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C ERTIFICATE OF INSURANCE I SSUE DATE <br /> ACORD 12ro1/2009 <br /> PRODUCER This certificate is issued as a matter of information only and confers no rights <br /> MCGRIFF, SEIBELS & WILLIAMS, INC. upon the Certificate Holder. This Certificate does not amend, extend or alter the <br /> P.O. Box 10265 coverage afforded by the policies below. <br /> Birmingham, AL 35202 COMPANIES AFFORDING COVERAGE <br /> 800 -476 -2211 <br /> ConY Columbia Casualty Company <br /> INSURED Company James River Insurance Company <br /> Galaxy Fireworks, Inc. B <br /> 204 East Martin Luther King Drive <br /> Tampa, FL 33603 Company <br /> C <br /> Company <br /> D <br /> Company <br /> E <br /> This is to certify that the policies of insurance described herein have been issued to the Insured named herein for the policy period indicated. Notwithstanding <br /> any requirement, term or condition of contract or other document with respect to which this certificate may be issued or may pertain, the insurance afforded by <br /> the policies described herein is subject to all the terms, conditions and exclusions of such policies. Limits shown may have been reduced by paid claims. <br /> CO TYPE OF INSURANCE POUCY NUMBER EFFECTIVE LIMITS OF LIABIUTY <br /> LT EXPIRATION <br /> A GENERAL LIABIUTY 4015647136 O6j10/260EACH OCCURRENCE $ 1,000,000 <br /> ® Conenefp81 General pia ' .'06/10/2010 FIRE DAMAGE 50,000 <br /> D arms Made ® ooamence t $ <br /> Crenate' aid . Prot <br /> MEDICAL EXPENSE $ EXCLUDED <br /> 03 Deductible 112.500 PERS. AND ADVERTISING INJURY $ 1,000,000 <br /> D GENERAL AGGREGATE $ 2,000,000 <br /> General Aguregale Limit applies per PRODUCTS AND COMP.OPER.AGG. $ 2,000,000 <br /> D F scy D Filed ®1-acaoa <br /> AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $ <br /> 0 My Automobile <br /> mobiles BODILY INJURY (Per person) $ <br /> D Scheduled Automobiles BODILY INJURY (Per accident) $ <br /> D Heed aIIOrnobaes PROPERTY DAMAGE (Per accident) $ <br /> D Non -owned Automobiles COMPREHENSIVE <br /> 0 COLLISION <br /> AND <br /> WORKERS' &�Ry WC Statutory Limit I 1 Other 1 1 <br /> EL EACH ACCIDENT $ <br /> EL DISEASE (Each employee) $ <br /> EL DISEASE (Policy Limit) $ <br /> B EXCESS UABIUTY 000319131 06/10/2009 EACH OCCURRENCE <br /> $ 4,000,000 <br /> ® Oearrence Daam's Made 06 /10/2010 AGGREGATE $ 4,000,000 <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> Please Note, Excess Umbrella Policy shown on certificate will extend coverage to the underlying: Automobile Liability Policy # M8VF3034, Limit $1,000,000 <br /> CSL,; 11/18/09 to 11/18/10; Insured with T.H.E. Insurance Company, Agent: Allied Specialty Ins.; Treasure Island, FL (1 -800- 237 -3355) call direct for COI <br /> 4. Sc <br /> Florida Workers Compensation Coverage Policy# WC093035; Limit: $1,000,000; 11/18/09 to 11/18/10 is provided by T.H.E. Insurance Company, Agent: Allied <br /> Specialty Ins.; Treasure Island, FL (1-800-237-3355); Call direct for COI <br /> (continued next page) <br /> CERTIFICATE HOLDER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO <br /> MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br /> LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF <br /> ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> Pasco Board of County Commissioners and Zephyr Mark Authorized Representative <br /> Rider <br /> 5953 Gall Boulevard F <br /> Zephyrhills, FL 33542 .,s9 4.4.. s. <br /> _ Page 1 of 2 Certificate ID 98QMK1Y9 <br />