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Nov 18 10 01:43p Lg Edwards Ins 3525676766 p.l OP ID: KS ACCORD" D ATE (MMroturrrr! CERTIFICATE OF LIABILITY INSURANCE 11/18/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 352-567-6751 N ro.cr Karen Surratt L.G. Edwards Insurance Agency 352- 567 -6766 lac.NNo. E 352-567-6751 1 ( No): 352-567-6766 P.O. Box 1548 E-MAIL ADDRESS: karensurratt@tampabay.rr.com Dade City, FL 33526 -1548 PRODUCER CUSTOMER ID 0: AMERI -1 INSURER(S) AFFORDING COVERAGE I NAIC tl INSURED American Solar Energy, LLC INSURER A : American Vehicle Ins Co Labron E Taylor, Jr INSURER e : Guarantee Ins Company Inc 5109 Meadows End INSURERC: Republic Surety Company Lakeland, FL 33810 INSURER D INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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 INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADM SUBR POLICY EFF POLICY EXP LIMITS LTR INSR wVD POLICY NUMBER (MM1DD/YYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY GL0521016551 04/25/10 04125/11 DAMAGE ES ( RtNIED 100,000 PREMIS Ea oca col � $ CLAIMS -MADE n OCCUR MED EXP (Any are person) $ 5,000 PERSONAL 8 ADV INJURY $ 1,000,000 ^, GENERAL AGGREGATE $ 1,000,000 GG AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1,000,000 Jl POLICY n JFC P1 LOC 1 $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO ! BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS (Per accident) $ NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR EACH OCCURRENCE l $ • EXCESS LIAB CLAIMS -MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION X WC STATU- 0TH- AND EMPLOYERS' LUt&UTY TORY I IM FR B ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N NIA GWG0334000313 -110 09/23/10 09/23/11 E.L. EACH ACCIDENT $ 100,000 IM OFFICEREMBER EXCLUDED? (Mandatary In NH) E.L. DISEASE - EA EMPLOYEE S 100,000 If yes, describe under DESCRIPTION OF OPERATIONS below . E.L. DISEASE - POLICY LIMIT 1 S 500,000 C Hillsborough Co OFL0584008 06/13/10 06/13/11 Surety 5,000 L&P Bond ( Bond DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (Attach ACORD 101, Additions! Remarks Schedule, If more space Is required) Solar energy contractors -Labron E Taylor, Jr.-License #CVCO56667, is exempt from workers compensation coverage. 30 day cancellation for workers compensation CERTIFICATE HOLDER CANCELLATION CITYOFZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CITY OF ZEPHYRHILLS ACCORDANCE WITH THE POLICY PROVISIONS. 813-780-0021 5335 8TH STREET AUTHORIZED REPRESENTATIVE ZEPHYRHILLS, FL 33541 ,/g / �` ry ^ / V � ^� i © 1988 009 ACORD CORPORATION. All rights reserved. ACORD 26 (2009/09) The ACORD name and logo are registered marks of ACORD