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JUL -22 -2010 02:56P FROM: 70 :7800021 P.2/2 <br /> • <br /> ACORD TM. CERTIFICATE OF LIABILITY INSURANCE I DA 04/118!201 m <br /> PRODUCER Phan; (879) 906-1I34 Fox 678/860959 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ASSOCIATES AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> PO BOX 16190 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 11470 N. 53RD 37. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> TEMPLE TERRACE FL 33887 <br /> INSURERS AFFORDING COVERAGE NAIC 0 <br /> AlanMY Lloe R001764 <br /> INSURED INSURER A: SOUTHERN OWNERS INSURANCE CO. 10190 <br /> EDMONSON ELECTRIC INC INSURER B: AUTO OWNERS INSURANCE CO. 15988 <br /> DBA & B J ENTERPRISES INC INSURER C FCCI INSURANCE CO. 10178 <br /> 1034 SKIPPER ROAD <br /> TAMPA FL 33813 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 OE ISSUED OR <br /> MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> MIA <br /> L INS TYPE OF INSURANCE POLICY NUMBER POLICY ITMENTYa Four( S <br /> uAPIRATION • <br /> OATH NONDO YI OATS RIRwaYYI LIMITS <br /> GENERAL LIABIUTY 20718528 02/06/10 02/08111 EACH OCCURRENCE 4 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY p IODATED $ 300,000 <br /> I CLAIMS MADE © OCCUR MED. EXP (Any ono parson) S 10,000 <br /> • <br /> A X contra:1Wlabllly PERSONAL a ACV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2.000,000 <br /> GENT. AGGREGATE LIMB APPLIES PER <br /> PROWCTB•COMPIOPA00. i 2,000,000 <br /> — 1 POLICY n !mi f LOC <br /> ■ <br /> AUTOMOBILE LIABILITY 4133615101 02/06/10 02/06/11 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea occident) $ 500,000 <br /> — ALL OWNED AUTOS BODILY INJURY <br /> 8 SCHEDULED AUTOS (Par moon) 3 <br /> X HIRED AUTOS <br /> X NON AUTOS BOOILYINJURY i <br /> (For aoddoM) <br /> -- PROPERTY DAMAGE $ <br /> (Par aeaidenl) <br /> GARAGE LABILITY AUTO ONLY • EA ACCIDENT 3 <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS / UMBRELLA UABILITY 4340464601 02/06/10 02/06/11 EACH OCCURRENCE _ $ 1,000,000 <br /> OCCUR 0 CLAIMS MADE AGGREGATE 3 1,000,000 <br /> B $ <br /> DEDUCTBILE 3 <br /> RETENTION $ 10,000 • i <br /> WORKERS COMPENSATION AND 001 -WC10A -59769 05/02/10 06102/11 X 1TT a LI Vs I l en" <br /> EMPLOYERS' LIABILITY <br /> C AIN PROPENTOIlPAa1aWE1ECUTIVE EL.EACHACCIDENT $ 50D,000 <br /> OPRCERAC&YEN EXCLUDED? <br /> II trM.weMbuWr <br /> E.L. DISEASE -EA EMPLOYEE $ 500,000 <br /> SPECIAL PRINISIONS bole. E.L. DISEASE -POLICY LINT? s 500,000 <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TUC <br /> 6336 8TH STREET EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS <br /> WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE <br /> ZEPHYRHILLS, FL 33642 TO 00 60 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY imp UPON THE INSIIRER. <br /> ITS AGENTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE 4// <br /> Attention: SEAN OR KAREN/813-780-0021 - - - MIkB R 'DS_ <br /> ACORD 26 (2001/08) Certificate a 197348 ® ACORD CORPORATION 1988 <br />