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......�.�. .............vii a�. s� . av. � v�zv�vvvvzvv <br /> ���Page : 001� <br /> �rC:ORD CERTIFICATE OF LIABILITY INSURANCE a�`�'°°"""' <br /> 3/29/2011 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DQES NOT AFFIRMATIVELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFOROE� BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER�S�, AUTHORIZED <br /> REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certfficate holder is an ADDITIONAL INSURED, the policypes) must be endorsed. I( SUBROGATION IS WANED, subject to <br /> the terms and condNions of the policy, certain policles may require an endorsemeM. A statement on this certiflcate does not conter rlgMs lo the <br /> certiflcate holder in fleu o( such endorsement(s). <br /> PRODUCER � Theresa Stutzenberger <br /> Insurance Office of America, Inc. ac : 407.788.3000 �� <br /> P.O. Box 162207 e*uu� <br /> aoor�ss: <br /> Altamonte Springs, FL 32716-2207 CUSTOMERID/: <br /> Theresa Stutzenberger INSURER(S7AFFORDINGCOVERA6E Nac� <br /> iNSUr�o INSURERA Charter Oak Fi re Ins Co 25615 <br /> Eagle Fire Protection, Inc. �NSUr�s: The Phoenix Ins Co 25623 <br /> 1205 Crown Park Circle INSURERC Travelers Indemnity Co 25658 <br /> Winter Garden, FL 34787 �NSU�o: FCCI Insurance Company 10178 <br /> INSUR62E Travelers Prop Cas Co of America 25674 <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 10-11 ALL REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDfTION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VNiICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTO ALL THE TERMS, <br /> EXCLUS�ONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> L7R NPE OF INSURANCE INSR NND POLICV NUMBER ►Np LIMRS <br /> cE"Ew�unsiun' DT CO 7298L330 TIA 1 11/01/2010 11/01/2011 EACHOCCURRENCE s 1,000,00 <br /> X COMMERCIAL GENERAL LIABILITY PREM SES Ea o rrrence $ 3� � OO <br /> CLAIMS-MADE � OCCUR MED EXP (My one person) $ S� QO <br /> A PERSONAL 6 ADV INJURY S �. , OOO , OO <br /> GENERAL AGGREGATE $ Z� OOO � OO <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ 2, OOO � OO <br /> POLICY X jEa LOC <br /> $ <br /> AUTOMOBILELIABILfTY T 810 7298L330 PHX 1 'I'I/O'IIZO'IO 'I�JO�JZO�� COMBINEDSINGLELIMIT <br /> X ANV AUTO (Ea acadeM� $ 1 ���, �� <br /> BODILV INJURY (Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY (Per accideM) $ <br /> B SCHEDULED AUTOS PROPERTV DAMAGE <br /> HIRED AIITOS (Per acadent) $ <br /> NON-OWNED AUiOS $ <br /> $ <br /> UMBRELLALIAB OCCUR D M CUP 7298L330 IND 1 ������20�� ���0��20�� EACHOCCURRENCE $ 4�Q�Q�QO <br /> C EXCESS LIAB CLAIMS-MADE AGGREGATE $ 4� OOO � OO <br /> DEDUCTIBLE <br /> $ <br /> X RETENTION y 1 0 � �� $ <br /> WORKERSCOMPENSATION WC 5866 ��IO'I/YO�O ��IO�/ZO�'I WCSTATI.F OTH- <br /> AND EMPLOYERS' LU181LIT' Y I N TORY IMITS ER <br /> D OFFICER/ME BE�EJCCLUDEp?ECUTIVE ❑ NIA EL.EACHACCIDENT $ SOO�OO <br /> (Mfnddory in NI-Q E.L DISEASE - EA EMPLOYE $ 5QQ � QQ <br /> If yes, describe under E.L DISEASE - POLICY LIMIT $ SQQ, QQ <br /> DESCRIPTION OF OPERATIONS below <br /> E Rente & Lease Equipment QT6607106V91TIL0 11l01I2010 11I01/2011 5100,000 aggregatre <br /> 51,000 deductible <br /> DESCRIPTION OF OPERA710NS I LOCATIONS 1 VEHICLES (Alh�h ACORD 107, Additlond Remuk: Schedule, H mae:paee is requhe� <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPNtATION DATE THEREOF, NOTICE WILL BE DELNERED IN <br /> ACCORDANCE WITH TNE POLICY PROVISIONS. <br /> CItY of Zephyrhills AUTHORI�DREPRESENTATNE 4 � _ <br /> 5335 8th Street ` �'"`1� <br /> Ze hyrhills , FL 33542 Daniel Anderson RICIA <br /> � 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />