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Lisa Booker 8137837891 <br /> p.2 <br /> 41! j7; . CERTIFICATE OF LIABILITY INSURANCE OP ID NA I CATEIMM700/YYYY) <br /> 06/09/10 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURERIS/. AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. <br /> •• - - , • • . . e -.7 c an ... r• , r. • -AI a., .. "" must peen.. s... " S ONI WAIVE.. subject to <br /> the temn and con Ions of the policy. certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder In lieu of such endorsement(s). <br /> enceucsR - c....n.n. -. <br /> The Vinson Group, LLC -Zeph PHONE FAX Insurance Services 1C, No. Est): f (NC. Ne): <br /> 5710 Gall Blvd., Suite C SS: <br /> 'PRODUCER FL 33542 - - - -- -- - - - - -- <br /> cueralEROS HMI <br /> Phone: 813- 788 -5900 Fax :813- 788 -9654 INSURER(S) AFFORCING COVERAGE NAIC L <br /> POURED <br /> INSURER A: aurl./ngtei. Lwauranc• company <br /> LI•C . <br /> INSURER 0: asimaartnt ins COMM --+ <br /> Larry i Lisa Booker . <br /> 39838 Stewart Road INSURER C: <br /> Zephyrhills FL 33540 INSURER D: <br /> INSURER E : <br /> _ ENSURER F : <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSLRAK'F LISTED BELOW NAPE BEEN ISSUED TO 1HE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATE-D. NOMARISIMDING . TERBOROOrDIAONOF ANY CONTRACT OR OTHER 000LNENrWTMRESPECTTOWHICHTHIS <br /> CERTIFICATE MAYBE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY TEE POUaES DESCRIBED HEREIN IS SLEIJECT TO ALL THE TERMS. <br /> EXCLUSIONS AND CONDITIONS OF SUCH POL IC IES. LIMITS SHOWN MAY K w EH REDUCED BY PAID CLAMS <br /> Ran Tr►EOFINSVRAMCE <br /> tHM WW1 POUCY N UMBER IE%VOfl YYYi (M AO � Learn — <br /> GENERAL LIAa1uvY EACH OCCURRENCE $ s 3.,000,000 _ <br /> 11 X RYJIr.RRCW. IiFHRRAI- I.IAp1.ITY 1038006424 0 1/14/10 01/14/11 Pr SES( E sx ra n ence/ _ 5100,000 <br /> 1 C AINSMADE © OCCUR MED EXP IAry one person) S 5 , 00 0 <br /> PERSONAL a ADY INJRY S 1 , 000 , 000 <br /> GEPERAL AGGREGATE 5 2 , 000 , 000 <br /> GEM. AGGREGATE LIMB APPLIES PER PRODUCTS - COMP/ AG G S i ncl uded <br /> 1 num. 1 AT 4 JE PRgi n Lac -$ — <br /> AUTOMOeLE LIABILITY COMBINED SNG(E LIMB <br /> _, ANY AUTO (Ea $ <br /> — <br /> BOOIL V INA17Y (Pet pesos') $ <br /> ALL GAPED AUTOS <br /> BODILY INJURY (Per acodeH) j 5 <br /> SCHEDULED AUTOS <br /> — <br /> PROPERTY DAMAGE i $ <br /> HIRED AUTOS (Per rcadett; <br /> — <br /> NONOVAVED AUTOS I $ <br /> MORELLA LIAR <br /> _ __ OCCUI EACH CCCURP.ENCE I $ <br /> EXCESS LIAR aAdMS,WOE AGGREGATE } S <br /> r— <br /> DEOLCTIBLE $ <br /> RETENTION $ f <br /> X WORKERSCOMPE?ISATION wsnarrnsT nlsvaAKI 05/13/10 05/13/11 XI `'A� RF %TA, oni- <br /> AND ERPLOYEiS LIABILITY YIN + l PO UNIT J ER _ <br /> ANY PROPRETORPARIHERIEXECU IVE ❑ N r A El. E401 ACCIDENT E 10 0, 0 0 0 <br /> CFFICERAAEMBER IXCUAE09 <br /> (leendatoty In me • 11. DISEASE - EA EMPLOYEE $ 10 0 , 0 0 0 <br /> It gat *Mcrae iodic <br /> DESd7IPTTON OF OPERATIONS below F I rJ.' ARP- P01 ICY I MIT $ 500,000 <br /> DESCRIPTION OF OPERATIONS/ LOCATIONS VEHICLES (Attach ACORD 101. Ae111wnsl Remarks eebedu)s. a more spouts required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION GATE THEREOF, NOTICE NTLL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> City of Zephyrhills AUTHORIZED REPRESENTATIVE <br /> Jackie <br /> 5335 8th St. �'m1400� t IZephyrhills FL 33542 �/�({ 9 ACO � All rights reserved. <br /> ACORD 25 (2009109) The ACORD name and logo are registered marks el ACORD <br />