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ACORD CERTIFICATE OF LIABILITY INSURANCE NWEKY9XE ° �Zi22;zo"i'a"' <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Risk Transfer Programs;, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> z�9 East Livingston st.reet HOLDER.THIS CERTIFICATE DOES NOT AMEND EXTEND OR <br /> or�ando, FL 32eo� ALTERTHE COVERAGE AFFORDED BYTHE POLICIES BELOW. <br /> PHONE 866-481-9363 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA.CastlePoint National Insurance Co 40134 <br /> Global Employment Sol�tions PEO II, Inc <br /> 3350 Bushwood Park Drive INSURER B: <br /> Suite 200 <br /> Tampa, FL 33618 INSURER C. <br /> INSURER D� <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD' POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMlDD/YY DATE MM/DDlYY LIMITS <br /> GENERAL LIABILITV' EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITV PREMISES Ea occurence $ <br /> CLAIMS MADE ❑ OCCUR MED EXP (Any one person) $ <br /> PERSONAL 8 ADV INJURY $ <br /> GENERALAGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUC7S - COMP/OP AGG S <br /> POLICY PR � LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS <br /> BODILY INJURY <br /> NON-OWNED AUTOS (Per accident) $ <br /> PROPERN DAMAGE <br /> (Per accident) $ <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC S <br /> AUTO ONLY qGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCC URRENCE $ <br /> OCCUR ❑ CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> A WORKERSCOMPENSATIONAND WSLTHPE 000082 07 12/31/2010 O1/O1/2012 X TORYLIMTS ER <br /> EMPLOYERS' LIABILITY <br /> ANYPROPRIETORIPARTNER/EXECUTIVE E.L.EACH $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, describe under <br /> E.L.DISEASE-EAEMPLOYEE $ 1,000,000 <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1, 00 0, 0 0 0 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> Coverage is extended to the leased employees of alternate employer (Alabama, Colorado, Florida, Georgia, Michigan, <br /> Missouri, South Carolina, Tennessee and Texas Operations Only):Dennis L Williams, Inc. # 80-03-063 (Effective 2/2/09) <br /> DISCLAIMER: The Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized <br /> representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter <br /> the coverage afforded by the policies listed thereon. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORETHE EXPIRATION <br /> DATETHEREOF,THE ISSUING INSURER WILL ENDEAVORTO MAIL 30 DAYS WRITTEN NOTICETO <br /> THE CERTIFICATE HOLDER NAMEDTO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO <br /> OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> City of Zephyrhills Building Department <br /> Attn Bobbie <br /> 5335 Bth Street <br /> Zephyrhills, FL 33540 <br /> AUTHORIZED REPRESENTATIVE � <br /> Page 1 of 1 <br /> ACORD 25 (2001/08) O ACORD CORPORATION 1988 <br />