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MAR-02-2011 11:43 From: To:7800021 P.1�2 <br /> acoRqM �ERTIFfCAT� OF LIABILITY INSURANCE °"�`�°°'"�' <br /> � , 03/02/Z011 <br /> THIS CER7IFICATE tS 13SUED AS A AAATiER OF INFORMATION ONLY AND CONFERS NO RIG1�tTS UPON Tf1E CERTIFICATE MOL�ER. THIS <br /> GER7IFICATE DOES NO'I' AFFIRIiIATIVELY OR NEGATIVE�Y AMEND, EXTEND OR ALTER THE COV�R/LGE AFFORDED 9Y THE POLlC1ES <br /> BELOW, TFtIS CERTIFICATE OF INSURANCE DOES NOT CON5T17U1'E A CONTRACT BE7W�EN THE 13SUING INSURER(S), AUT1i0R�ZED <br /> REPRESENTATIVE OFi Pfl00UCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANI': If tho c�tlflcate holdrr I� an ADDITIONAL INSURED, tM0 poNcy(ies) must be endorsed. If SUB �GA ON IS WAIVEQ, sub�ect to <br /> the terms and condiUona Ot tM6 pollcy, certsin qoltCles may r�qulro an endaroem9nt. A sta�ement on Mla cortiflcate dooe n0t confer riqhte to tha <br /> cortNk�te h01d�r In Nsu of auch endoraament(s). <br /> nnoouc� <br /> Insurance dffice of America� Ync. NoE.,� :(813)637-8a77 �(813)637 <br /> 4915 W. Cypress St�eet ��„ • . .. _ <br /> Taiepa, FL 33b07 ROD ,� _ _ <br /> WSUR61q8) AFFOKDI COVERAGE , N�',.! <br /> q�9UpE0 _ p�� p�p� ; ��� � Auta-Own 10190 <br /> American Electrica7 Services of Tampa B�y, Inc INWIRERB <br /> 6408 W. Lieebaugh Avenue IN SUNERC ; _„ <br /> Suite loZ 0 0UN6RD : <br /> Tampa, FL 33625 M,y�r�ne: .. .� <br /> MWRERF: <br /> COVERAQE5 QEF1'I'iFICATE NUMBER: 11-12 Master Cert FiEVl510N NUIYIBER: <br /> THIS IS TO CERTIFY THAT 7HE POLIC�ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE IN5URE0 NAMED ABOVE FOR THE POLICY PEfiIOD <br /> INDICATEO. NOTWITNSTANGINp ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BH 15SUED OR MAY PER7AIN, THE INSUFiANCE AFFORDED BY THE POLICIES DESCAIBED HEREIN IS SUBJECT TO ALL TNE TERMS, <br /> �XCL USIQNS AND CONDIT14 OF SUCH POLIC�ES. LIMITS SHOWN MAY HAVE 6E6N REDUCEO BY PAID CLAIMS. <br /> L�p � 1YpE OF R19URAMCE p�gp y V0 POLICY IWYBER . ' p MlD YYrr �� <br /> coi�u u�auvr BGL3301314462 0?J01IZ011 o2ro1/2012 GCM 0(iCt1MNENCE s 1, 000 � DO <br /> X COMMERCIAL OENEAA� LIA6ILITV PREMISC$ tES eccr�inncel _ 5 �OO � OO <br /> CLAiMSM�oG u OCCUR MED IXP {Any dM ON i0�) 5 S� 0 <br /> /� PERSONA4 6 ADV INJURY 9 1. �0 � � 0 <br /> GENER ALAGGRECATE i Z� OOO OO <br /> GCNL AGOREC�+Tq LIMIT APPLICS PER' PRODIlC'f3 • CUMF40P �G = Z� OOO OO <br /> X POLK'iY JCC�T LOC <br /> AUTOAAOOILELI�B��m BALilO13144GZ O���ZO�� OZ/O1I�O�2 ��"���SINGLELIMIT <br /> (Ee acdtlerNl : 1 � 000, 00 <br /> X ANY AUTO BOOILY INJ (Pyr penon) f <br /> ALL OVYNED AUTOS BO�R� I WU� (� �eM) b F <br /> A SCHEGUI.fD AtJTOS �pEp7V DAMAC'aC <br /> X hlipED AUTOS (Per ecclOeM) : <br /> X NOMOWNEO AUTOS , , s <br /> s <br /> uMenEw►w�e X p� BUL1101314462 02/01/2011 02/01/2012 EAClIOCCURRENCE i 2,000 00 <br /> � E7tCFSS IJAB CLaMg.1AADE AGGREOATE . ! Z OOO � OO <br /> DEDUCTIS�E S <br /> RHTENTION 5 = <br /> WORKER9CCGP�N6A TATU• <br /> Y IMYTS <br /> ANO EM7�OYER6' LIAOILITY Y I M ' <br /> ANY PRpPRICTOM'ARTNEf1/E%ECUTNCa N � A E.L. EA(iM ACCIDCNT S <br /> OfTICCRIMCMEER EXCWDE09 ' <br /> ��� H� t � DI$EAS[ • G EMPIUvk i <br /> 11 fksaihe urxkr E.L. DISEASE • POL�CV LIAMT S <br /> O• RIPT OFOPFRAT W�low <br /> A n an ar ne BiM1101314A62 0?J01/2011 02r01/2o12 Leased/Rented Equipment <br /> Limit: 530,000 <br /> OESGRIPTION OF OPEfiA1'IONB / GOCATIONS ! VEMICLEB (Atuch ACOfiD 107, AOtlipon�l RMna�k� 6cMduk, II n�0►a ap�a �� nqulnd) <br /> CERTIFICATE HOLO�R CANCELLATION <br /> SI10UlD ANY OF TME ABOYE OE9CRiBED POI.ICIES 6E CANCEL�ED 9EFpRE <br /> TME EXPIRATION DATE Y'HEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCOROANCE WI7?I TNE POLIC� PROVISIONS. <br /> City of tephyrhills AUTMORREDRFFnE6ENTATNE C � <br /> 5335 8th 5treet <br /> Ze hyrhills, FL 33542 Ro er Perkerson ]ONESK <br /> m 1 gB8.2009 ACQRD CORPORA7tON. All rights re9erved. <br /> ACORD 25 (2009l09) Tha ACORD name a�d logo are ragistared mark9 of ACORD <br />