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3f 5/13/2010 11:19 Lion Insurance LION INSURANCE COMPANY -►CITY OF ZEHYRHILLS 1/1 <br /> Date <br /> CERTIFICATE OF LIABILITY INSURANCE 1 5/13/2010 <br /> Producer: Lion Insurance Company This Certificate is issued as a matter of information only and confers no rights <br /> 2739 U.S. Highway 19 N. upon the Certificate Holder. This Certificate does not amend, extend or alter <br /> the coverage afforded by the policies below. <br /> Holiday, FL 34691 <br /> Insurers Affording Coverage NAIC # <br /> Insured' Insurer A: Lion Insurance Company 11075 <br /> South East Personnel Leasing, Inc. <br /> 2739 U.S. Highway 19 N. Insurer B: <br /> Holiday, FL 34691 insurer C: <br /> 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 any requirement, term or condition of any contract or other document with respect to which <br /> this certificate may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms. exclusions, and conditions of such poi cies. Aggregate limits shown may have been reduced by <br /> paid claims. <br /> INSR ADDL Policy Effective Policy Expiration Date <br /> LTR INSRD Type of Insurance Policy Number Date Limits <br /> (MM/DD/YY) (MM /DD/YY) <br /> GENERAL LIABILITY $ <br /> Each Occurrence <br /> Commercial General Liability <br /> Damage to rented premises (EA <br /> Claims Made ❑ Occur occurrence) <br /> Med Exp $ <br /> Personal Adv Injury $ <br /> General aggregate limit applies per: _ <br /> Policy 0 Project 0 LOC <br /> General Aggregate $ <br /> Products - Comp/Op Agg $ <br /> AUTOMOBILE LIABILITY Combined Single Limit <br /> Any Auto (EA Accident) $ <br /> - All Owned Autos <br /> Bodily Injury <br /> - Scheduled Autos <br /> (Per Person) $ <br /> - Hired Autos <br /> Bodily Injury <br /> Non -Owned Autos (Per Accident) $ <br /> ... Property Damage <br /> (Per Accident) <br /> EXCESS /UMBRELLA LIABILITY Each Occurrence <br /> Occur a Claims Made Aggregate <br /> Deductible <br /> A Workers Compensation and WC 71949 01/01/2010 01/01/2011 X I WC Statu I 1OTH <br /> Employers' Liabilk to Limits ER <br /> Any proprietor /partner /executive officer /member E.L. Each Accident $1000,000 <br /> excluded? <br /> E.L. Disease - Ea Employee $1.000.000 <br /> If Yes, describe under special provisions below. <br /> E.L. Disease - Policy Limits $1,000,000 <br /> Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 <br /> Descriptions of Operations /LocationsNehicles /Exclusions added by Endorsement/Special Provisions: Client ID: 29 <br /> Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company": <br /> Sealander Contractor Services, Inc. <br /> Coverage only applies to injuries incurred by South East Persomel Leasing, Inc. active employee(s) , while working in Florida. <br /> Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. <br /> A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. <br /> Project Name: <br /> FAX: 813 - 788 -4028 & 813 - 780 -0021 / ISSUE 05 -13 -10 (SD) <br /> Begin Date: 11/25/2007 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHIL LS Should any of the above described policies be canceled before the expiration date thereof, the issuing insurer will <br /> endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no <br /> obtigation or liability of any kind upon the insurer. its agents or representatives. <br /> 5335 6TH ST. /' <br /> ZEPHYRHILLS, FL 33540 ' S Vgt .� <br />