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DATE (MM/OONY) <br /> CERTIFICATE OF LIABILITY INSURANCE 12/09/2010 <br /> PRODUCER Serial 1 179484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> FRANKCRUM INSURANCE AGENCY, INC. HOLDER. THIS CERTIFICATE DOES NOT MEND. EXTEND OR <br /> 100 S. MISSOURI AVE. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. _ <br /> CLEARWATER FL 33756 INSURERS AFFORDING COVERAGE NAICO <br /> INSURED INSURER A: FRANK WINSTON CRUM INSURANCE, INC. 11800 <br /> INSURER E' <br /> FrankCrum 1 -800 -277 -1620 iNsuRER , <br /> 100 S MISSOURI AVENUE INSURER D: <br /> CLEARWATER FL 33758 INSURERE — - <br /> THE POLIOIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTNRTMSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OF OTHER DOCUMENT WITH RESPECT TO WNICN THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCWSIONS ANO CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> wsR 7 A00'L P OUCY NUMBER POLICY EFFECTIVE POucy - wax: R' LIMITS <br /> WIRD TYPE OF INSURANCE DATE (MMIDDIVY( DATE (MWODIYYI <br /> EACH OcwRRENCE 5 <br /> GENERAL LIABILITY <br /> COMMERCIAL GENERAL LIABILITY FIRE DAMAGE VIM ens 5I0) 5 , <br /> 71CLUMS MADE DOCCUR M .r1 1 <br /> PERSONAL $ ADV INJURY 1 , <br /> GEA'ERAL AGGREGATE 5 <br /> CENL AGGREGATE UNIT APPLIES PER PRODUCTS - COMP'OP A00 5 <br /> f POucV ' (PROJECT FLOC <br /> AUTOMOBILE UASILITY GOMSINED SINGLE LIMIT 5 <br /> (E..eado/0 <br /> ANY AUTO <br /> AU. OWNED AUTDB BODILY INJURY 5 <br /> (Poi prAPN <br /> SCHEDULED AUTOS <br /> HIRED AurOB BODILY INJURY 5 <br /> (Dm mold /NI <br /> ,.., NON.OWNED AUTOS <br /> PROPERTY DAMAGE $ <br /> . (Pm IccideAl) <br /> 4 444 — 1— <br /> BRANY ARACE LIABILITY AUTO ONLY. EA ACCIDENT 1 <br /> AUTO ,_ OTHER THAN EA ACC 5 <br /> AUTO DULY AGO 1 <br /> EXCCI3 I UMBRELLA LIABILITY CACTI OCCURRENCE 5 <br /> OCCUR OOLAINS awe AGGREGATE $ <br /> s <br /> DEDUCTIBLE 5 <br /> RETEN $ _ , 1 <br /> , WORKERS COMPENIAT1dJ AND + WC 5tATU• 1 OTHER <br /> A EMPLOYERS' LN8I.ITI WC201000001 07/01 /2010 01/01/2011 X L TORY LOOTS <br /> ANY PROPRIETDRI PARTNER I EXECUTIVE <br /> OFFICER I NEWER EXCLUDEDT E L EACH ACCIDENT - E 1,000.000 <br /> ✓ yen, a.em. E.L DISEASE. EA EMPLOYEE $ 1,000,000 <br /> S PECIAL PROVISIONS MI.0 <br /> E.I. DISEASE- voucYLeN1T 1 1 000,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS /LOCATIONS 1 VEIMCLEB I EACLU01oNI mono BY OJDOASEMENT I SPECIAL PR3VI$IONS <br /> EFFECTIVE 07/20/2009, COVERAGE IS FOR 100% OF THE EMPLOYEES OF FRANKCRUM LEASED TO METAL ROOFING <br /> CONSULTANTS, INC. DBA ALUMA -TILE ROOFERS, INC. (CLIENT) FOR WHOM THE CLIENT IS REPORTING HOURS TO FRANKCRUM. <br /> COVERAGE IS NOT EXTENDED TO STATUTORY EMPLOYEES. <br /> CERTIFICATE HOLDEN cANCEU.ATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> PATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE <br /> TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SHALL IMPOSE <br /> MO OBLWATION OR LIASLJTY Of ANY KI O UPON THE INSURER, ITS AGENTS OR <br /> CITY OF ZEPHYRHILLS BUILDING DEPT. REPRSSENTATNES. <br /> 5335 8TH STREET AumoRIzED REPRESENTATIVE <br /> ZEPHYRHILLS, FL 33542 -� <br /> 100 /(00 wn.If YV-1 7.I :AI (IIn7. /Rn /7.1 <br />