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ACORD CERTIFICATE OF LIABILITY INSURANCE 06 /01 /2010 <br /> I• .IDUCER (813)637 - 8877 , ' FAX (813)637 -8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Insurance Offi ce of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 4915 W. Cypress Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Tampa, FL 33607 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED Samran Florida Inc. INSURER A: National Trust Insurance Co. 20141 <br /> DBA: Public Imagery INSURER B: FCCI Commercial Ins. Co. 33472 <br /> 7704 C Industrial Lane INSURER C: Bridgefield Employers Ins. Co. 10701 <br /> Tampa, FL 33637 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 <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 ESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN RED CED BY PAID CLAIMS. <br /> INSR DD'L TYPE OF INSURANCE POLICY MBER POLICY EFFECTIVE POLICY EXPIRATION <br /> I SRI" RATF IMM/DIl /YY1 DATE IMM/DMYYI LIMITS <br /> GENERAL LIABILITY GL0010370 06/01/2010 06/01/2011 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY D TO RENTED ra) $ 100,000 <br /> CLAIMS MADE I X I OCCUR MED EXP (Any one person) $ 5,000 <br /> A X PD Ded $250 PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 <br /> TI POLICY n 781: n LOC <br /> AUTOMOBILE LIABILITY CA0016070 06/01/2010 06/01/2011 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ <br /> _ 1,000,000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> A SCHEDULED AUTOS (Per person) <br /> — <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON -OWNED AUTOS (Per accident) <br /> X Comp Ded $500 PROPERTY DAMAGE <br /> X Coll Ded $500 (Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ • <br /> EXCESS/UMBRELLA LIABILITY UMB0010757 06/01/2010 06/01/2011 EACH OCCURRENCE $ 5,000,000 <br /> OCCUR I I CLAIMS MADE AGGREGATE $ 5,000,000 <br /> B <br /> DEDUCTIBLE • $ <br /> X RETENTION $ 10,000 jj $ <br /> WORKERS COMPENSATION AND 83034528 06/01/2010 06/01/2011 X I TWRY IM T- I IOT <br /> EMPLOYERS' LIABILITY <br /> c ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ 500 <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, escnder <br /> E.L. DISEASE - EA EMPLOYEE $ 500,000 <br /> SPECIA PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> City of Zephyrhi 11 s 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> Attn: Building Department BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> 5335 8th Street OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> Zephyrhills, FL 33542 AUTHORIZED REPRESENTATIVE, <br /> Mark Shobe /HELTOD <br /> ACORD 25 (2001/08) ©ACORD CORPORATION 1988 <br />