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FROM :BAY INSURORB FAX NO. :8139073995 Jul. 02 2009 11:11AM P1 <br /> A - 9 — �--„4. * CERTIFICATE OF LIABILITY INSURANCE -----1 woman <br /> z oos <br /> PRODUCER Phone: (813)907 Fa (1313)9C17-3985 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION <br /> BAY INSURORS CORPORATION ONLY AND CONFERS 310 RIGHTS UPON THE CERTIFICATE <br /> P 0 BOX 7710 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> WESLEY CHAPEL FL 33545 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC 0 <br /> • <br /> INSURED INSURER A: MID - CONTINENT GROUP <br /> BETTIN CONSTRUCTION, LLC INSURER B: <br /> 28760 WALKER DRIVE INSURER C: <br /> WESLEY CHAPEL FL -. ... _..._. <br /> 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 OT 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, L•XCWSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE uMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> MBR AODL TYPE OF !MIDRANGE POLICY NUMBER rouCV SOMME POLICY SERRATION LIMITS <br /> LTR WERE DATE IIRDODNE DATE IWA'DOIVYI <br /> GENERAL UABILITY 04GL- 000734936 07/14/09 07/14/10 EACH OCCURRENCE t 500,000 <br /> X COMMERCIAL OENERAI. LIABWTV DAMAGE ENa O RENTED lUe O ) $ 100,000 <br /> CLAIMS MADE I X ( OCCUR <br /> MED. EXP (Any one Pram) $ EXCLUDED <br /> 1 <br /> A PERSONAL 5 ADV INJURY $ 500,000 <br /> — _. . _— GENERAL AGGREGATE 3 1,000,000 <br /> GEML AGGREGATE LIMIT APPI.IFS PER: PRODUCTS - COMP/OP AGG• S 1,000,000 <br /> X I POLICY I .. 1 J PN:O- r ' LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO 3 <br /> (Fa accident) <br /> AU. OWNED AUTOS BODILY INJURY <br /> _. par Person) f <br /> SCHEDULED AUTOS <br /> HIRED AUTOS OOOILY INJURY $ <br /> - <br /> NON OWNED AUTOS (Per accident) .... -- - <br /> PROPERTY DAMAGE f <br /> _.._.... .. (Per occident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ _- <br /> ANY AUTO OTHER THAN EA ACC f ._ . <br /> AUTO ONLY: AGO f , <br /> EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE 3 <br /> OCCUR n CLAIMS MADE AGGREGATE S <br /> 1 <br /> DEDUCTIBLE ..._._– .. f <br /> RETENTION f 3 <br /> WC&TAW- I OTTER <br /> WORKERS COMPENSATION AND TORY IM1TB I <br /> EMPLOYERS' LIABILITY E.L EACH ACCIDENT 3 <br /> Apv,Ro.* t #IMRTNERIEMLCUTNE ... -.. .... <br /> oFECEWNNABIREXOLWEOT E.L. DISEASE.EAEMPLOYEE S <br /> R EC I AL PROVISIONS ISION B E.L. DISEASE- POLICY LIMIT f <br /> ICAL PROIl1ON row <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS /LOCATIONS/VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> • CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS <br /> 5335 8TH STREET WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE <br /> ZEPHYRHILLS, FL 33642 TO 00 SO SHALL IMPOSE NO OBLIGATION OR LIABILII Y of ANY IOND UPON THE INSURER, <br /> (TS AGENTS OR RENKEStN1ATIVES. <br /> FAX 813-700-0021 AUTHORIZED REPRESENTATIVE <br /> Attention: <br /> A <br /> /'‘,.---‘62-4--31- <br />