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ADDITIONAL INFORMATION ISSUE DATE <br /> 03/09/2010 <br /> PRODUCER CERTIFICATE HOLDER <br /> MCGRIFF, SEIBELS & WILLIAMS, INC. Main Street Zephyrhills <br /> P.O. Box 10265 5224 7th Street <br /> Birmingham, AL 35202 Zephyrhills, FL 33542 <br /> 800 -476 -2211 <br /> INSURED <br /> Pyrotecnico of Florida, LLC <br /> P.O. Box 310 <br /> New Castle, PA 16103 <br /> workers Compensation and Employers Liability <br /> ** *Proof of Insurance Only * * ** <br /> Insurance Carrier: Travlers Insurance Company, issued through: <br /> Florida Workers Compensation Joint Underwrting Association, Inc. <br /> 2420 Lakemont Ave. Sutie 100; Orlando, FL 32814 <br /> States Insured: Florida <br /> Policy Number: 6FR13UB0668N01409 <br /> Policy Period: 6/22/2009 to 6/22/2010 <br /> Employers Liability Limits: <br /> Bodily Injury by Accident $1,000,000 each accident <br /> Bodily Injury by Disease $1,000,000 policy limit <br /> bodily Injury by Disease $1,000,000 each employee <br /> Pay: 2 of <br /> Certificate 10# LPLGWYQF <br />