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Sep. 21. 2010 11:00AM No. 4258 P. 1/1 <br /> ACORD . CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> TM I <br /> 09/21/2010 <br /> PRODUCER Phone:,(813)988 -1234 Fax 813- 988 -0989 <br /> ASSOCIATES AGENCY, 988-1234 THIS CERTIFICATE IS ISSUED AS •A MATTER OF INFORMATION <br /> PO BOX 16190 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 11470 N. 53RD ST. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> AI TFP TAR COVFRAOF AFFORnFO RY TMF POLICIFS RFLOW <br /> TEMPLE TERRACE FL 33687 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> Agency Lic #:R001766 <br /> INSURED INSURER A: AUTO OWNERS INSURANCE CO. 18988 <br /> FAITHBILT BUILDERS, INC & INSURER B: AUTO OWNERS INSURANCE CO. 18988 <br /> FAITHBILT CONSTRUCTION, INC. <br /> PO BOX 270538 INSURER C: <br /> TAMPA FL 33688 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 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 /> • <br /> INSR ADD'L TYPE OF INSURANCE POLICY NUMBER POUCY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD DATE IMM/OD/YYI DATE (MM/DONYI LIMITS <br /> GENERAL LIABILITY 20670438 06/30/10 06/30/11 EACH OCCURRENCE $ <br /> X COMMERCIAL GENERAL LIABILITY DAM — 1,000,000 <br /> AGE TO RENTED <br /> PREMISES (Ea ocaurence) $ 300,000 <br /> CLAIMS MADE X OCCUR MED. EXP (Any one person) $ 10,000 <br /> A PERSONAL & ADV INJURY _ $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: — <br /> PRO- PRODUCTS - COMP /OP AGG. $ 2,000,000 <br /> POLICY n JECT n LOC <br /> AUTOMOBILE LIABILITY 4642391900 09/04/10 09/04/11 <br /> COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ 100,000 <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> B X HIRED AUTOS <br /> BODILY INJURY <br /> X NON -OWNED AUTOS (Per accident) $ <br /> PROPER DAMAGE $ <br /> (Per acciden t) <br /> GARAGE LIABILITY <br /> AUTO ONLY - EA ACCIDENT _ <br /> ANY AUTO _ <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> — <br /> 71 OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> $ <br /> RETENTION $ <br /> WORKERS COMPENSATION AND l <br /> WC OR <br /> RYTLIMITS 1 1 OTHER <br /> EMPLOYERS' LIABILITY <br /> • <br /> ANY PROPRIETOR PARTNER /EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> R yes, describe sneer <br /> E.L. DISEASE -EA EMPLOYEE $ <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER: <br /> DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> Cky of Zephyrtlills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> Building Department 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 TO <br /> Zephyrhills, Fl 33542 AGENTS OR REPRESENTATIVES. V OBLIGATION OR LIABILITY OF ANY KIND ICON THE INSURER, ITS <br /> AUTHORIZED REPRESENTATIVE <br /> Attention: Jackie fx 813 - 780 -0021 <br /> Trevor McCarthy <br /> ACORD 25 (2001/08) Certificate # 206166 6 ACORD CORPORATION 1988 <br />