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Client#:635450 JOHNRYAN2 ACORDT. . CERTIFICATE OF LIABILITY INSURANCE DATE 01/27/20 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 CON (ACT NAME: USI Insurance Svcs of NE, Inc. PHONE 603 625 -1100 FAX PO Box 6360 ac, NoIL , Exl►: (ac, No): -MA ADDRESS: Manchester, NH 03108 -6360 PRODUCER CUSTOMER ID #: 603 625 -1100 INSURERS) AFFORDING COVERAGE NAIL # INSURED INSURER A: Liberty Mutual Fire Insurance C 23035 John Ryan Co. Inc. INSURER B : Marketing Application Only 9999 149 Camelot Dr INSURER C Plymouth, MA 02360 -016 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 ADDL SUBR POLICY EFF POLICY EXP LIMBS LTR INSR NVD POLICY NUMBER (MM /DD/YYYY) (MM/DD/YYYY) A GENERAL LIABILITY Y Y YY2Z11259309039 12/23/2009 06/23/2011 EACH OCCURRENCE $1,000,000 DAMAGE TO X COMMERCIAL GENERAL LIABILITY PREMISES Ea ence) $1,000,000 CLAIMS -MADE X OCCUR MED EXP (Any one person) $10,000 PERSONAL & ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $2,000,000 — 1 POLICY X WI : LOC $ A AUTOMOBILE LIABILITY Y Y AS2Z11259309029 12/23/2009 06/23/2011 COMBINED SINGLE LIMIT (Ea accident) $ 000.000 X ANY AUTO BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $1,000,000 X HIRED AUTOS (Per accident) X NON -OWNED AUTOS $ _ A UMBRELLA LIAB X OCCUR Y Y TH2Z11259309069 12/23/2009 06/23/2011 EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS -MADE AGGREGATE $5,000,000 DEDUCTIBLE $ X RETENTION $ 10000 $ B WORKERS COMPENSATION Y WC7Z11259309019 12/23/2010 12/23/2011 X WC STATU- N OTH- AND EMPLOYERS' LIABILITY TORY LIMITS FR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? © N/A (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephryhills ACCORDANCE WITH THE POLICY PROVISIONS. Building Dept 5335 8th Street AUTHORIZED REPRESENTATIVE ZEPHYRHILLS, FL 33542 - 41 © 1988 -2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD #S5259185/M5121419 DJPCA