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RECEIVED 021e6/2�11 15:55 ,. <br /> ✓ <br /> , OP ID• 5B <br /> ,d►co ' CERTIFICATE OF LlABILITY INSURANCE `��` <br /> � oz�os��, <br /> TMIS GEI2TIFICATE IS ISSUEC AS A MA'�� OF lNFdRA6A710N ONLY AND CONFER3 NQ WGHT9 UPON THE CERTIFIGATE HORD�R- TNIS <br /> CERTIFtCATE DOES NOT AFfiRA�IRTIVELY bR NEQA�1vELY ARAEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY TME POLIC�ES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT SE7WEEN TFtE 135U1N0 �N8i/RER(3), AVTt14R�ZED <br /> REPR,ESENTATIVE OR PRODUCER. AND THE CERTIFICAI'6 HOLDER <br /> IMPOR7'A�r H the certlfice� hok�or 1s an ADDfnOPtAL 1N3UREi1, the polScy(i9sj 1Y►ust be endors6d. ff SUBROGATION IS WAtVEp, eubjeet to <br /> th6 SeRIiB dntl CWIdItl0113 Of tfie pvlicy, cePtdin (�oliciea may rcqul�6 an endorsament A s�abmnwnt on thit corllflcake does not CoAlA� ►IghLS to the <br /> r,ertificata bolder in fieu ot such sndorsemeM(s}. <br /> a�ouc�R 727-�2G�3n CONTACT �ean RiChard <br /> NAME: <br /> F�ast�r Agency-Cfea;rvvater 727-72SatB98 A ",°",,;. �, ,,,�, N,� T27-725 <br /> 3165 N McN1ullen 800th Road G E ��� - <br /> Clearwater, FL 38761 �ES, j1lChard 91e1'dgellC .COm <br /> Daaie� B. 8eicher, A/1� � ._ _.._ . <br /> iN9UREW91 ��a►� cOVVe NaiC • <br /> inisuRen AM5 WC, lnc. ,nyuri�re n. Nautilu5lnsurance Ca. _ 17370 <br /> 13784 VI► Rena Drive ,�suRER e. Mercu Insurance G roup _ 11908 <br /> Largo, FL 33771 - <br /> - 7 2��- s3 S- 4 3 93 � �,�o -_ -- - <br /> � L�- S 3 0- 3� 6 S � tNSIMERE �, _ - --. - <br /> INSURER F. <br /> COVEI'2AGE3 CER'TIFICATE NUN18�R: REYISION NtlMBER� <br /> T11iS IS TO CERTIFY TNAT THE Pp��C�ES OF INSURANCE LISTED BElO� HP.�/E 96EN �SSUED TO THE WSURED NAMEfl qBOVE FOR THE POLICY PERIOO <br /> INDICATEp, N0TIMTHSTANOING ANY REQU�REM6NT, TERM OR CONbITION OF ANY CO�RAGT OR OTHER OOCU9AENT UNTH RESPECT TQ WHlCM TMIS <br /> CEftTIFICATE AAAY BE ISSUED OR MqY PEa7qlN, THE INSURANCE AFFORDED BY THE POLICIES DESCRfSED HEREIN �S SVBJECT TO ALL THE TERMS, <br /> EXCL USIONS AND CONDITI OF SUCH POUCIES. L�MITS SMOWN MAY HAVE BEEN REDUCED SY PAID CLAIMS. __ _ <br /> L1S2 <br /> 7Y� OF W5UrrAniCE POLCY NUMBER IUD MN � ��RS <br /> GENERAL LWBILITY I I EACH OCCURRfNCE � S ��OOO�O <br /> ,l� X COMM£RCALGENERal�taa�irr � NNO36122 i 04141/'IQ � 09/6�H1 RE�ni9ES eaomuienoe $ ���� <br /> CI.f11MS-�1ADE a OCCUR I MED EXP (q^Y �^° Ra�) S S.OIy <br /> PERSONALG A [NJU S MY � r���� <br /> _ � �GENERA S �+�i� <br /> OEN'LAGGREG4TELIMITAPPLtESPER: PRO� Dl1CTS-G(?MPlOPAGG E Zi�Or <br /> X i PpLiCY PRO- �� 8 <br /> AUTOMOBiLE LIABLL77Y I COMBINEO SINOLE LJMIT a i <br /> B X ANV Au'r0 ' F1C7�154T1�Z � O9IOIMO O9/Q1YI1 � 9Cp0a�t) '^- --' <br /> eooi�t a S <br /> ALLOWNEDAUTOS 8001LYfNJURY(Par5a3tla+t1 S <br /> $�F+EDUi.ED AUTOS aROpER'fl' OAMACE <br /> HIFED �U'T0.5 � <br /> {Pe�acdtl6let) S <br /> NON-0WN6QAU70S � _ J,.. a --_.,�_ ._ <br /> _ � <br /> UMBRIIlA LIA9 �C EqCH OCCURRENCE S _� __ <br /> ExCESS uAe C�aMS-w+oe a acoREGnT � S <br /> �uCri� _ � S <br /> � <br /> R ENTI r, e <br /> WOS11(ERS COMPENSATiON i <br /> i WCSTATI� on+ <br /> T <br /> j Af1D E16PlOVER4' LI0.BILITY Y f N i <br /> iANVPROPR�EroWPARTNERlF.7CECU7NEa N!A E.LE4CMACCIDEN7 3 --- <br /> � aFFfCER/MEMBER EXGIUDED7 , J "� <br /> � tFq1lWtOry �n NM) I � ' E.l. OlB�A$E - EA EMPLqYEE g <br /> If yGA tlCfC�b¢ ufldC ' --. .•...• . . . ' —" '"""'_"" <br /> OE 1PTION OF OPFRATIONS below i E.L DISEASE - POLICY UMIT S <br /> OESCFt�PnpN OF OPb9AtI0NS r �OCATIONS f I�NICLES �ACad�ACORD 10f, AEtlitionel Remarke 3cMEub, if Maa epaee ie ro4iiree� <br /> CERTiFlCATE HOLDER CANCELLATION <br /> CI7'YZEP <br /> 3HOULD A�' dF 7HE A�� ��R16ED P'OLICIES BE CAMCELLED BEFORE <br /> THE EXPIRATION DATE TNEREOF, NQTICE WILL B� DELIYERED IN <br /> Clp� of ZeDhYrl�IIls ACCbRDAtlCE WITH 7HE POLlCY PROVI910NS. <br /> Building Departmertt <br /> 5335 8th 56eet nunraauo �SErrranvE <br /> Rep1►yrhilis, FL 33b42rt312 � r � �� <br /> J 6�i1. <br /> � 1958-2009 ACBRD CORPORATION. All righEs resQrved. <br /> ACORD 25 (2009/09) The ACORb name and logo are registered matks of ACARD <br />