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From:Vickie Dennis FaxID:863- 967 -7592 Page 2 of 3 Date:07/02 /10 11:54 AM Page:2:of3 _ <br /> • <br /> DATE (MM/DD/YY1 <br /> CERTIFICATE OF LIABILITY INSURANCE O o1 07/02110 <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. American Fire & Casualty <br /> INSURER B. Ohio Casualty <br /> Wyatt-Fitzgibbons Sheet Metal <br /> Michael Wyatt INSURER C atidgatiald Employers Ina. Co, <br /> 905 Strain .Blvd. INSURER D: <br /> Lakeland FL 33815 <br /> l 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 /> INK AUU L POLICY NUMBER POLICY EFFECT !Nit POLICY EXPIRATION LIMITS <br /> LTR NSRC TYPE OF INSURANCE DATE (MM /DD/YYYY) DATE (MM/OD/YYY <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> U/4W <br /> A X COMMERCIAL GENERAL LIABILITY BKA1154410814 04/01/10 04/01/11 PREMIS E S (Eaoccu KtN I tU rence) $ 300000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 <br /> PERSONAL 8 ADV INJURY $ 1000000 <br /> GENERAL AGGREGATE $ 2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 2000000 <br /> n POLICY [7 jECT n LOC Emp Ben. 1000000 <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT $ 1000000 <br /> A X ANY AUTO BAW54410814 04/01/10 04/01/11 (Ea accident) <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X 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 $ 5000000 <br /> B X OCCUR CLAIMS MADE US054410814 04/01/10 04/01/11 AGGREGATE $ <br /> DEDUCTIBLE $ <br /> X RETENTION $ 10000 $ <br /> WORKERS COMPENSATION X TORY LIMITS 01H- <br /> AND EMPLOYERS' LIABILITY Y / N <br /> C ANYIPROPRIETOREXTNE E XECUTIVE 1 I l 0830 -44641 04/01/10 04/01/11 E.L. EACH ACCIDENT $ 500000 <br /> (Mandatory in NH) 1 E. L. DISEASE - EA EMPLOYEE $ 500000 <br /> If yes. describe under <br /> SPECIAL PROVISIONS below E L. DISEASE - POLICY LIMIT $ 500000 <br /> OTHER • <br /> B rented equipment BM054410814 04/01/10 04/01/11 blanket 125000 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> • <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 <br /> Building Department REPRESENTATIVES. <br /> AU <br /> 5335 8th Stree AUTHOR), ENTATIVE <br /> IZephyrhills FL 33542 <br /> ACORD 25 (2009/01) © 19 8 -2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br /> • <br />