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• � CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) <br /> OP ID VD <br /> GGRL -01 05/24/10 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Mulling Insurance Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P 0 Box 308 208 E Park Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Auburndale FL 33823 -0308 <br /> Phone: 863- 967 -4454 Fax: 863 -967 -7592 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: Gotham Insurance Company <br /> INSURER B. Progressive Ins. Companies 10193 <br /> GGR, LLC . / GGR Roofing Inc. INSURER C. <br /> Terri Ingram <br /> P.O. BOX 1337 INSURER D: <br /> Auburndale FL 33823 <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 <br /> ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> I TR NSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD ) DATE (MM/DD YYYOY) LIMITS <br /> L NSRC <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> U/ jW .. I V RS(Eatr 1 CU <br /> A X COMMERCIAL GENERAL LIABILITY GL00449310 04/10/10 04/10/11 - PREMI $100000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 <br /> PERSONAL & ADV INJURY $ 1000000 <br /> GENERAL AGGREGATE $ 2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP /OP AGG $ 1000000 <br /> POLICY JECCT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 300000 <br /> B ANY AUTO 05957879 -2 09/04/09 05/25/10 (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY $ <br /> X SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS BODILY INJURY $ <br /> NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY. AGG $ <br /> EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> (OCCUR CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKER COMPENSATION WCSIAIU UIH <br /> AND EMPLOYERS' LIABILITY TORY LIMITS ER <br /> Y/N <br /> ANY PROPRIETOR/PARTNER /EXECUTIVE E . EACH ACCIDENT $ <br /> OFFICER /MEMBER EXCLUDED? <br /> (Mandatory In NH) E . DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES !EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> Roofing - commercial or residential over 3stories <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> CITYZEP DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> City of Zephyrhills REPRESENTATIVES. <br /> Building Department AUTHORIZED REPRESENTATIVE <br /> 5335 8th Street <br /> Eephyrhills FL 33542 _ <br /> ACORD 25 (2009/01) 9 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />