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AC Rd CERTIFICATE OF LIABILITY INSURANCE 6/9/21 <br /> THIS EC RTIFICATE is ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(8), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the poricy(tes) must be enthused. If SUBROGATION 15 WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endontement. A statement on this certificate does not confer rights to Me <br /> certificate holder In Eau of such endomems s , <br /> PRODUCER NA MIE: <br /> SrittoD,- Gallagher and Associates, Inc. -- FAX <br /> 6240 SON Center Rd. — No : • •- <br /> L <br /> Cleveland OH 44139 ADORES& <br /> FNOOUCaR <br /> CUSTOMER IDE: <br /> INSURER(S) AFFORDING COVERAGE NAIC 0 <br /> u <br /> INSURED INSURER A : LexinatOf Insurance Co <br /> Galaxy Fireworks Inc - INSURRRB:Axis Surplus Ins Com0anv <br /> 204 E. Martin Luther King Blvd "" " <br /> Tampa FL 33603 INSU RRC:New Hampshire insurance Co. 23841 <br /> INSURER D : <br /> INSURER B : <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER: 821771136 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br /> PERIOD INfDIC��ATTE�ED(, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO <br /> - MALL H THE TERMS, EXXCCWSIONS ISSUED PERTAIN. S PPOOLIICCIES.LLIM AFFORDED <br /> ITSSHO N MAY <br /> HAVE BEEN REDUCED PHEREIN I IMS B <br /> L <br /> N TR S TYPE OF INSURANCE AUULbUM EF <br /> N - POLICY P FOLIC"�p <br /> wIR WM POUCY NURSER IMMIDDIYYY117 PAM IDW"YYYI LIMITS .. <br /> A GENERAL UABIUTY 64200905 6/10/2010 6/10/2011 EAC _ IRRE NCE 51,000,000 <br /> x COMMERCIAL GENERAL LIABILITY PAEM aow 550 000 <br /> CLAIMB-MAM Ell OCCUR MED EXPSMy one prison) $ <br /> PERSONAL d, ADVINJURY 61, 000,000 <br /> GENERAL AGGREGATE 52,000,000 <br /> GEN'L AGGREGATE OMIT APPUES PER: PRODUCTS - cOMPlOF AGG 52, 000, 000 -- <br /> 7 Foue, n .�,, 1 LOC $ <br /> C AUTOM0e0.EUABIUTY CA66144430 6/10/2010 6/ }0/201} COMBINEO SINGLE WAIT 61,000.000 <br /> MeemMen0 <br /> x ANY AUTO <br /> BODILY *WRY (Per pe/son) <br /> ALL OWNED AUTOS BODILY INJURY (Per e0deenn <br /> _ SCHEDULED AUTOS FROPER71QAMAf;E <br /> x MIRED AUTOS ecdlien1) w 5 <br /> X NON-OYRJEDAUTOS $ <br /> 5 <br /> uMBRELLALUIB X OCCUR EAV753129 6/10/2010 6/10/2011 EACMOCCURRENCE $4,000,000 <br /> X EXCE55 UAB CLMMS4M0E AGGREGATE w _ $4,000,000 <br /> DEDUCTIBLE $ <br /> RETENTION 5 $ <br /> WOnRMMI COMPEN3ADON I T U TU I !Tr <br /> AND EMPLOYERS' UABIU7Y — <br /> ANY PROPRICORIPARTNER/EXECUTIVE r� N f A E.L. EACH ACCIDENT s <br /> OFFICER/MEMBER EXCLUDED? I J <br /> (Mandatory M NH) E.L. OISEASE - EA EMPLOYEE 5 <br /> n Foe, d al0'under <br /> DESCRIPTION OF OPERA - DONS Mew E.L. DISEASE _ POLICY UMIT 5 <br /> oaSCRIPTION OF OPERATIONS f LOCA7tONS 1 VEHICLES (Attach ACORD 101, Addtiomd Remelts S6heduts, I men woe le required) • <br /> Stand )rocaton: 5943 -5953 Gall Boulevard, Zephyrhills, FL 33542 <br /> Additional Insured: City of Zephyrhills, Pasco County Board of County Commisioners, Zephyr Mark Rider all <br /> their agents, representatives and subsidiaries. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED <br /> WORE THE EXPIRATION DATE THEREOF NOTICE WILL BE DEUVERED <br /> IN ACCORDANC WITH THE POLICY PROV <br /> City of ZephyrhiUe, Pasco County Board of <br /> County <br /> Commisioners and Zephyr Mark Rider AUTHOR12mREPRESENTAEVE <br /> 5335 8th Street <br /> zephyrhille, FY. 33542 <br /> ® 1988.2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />