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12/01/2010 12:59 7273276441 LARRY HOLLY ASSOC PAGE 02/02 <br /> ACQRQ" CERTIFICATE OF LIABILITY INSURANCE <br /> ..'"� M/DD/YYTY) <br /> PRODUCER 1 DATE (M 17/01 /2010 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> LARRY R HOLLY & ASSOCIATES, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 2437 CENTRAL AVENUE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ST PETERSBURG, FL 33713 ALTER THE COVERAGE AFFORDED SY THE POLICIES BELOW, <br /> INSURERS AFFORDING COVERAGE NAIC i <br /> INSURED <br /> TABAR CONSTRUCTION, INC. INSURER A: ATLANTIC CASUALTY INSURANCE COMPANY <br /> BRETT TABAR INSURER B RLI SURETY - FLORIDA <br /> 2021 44TH AVENUE NORTH INSURER C� <br /> S ST PETERSBURG, FL 33714 INSURER D: <br /> INSURER £: <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 011IER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE 15SUbD OR MAY <br /> 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 CLAIM <br /> LTR 1c,r1v r�,7E y Wya <br /> sl` TYPE OF INSURANCE POLICY NUMBER p RTE (MWD�OIVY) IMNWDry <br /> LI MIT ` $ <br /> GENERAL LIABWTY <br /> EACH OCCURRENCE $ $100,000.00 <br /> A El COMMERCIAL GENERAL LIABILITY #L030001563.6 12.08.2010 2.08.20 1 DAMAGE TO RENTED <br /> 0 CLAIMS MADE ® OCCUR PREMISES (3. eeeurcnce) $ VI 00,000.00 <br /> MED E)(P (Any one Demon) $ $5,000,00 <br /> PERSONAL & ADV INJURY S $100,000.00 <br /> GENERAL AGGREGATE s $300,000.00 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP A00 $ $300,000.00 <br /> 1 POLICY f PROJECT FL LOC <br /> AUTOMOBILE LIABIUTY <br /> ANY AUTO Es Roc eM) INGLE LIMIT s <br /> ALL OWNED AUTOS .. <br /> SCHEDULED AUTOS BODILY INJURY = <br /> (Per person) <br /> HIRED AUTOS - — - <br /> NON OWNED AUTOS BODILY INJURY $ <br /> (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY <br /> • ANY AUTO AUTO ONLY - EA ACCIDENT $ <br /> - 1 OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG 3 — <br /> EXCESS/UMBRELLA uABILITY <br /> • OCCUR CLAIMS MADE EACH OCCURRENCE $ <br /> AGGREGATE $ <br /> $ <br /> DFn11CTIPLE <br /> 1 RETENTION s $ <br /> WORKERS COMPENSATION AND $ <br /> EMPLOYERS' LIABIUTY -1 TORY LII ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? <br /> a e, O VI under Fl . CEASE. FA F.MPtAYF.F S <br /> SPECI PROSIONS below <br /> OT RR E.L. DISEASE • POLICY LIMIT * <br /> B CONTRACTORS CODE #LSM0017091 08.01.2010 08.01.2011 $5,000.00 <br /> COMPLIANCE BOND <br /> u e e t 4 o Y 'Ant Ul UMeNA J IONE / LULA I IURa J VEMR...t$ I CX4LV6ION21 ADDRA bY ENa)UreeeMCN I / sMl4 IIIIUNs <br /> Please send any neccessary changes to Michele at: mlholly1 ©tampabay,rr,com OR FAX TO: 727.327.6441 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> 5335 8TH STREET DATE THEREOF, THE ISSUING INSURER WALL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> ZEPHYRHILLS, FL 33542 NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 30 *HALL <br /> IMPOSE NO OBLIGA ii i OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENT TI i <br /> FX #: 813.780.0021 AUT N° "' � j r J fiy /1 <br /> ACORD 25 (2 001/OS) LARRY R HOLLY <br /> 6 ACORD CORPORATION 1985 <br />