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07/06/2010 TUE 9:49 FAX 0001/001 <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE NAMtDO/ <br /> PRODUCER Phone THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> AUBREY ROGERS INSURANCE AGENCY 352 - 373 -2003 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 2400 NW 6TH STREET HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br /> GAINESVILLE, FL 32609 Fax ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> 352 -376 -2235 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A.CANAL INDEMITYA <br /> PAUL SCHAPER ROOFING, INC, PAUL SCHAPER • -. — <br /> CONSTRUCTION, INC DBA EAST PASCO CRANE INSURER D: - <br /> BARRIER REEF POOLS OF FLORIDA NSURER C; -- <br /> 8949 GALL BLVD, ZEPHRYRHILLS, FL 33541 INSURER O _ <br /> INSURER F; <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN 1SSUE0 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 /> IN5R AMYL POLICYEFFGCTrvy l POLIC rMrOD MIDQIATIDN <br /> I TR /NSRD TYPE OF WII IRANf POLICY NUMBER ttATF lNy�lDiyyyY DATE / mrr1 UNITS <br /> A GENERAL LIABILITY GL98233 6/08/2010 6/08/2011 EACH OccuRRFNcE s 500.000 <br /> X COMMERCIAL GENERAL LIABILITY PR • •• $ 50,000 <br /> CLAIMS MADE n OCCUR MED EXP (Any ono paw) S 5,000 <br /> .. .._. PERSONAL & ADV INJURY S 500,000 <br /> .. ._ GENERAL AGGREGATE $ 1.000,000 <br /> OEN'L ADDRECATELIMIrAPPLIES PCR PROOUCTS- COMP/OP AGG S 500,000 <br /> POLICY I -, fRC T n 1.00 - .. -- <br /> AUTOMOBILE LABILITY <br /> _^ ANY AUTO ( COMBINED I SINGLE LIMIT a <br /> ALL OWNED *tiros <br /> BODILY INJURY S <br /> SCHEDULED AUTOS re. Demon) <br /> HIRED AUTOS <br /> '—' BODILY INJURY <br /> NON-OWNED AUTOS (ForpuugpnI) <br /> - ' -' PROPERTY DAMAGE 5 <br /> (Per acddcnl) <br /> GARAGE LIABILITY AUrOONLY- EAACCIDENT S <br /> MY AUTO EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG S <br /> EXCESS 1 UMBRELLA UABIUTY EACH OCCURRENCE $ <br /> OCCUR n CLAMS MADE AOCRECATE S <br /> DEOUCTIeLE <br /> - - <br /> RETENTION S S <br /> S <br /> WORKERS COMPENSATION <br /> ANDEMPLOVERS•UABILITY YIN <br /> ,T 1°4 <br /> ANY PROPWETOR/PARTNER/G7QCUTNE ❑ EACH S <br /> OFFICER/MEMBER EMBER EXCLUDED? <br /> (Mandatory In NH) C.L DISEASE • EA EMPLOYEE $ - <br /> If yc. de:c lbe under <br /> SPEC PROV ISIONS below E.L. DISEASE - POLICY LIMIT 5 <br /> OTHER <br /> DESORPTION OF OPERATORS / LOCATIONS / VEHICLES 1 EXCLUSIONS AODEO BY ENDORSEMENT! SPECIAL PROVISIONS <br /> PAUL SCHAPER ROOFING INC, PAUL SCHAPER CONSTRUCTION, EAST PASCO CRANE SERVICE. <br /> BARRIER REEF POOLS OF FLORIDA <br /> LICENSE #CCCO58134, CBCO59817 AND CPC1455713 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OPINE ABOVE DESCRIBED POLICIES 05 CANCELLED BEFORE THE EXPIRATION <br /> CITY OF ZEPHYRHILLS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MUL 10 DAYS WRITTEN <br /> 5335 8TH STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> ZEPHYRHILLS, FL 33541 IMPOSE No oe ITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br /> R r, M E T A J <br /> FAX: 813 - 700-0021 <br /> ACORD 25 (2009101) 7 el 198'09 ACORD CORPORATION, All rights reserved. <br /> The ACORD name and Togo are regi red marks of ACORD <br /> Type of Identification Produced FL - .„3 5 (1,5 -/ (67) - �� �1 'JAL ...C..) , , _ _ -- <br /> Verification pursuant to Section 92.525, Florida Statutes, Under penaltie • perjury, I declare that I have r °ad the foregoing and that <br /> the facts stated in it are true to the best of my knowledge and belief. <br /> t ' : otatural•P a ignin Bove <br /> Notary Public: — / <br /> (Type, Print, or staml•' ST. ,T OF FLORIDA, COUNTY OF PASCO <br /> THIS IS TO CERTIFY THAT THE FOREGOING IS A <br /> TRUE AND CORRECT <br /> �1DIIHL. _ COPY OF THE DOCUMENT <br /> ON FILE OR OF PUBLIC, R ECORD IN THIS OFFICE <br /> UNCOMMON 00881238 WIT MY HAND AlDIOF ICIALSEALTHIS <br /> - :. _<< limds , 20 Underwriters 1p <br /> DAY OF a A _ 2 O I <br /> PAU A . O'N I , t v- 8, Cit MPTROLLER <br /> BY DEPUTY CLERK <br />