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/ 1 � DATE (MMIDD/YYYY) � �`� ° CERTIFICATE OF LIABILITY INSURANCE 12/16/2010__, THIS CERTIFICATE IS ISSUED AS A MATTER; OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HQLDER'. IHI�`�� CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE CO�/ERAGE AFFORDED BY THE POLICIES!=� BELOW. THIS CERTIFICATE OF INSURANC6_DOES.NOT__CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSUR�R(S), AUTIiOR�ZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICJ4TE HOLDER. � G � �� - IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED; su�iject 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). coNrnCT Audra Bell PRODUCER NAME: CGB Insurance, LLC `''"�� PHONE .(813) 949-2708 FAX cei3>zoo-zizo - A1C No : 17894 US Hwy 41 North p�,+�� ' noort�ess:audra@cgbinsurance G� PRODUCER p0000145 Lutz FL 33 49� INSURER S AFFORDING COVERAGE NAIC # INSURED D`C � I URERA:FCCI Commercial Insurance 33472 ` !iMS,URER B . Martin Electric, Inc. r � s -�Ft�� i(�URERC: 14827 lOth Street N C� INSURERD. R�t`��` INSURER E . Dade City FL 33523 INSURERF. COVERAGES CERTIFICATE NUMBER?Ol1 Master 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 OOCUMENT 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 7ypE OF INSURANCE A � U R POIICY EFF POLICY EXP LIMITS L7R iNSR WVD POLICY NUMBER MM/DD/YYYY MM/DD! GENERAL LIABILITY EACH OCCURRENCE $ 1� OOO � OOO - X COMMERCIAL GENERAL LIABILITY PREMISES Ea ccurrence S lOO � OOO A CLAIMS-MADE ❑X OCCUR L0008112 3 /1/2011 1/1/2012 MED EXP (Any one person) a 5, 000 PERSONAL &ADV INJURY 5 1, 000 � 000 GENERAL AGGREGATE S 2� OOO � OOO GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG E 2� OOO � OOO X POLICY j CT LOC a AUTOMOBILE LIABILITV COMBINE� SINGLE LIMIT $ 1� OOO � OOO (Ea accident) X ANY AUTO BODILY INJURY (Per person) $ A ALLOWNEDAUTOS 0012676 3 1/1/2011 1/1/2012 BODIIY INJURY (Peracddent) $ SCHEDULED AUTOS PROPERTY DAMAGE HIREDAUTOS (Peraccident) $ NON-0WNED AUiOS Uninsured/Underinsured S 30 , 00� PIP-Additional E 90,000 X UMBRELLA LIAB OCCUR EACH OCCURRENCE b' 1� 000 � 000 EXCESS LIAB CLAIMS-MADE AGGRcGATE S 1� OOO � 00^ DEDUCTIBLE b A X RETENTION S SO OOO 0008198 3 1/1/2011 1/1/2012 $ A WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y � N E L. EACH ACCIDENT $ $OO OOO OFFICERlMEMBEREXCLUDED? � N�A 001-WC11A-61201 1/1/2011 1/1/2012 (Mandatory in NH) � E.L. DISEASE EA EMPLOYE $ 500 000 If Yes, describe untler E.L. DISEASE POLICY LIMIT S 50� 000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (Attach ACORD 101, AddiGonai Remarks Schedule, it 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 Ryman Construction ACCORDANCE WITH THE POLICY PROVISIONS. of Florida Inc - 36413 SR 54 W AUTHORIZED REPRESENTA7IVE Zephyrhills, FL 33541 Kraig Blancher/AM��,NDA ��"`"J A ' ��`� ACORD 25 (2009/09) O 1988-2009 ACORD CORPORATION. All rights reserved. �w�onnc .............. Tl.e A!`r1Of1 n n�l 1.+ cfc�orl m��lrc nf Af_ARII