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05/11/2005 19:52 9417395608 ASSURE LLC PAGE 01/01 <br /> ACORDW - CERTIFICATE OF LIABILITY INSURANCE DATE(YY) <br /> 7/9/2010 2010 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ASSURE LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 2511 Manatee Avenue E HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Bradenton, FL 34208 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (941) 739 - 5121 INSURERS AFFORDING COVERAGE <br /> i NSUREO NAICe <br /> Dun -Rite Concrete Inc INSURER k Accident Insurance Company <br /> Dun -Rite Construction INSURER B: 21st Century Insurance <br /> 26524 Pheasant Run INSURER C: United Specialty .Insurance co <br /> Wesley Chapel, FL 33544 INSURER D. 1lrs.dgaticld Emp{oyera Ifl uranaa Co <br /> )813- 345.8666 F 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 /> INSR ADO'L <br /> LTR IroSRD TYPE OF INSURANCE POLICY NUMBER POLICcY F ECTIVE POLICYEXPIRATI N <br /> DATE( y� I CTI DATF(MM/RONY) LIMITS <br /> GENERAL uABIUTY <br /> EACH OCCURRENCE $ 1,000 , 000 <br /> UnivrAtat 10 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (Ea oca,re nce) $ 100,000 <br /> CiLAIMBMADE X OCCUR <br /> MED EXP (Any one Demon) S 5,000 <br /> A X PD Ded: $1000 AGL84749 09/03/09 09/03/10 PERSONAL & ADV INJURY f 1, 000, 000 <br /> GENERAL AGGREGATE 1 2 , 000,00 0 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000 2,000,0 <br /> — I FOLIGY [ JEC El T LO <br /> AUTOMOBILE LIABILITY <br /> X ANYAUTO (c d SINGLE LIMIT $ 2,000,000 <br /> _ ALL OWNED AUTOS ^-- <br /> X SCHEDULED AUTOS BODILY INJURY f <br /> (Per parson) <br /> B X HIRED AUTOS AIG1071720 09/02/09 09/02/10 <br /> X NON- oWNEDAUTOS BODILY INJURY $ <br /> (Per/accident) <br /> PROPERTY DAMAGE $ <br /> (PereocberB <br /> GARAGE LIABILrr AUTO ONLY -EA ACCIDENT $ <br /> _ ANYAUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSNMBRELLA LIABILITY EACH OCCURRENCE $ 1,000 s____ OOO <br /> X I OCCUR CI CLAIMSMADE AGGREGATE $ 1,000,000 <br /> UEP000017 09/03/09 09/03/10 $ <br /> C DEDUCTIBLE <br /> 8 <br /> RETENTION S <br /> S <br /> WORKERSCOMPENSATIONAND WCSIArU OTH- <br /> EMPLOYERS' LIABILrTY x TORYLIMITS FR <br /> ANY D OFFICER/MEMBER PROPRIETOR/PARTNER/EX <br /> ExcLUOEO? Rc� E.L EACH ACCIDENT $ 1,000,000 <br /> ff $ de-cn BER r 830-42887 09/02/09 09/02/10 E.L DISEASE. EA EMPLOYEE $ 1, 000, <br /> Z 0 E EL DISEASE - POLICY LIMIT $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of 2ephyrhilla - Building Dept SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> 5335 8th St DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL3O DAYS WR(17EN <br /> NOTICE TO THE CERTIIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO $O SHALL <br /> Zephyrhills , FL 33542 <br /> FAX: 813 - 780 -0021 IMPOSE NO OBLIGATION OR LIABILrrV OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> RED sassug ss. <br /> AUTHORIZED REPRESENTATIVE r /J���� <br /> I y rn j , / GGL...•III <br /> ?5(2001/08) <br /> CORD CORPORATION 1988 <br />