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From: Brown & Brown Insurance Date: 12/17/2009 2:15:11 PM <br /> CERTIFICATE OF LIABILITY INSURANCE OP DS 2 DATE(MIMOD /09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 17757 US Highway 19 N, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Clearwater FL 33757 -2456 <br /> Phone: 727 - 461 -6044 Fax: 727 -442 -7695 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: National Ytust In.ut.Ae. Co. 20141 <br /> Air Rescue Air Conditioning, INSURER B: but K.L les Co of Saws e. 24724 <br /> Inc <br /> INSURER F CCI Insurance Com an 10178 <br /> dba Air Rescue P Y <br /> 1429 Massaro Blvd. INSURER D: Sc. Yawl tato F Hatt* m. Ca. 24767 <br /> Tampa FL 33619 <br /> INSURER E '. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCV PERIOD INDICATED. NOTW1TNSTANDING <br /> ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIE5 DE5CRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> 1 555 ALKYL POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR NERD TYPE OF INSURANCE POLICY NUMBER DATE IMMTIODNWY) DATE IIBIODrYYYV) LIMITS <br /> GENERAL LIABILITY EACH OCWRRENCE 5 1000000 <br /> DAMAGE TO RENTED <br /> A X COMMERCIAL GENERAL LABILITY GL00088501 06/09/09 06/09/10 PREMISES (Ea CCWMCe1 s 100000 <br /> CLAIMS MODE X OCCUR MW EXP IAnyanc pawn) s 5000 <br /> PERSONAL RAWINJURY 5 1000000 <br /> GENERAL AGGREGATE 5 2000000 <br /> GEHL AGGREGATE LIMIT APPL IES PER: PRODUCTS - COMP,00A00 5 2000000 <br /> PRO - <br /> POLICY X JECT LOC —' <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIAR $ 1,000,000 <br /> B X ANY AUTO 01CI16421310 02/12/09 02/12/10 (Ea ac'il0U <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> SCHEDU LEDAIJTOS <br /> 'Per IX:FIC5) 5 <br /> HIRED AUTOS <br /> BODILY INJURY <br /> NON -OWNED AUTOS 1Pa =Won <br /> PROPERTY DAMAGE <br /> (Per ac000111 <br /> GARAGE LIABILITY AUTO ONLY- EA ACCIDENT <br /> ANY AUTO <br /> OTHER THAN EA ACC 5 <br /> AUTO ONLY: AGO <br /> EXCESS( UMBRELLA LIABILITY EACH OCCURRENCE 5 5000000 <br /> D X OCCUR CLAIMS MADE QK06803350 07/15/09 07/15/10 AGGREGATE 5 5000000 <br /> DEDUCTIBLE <br /> 5 <br /> RETENTION 5 10,000 <br /> WORKERS COMPENSATION <br /> WC STATU- DTH- <br /> AND EMPLOYERS' LIABILITY LIMITS ER I Y IN <br /> ANY PROPRIETOIVPARTNERIEXECUTIVE E.L. EACH ACCIDENT 5 <br /> OFFICER/ EMBER EXCLUDED? <br /> (Mandatory in NM) E.L. DISEASE- EA EMPLOYEE 5 <br /> Ryas. describe under <br /> SPECIAL PROVISIONS 50105 E.L. DISEASE. POLICY LIMIT 5 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BV ENDORSEMENT (SPECIAL PROVISIONS <br /> fax 813 780 -0021 <br /> CERTIFICATE HOLDER CANCELLATION <br /> 8N OULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TM E EXPIRATION <br /> CTYZEPH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> City of Zephyrhills IMPOSE NO OBLIGATOR OR LIABILITY OF ANY KIND UPON TIE INSURER, ITS AGENTS OR <br /> Building Department <br /> REPRESENTATIVES. <br /> 5335 8th Street AUTH ZBD REPREEENTATNER <br /> Zephyrhills FL 33540 <br /> ACORD 25 (2009/01) © 1988-2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />