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From:Nieta Alford FaxID:Beall Insurance Sery Page 2 of 2 Date:7/31/2009 03:24 PM Page:2 of 2 <br /> a'/� f� <br /> E2 CERTIFICATE OF LIABILITY INSURANCE OP ID _ 0 DATE (MM/DDIYYW) 07/31/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> The Vinson Group , LLC -Zeph ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Beall Insurance Services HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 5710 Gall Blvd. , Suite C ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Zephyrhills FL 33542 <br /> Phone: 813- 788 -5900 Fax: 813- 788 -9654 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A <br /> Burlington insurance Company <br /> INSURER B Businessrirsi insurance Cowpan <br /> BMI , LLC. <br /> Lisa Booker INSURER C <br /> 39838 Stewart Road INSURER D: <br /> Zephyrhills FL 33540 <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 /> INblr WUU L POLICY NUMBER POLICY EH- ECTIVE POLICY kXPIRATIOA LIMITS <br /> LTR NSRD TYPE OF INSURANCE DATE (MMIDD/YYYY) DATE (MM/DD/YYYY) <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000 , 000 <br /> A X COMMERCIAL GENERAL LIABILITY 1838006424 01/14/09 01/14/10 PREMISE (Ea occurence) $ 100 , 000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5 , 000 <br /> PERSONAL & ADV INJURY $ 1 , 000 , 000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ included <br /> — 7 POLICY P JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (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 /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY . AGG $ <br /> EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> 7 OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION X TORY LIMITS I <br /> AND EMPLOYERS' LIABILITY Y / N <br /> X ANY PROPRIETOR/PARTNER /EXECUTIVE SUSINEssrxpST INSURANCE 05/13/09 05/13/10 EL EACH ACCIDENT $ 100,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> (Mandatory in NH) E L DISEASE - EA EMPLOYEE $ 100 , 000 <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> 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 /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> City of Zephyrhills REPRESENTATIVES. <br /> Jackie <br /> 5335 8th St. AUTOO REPRESS T <br /> (Zephyrhills FL 33542 _ <br /> ACORD 25 (2009/01) -2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />