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* 10/11/2010 13:51 Lion Insurance LION INSURANCE COMPANY -►CITY OF ZEPHRYHILLS 1/1 Date CERTIFICATE OF LIABILITY INSURANCE 1 10/11/2010 Producer: Lion Insurance Company This Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter 2739 U.S. Highway 19 N. the coverage afforded by the polides below. Holiday, FL 34691 Insurers Affording Coverage NAIC # Insured: South East Personnel Leasing, Inc. Insurer A: Lion Insurance Company 11075 2739 U.S. Highway 19 N. Insurer 8: Holiday, FL 34691 Insurer C: Insurer D: Insurer E: Coverages The policies of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement. term or condition of any contract or other document with respect to which this certificate may be issued or may pertain, the insuance afforded by the policies described herein is subject to all the terms. exclusions, and conditions of such poi cies. Aggregate limits shown may have been reduced by paid claims. INSR ADDL Policy Effective Policy Expiration Date LTR INSRD Type of Insurance Policy Number Date Limits (MM/DD/YY) (MM/DD/YY) GENERAL LIABILITY Each Occurrence $ Commercial General Liability Damage to rented premises (EA Claims Made 13 Occur occurrence) $ Med Exp $ General aggregate limit applies per: Personal Adv Injury $ _ D Polity ❑ Project ❑ LOC General Aggregate $ Products - Comp/Op Agg $ AUTOMOBILE LIABILITY Combined Single Limit Any Auto (EA Accident) $ All Owned Autos Bodily Injury - Scheduled Autos ■ (Per Person) $ Hired Autos Bodiy Injury Non -Owned Autos (Per Accident) $ Property Damage (Per Accident) $ EXCESS /UMBRELLA LIABILITY Each Occurrence Occur 0 Claims Made Aggregate Deductible A Workers Compensation and WC 71949 01/01/2010 01/01/2011 X I WC Static 1 1 OTH- Employers' Liability tory Limas ER Any proprietor/partner /executive officer /member E.L. Each Accident $1.000,000 excluded? E.L. Disease - Ea Employee $1.000.000 If Yes, describe under special provisions below. E.L. Disease - Policy Limits $1.000,000 Other Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 Descriptions of Operations /LocationsNehicles/Exclusions added by Endorsement /Special Provisions: Client ID: 20 -19 -267 Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company": Kehle Plumbing, Inc. Coverage only applies to injuries incurred by South East Persomel Leasing, Inc. active employee(s) , while working in Rorida. Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity. A list of the active employee(s) leased to the Client Company can be obtained by faxing a request to (727) 937 -2138 or by calling (727) 938 -5562. Project Name: FAX: 386 -437 -8488 & 813 - 780 -0021 / ISSUE 10 -11 -10 (SD) Begin Date: 1/1/2002 CERTIFICATE HOLDER CANCELLATION CITY OF ZEPHYRHIL LS Should any of the above described policies be cancelled before the expiration date thereof. the issuing insurer will endeavor to mail 30 days written notice to the certificate holder named to the left, but failure to do so shall impose no obligation or liability of any kind upon the insurer, its agents or representatives. 5335 8TH STREET ZEPHYRHILLS, FL 33542 j�is.a4� K