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ACOR � ' DATE(MM /DD/YYYY) <br /> (J CERTIFICATE OF LIABILITY INSURANCE 8/6/2009 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> KILBRIDE INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 400 N Parsons ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Brandon, FL 33511 <br /> (813) 684 - 7467 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED Adam Brooks INSURER A: Burlington Insurance Company <br /> • <br /> Dba: Brooks Mobile Home Service INSURER B: <br /> 9716 Del's Acre Rd. INSURER C: <br /> Thonotosassa,FL 33592 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 ADD•L POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00( <br /> X COMMERCIAL GENERAL LIABILITY <br /> PREMISES (Ea E occurence) $ 50,00( <br /> CLAIMS MADE X OCCUR MEDEXP(Anyoneperson) $ 5,00( <br /> A 019B015372 11/03/08 11/03/09 PERSONAL & ADV INJURY $ 1 , 000 , 00( <br /> GENERAL AGGREGATE $ 2,000,00( <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1 , 0 0 0 , 0 0 ( <br /> X !POLICY 7 JECT �I LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANYAUTO (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY <br /> NON -OWNED AUTOS (Peraccident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY- EA ACCIDENT $ <br /> ANYAUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: <br /> AGG $ <br /> EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR I CLAIMSMADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND WCSTATU- 0TH- <br /> EMPLOYERS' LIABILITY TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, describe under <br /> E.L. DISEASE - EA EMPLOYE $ <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION-OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Zephyrhills Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATIOI <br /> 5335 Eight St. 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 SHAL <br /> Zephyrhi 11 s , FL 33540 <br /> IMPOS .0 OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OI <br /> RE" ES: TATIVES. <br /> A HORI ED REPR!SENTATIVy <br /> A>L t <br /> ACORD25 (2001!06) © ACORD CORPORATION 1988 <br />