAW MGR I$$IJFD TO THE INSURED NAMED ABOVE ron THE POLICY PERIOD INDICATFD, NOTWI) HS IANUINC <br /> ANY REOUIREMENT. TERM OR CONDITION or ANY CONTRACT OR OTHFR DOCUMENT WI I M RESPECT TO WHICH THIS CERTIFICATE MAY OC !MUM OR <br /> MAY PFRTAIN, TUC INSURANCE AFFORDFD RYTHF POLICIES DESCRIBED HEREIN IS SUOJCCT TO ALL TI IF. TFRMS, FXCI USIONS AND CONDITIONS OF SUCH <br /> POLICIES. AUCRCA'f t LIMITS SHOWN MAY HAVE BEEN REDUCED OY PNO CI AIMS <br /> INSR MOIL — POLICY EFFECTIVE POLICY EXPIRATIWT' <br /> LTR INSRE TYPE OF INSURANCE POLICY NUMBER DATE (MM/DO/TY) DATE (MMJDD/YY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 100 , 000 <br /> A X COMMERCIAL UENERAL LIABILITY HGL543326 -08 06/03/09 06/03/10 P (Ea RENTE Pence) 150,000 <br /> X I CLAIMS MADE U OCCUR MEU tXP (My one person) S 1 , 0 <br /> PERSONAL &ADV INJURY S 100,000 <br /> GENERAL AGGRFGATF $ 300,000 <br /> GCN'LAGGRCGATCP� IT APPLICSPFR PHOLUC1$- CUMt/UPACU 1 300,000 <br /> - 7 pOUCY n JFCT n LOC <br /> AUTOMOBILE LIABILITY <br /> COMbINEU SINCLE LIMI I' <br /> ANY AUTO (Es accident) s <br /> ALL /WNEpAUTOS • <br /> OODILY INJI IRY <br /> SCHEDULED AUTOS (Per perenn) <br /> I IIRCD AUTOS <br /> NON -OWNED AUTOS BODILY INJURY $ <br /> (Per awiderd) <br /> PHOFEN I Y UAMACt <br /> (Per accident) <br /> GARAGE LIABILITY <br /> AUTO ONLY- EA ACCIDENT S <br /> ANY AUTO <br /> OTHFR THAN FA ACC 1 <br /> AUIOONLY: ACC S <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> 7 OCCUR n CLAIMS MADE <br /> AGGREGATE <br /> S <br /> RE PENrIUN 1 $ <br /> WORKERS COMPENSATION AND WC S IA I U- O t M- <br /> EMPLOYERS' LIABILITY FURY uMITS ER <br /> ANY PROPRIETORR'ARTNER/EXECUTIVE E.L EACH ACCIDENT g <br /> OrTICER/MEMBER EXCLUDED? <br /> If Tee, Ge■cnbe under E.L DISEASE - CA EMPLOYEE S <br /> SPECIAL PROVISIONS below E.L. DISFASF . POI ICY 1 IMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS ^� <br /> Fax: 813 780 -0021 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CxTYZ-1 SHOULD MY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED E„ BEFORE THE EXPIRA . 0N <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 /> Building Department IMPOSE NO OBLIGATION IN <br /> LIGATION OR LIABILITY OF ANY D UPON THE INSURER, ITS AGENTS OR <br /> Zo ph 8th Stet REPRESENTATIVES. 110.011 Zephyrhilla FL 33542 AUTHORIZED REPRESENTA <br /> _ Fairchild, Addison & McKone <br /> ACORD 26 (2001108) ® ACORD CORPORATION 1988 <br />