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'°`` ° CERTIFICATE OF LIABILITY INSURANCE DATE(MMUDDM(Y1� <br /> 04/08/2011 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMENO, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> THIS CERTiFiCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED REPRESENTATIVE <br /> OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION is WAIVED, subject to the <br /> terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate dces not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER CONTACT <br /> PAYCHEX INSURANCE AGENCY INC ac no �: an �2-s�as � No : an e��-0aa� <br /> 150 SAWGRASS DR E.�� <br /> ROCHESTER, NY 14620 � �•�^ <br /> (877) 362-6785 PRODUCER <br /> • 6658VA137 <br /> SVJ96 7OA INSURER(S) AFFORDING COVERACaE NAIC • <br /> INSURED INSURER A.'TFIE TRAVELERS INDEMNITY COMPANY OF AMERICA <br /> FORT KNOX FIRE AND INSURER e: <br /> COMMUNICATION INC INSURER C. <br /> 6201 JOHNS RD STE 7 INSURER D: <br /> TAMPA, FL 33634 <br /> INSURER E: <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: 060395805380890 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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS <br /> AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> NSR n,PE OF INSURANCE �� SUBR POLICY EFF POLICY EXP <br /> TR INSR POLICY NUMBER M�p MM/pD LIMRS <br /> GENERAL LIABIITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY D E TO R D <br /> CLAIMS-MADE � OCCUR PRE I E S <br /> MED EXP An one rson $ <br /> PERSONAL 8 ADV INJURY $ <br /> GENERALAGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: pR T- M P A $ <br /> PR0. <br /> POLICY JECT LOC <br /> $ <br /> AUTOMOBIIE LIABILfTY COMBINED SINGLE IIMIT $ <br /> (Ea acddent) <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS <br /> BODILY INJURY (Per accident) $ <br /> HIRED AUTOS �PeOP� $ <br /> ) <br /> NON-OWNED AUTOS $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> E%CESS LIAB CLAIM&MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> RETENTION $ $ <br /> A WORKERSCOMPENSATION N/A UB-1223N649-11 �3/�l/2��� 03/01/2012 X T �ER <br /> AND EMPLOYERS' LU181LITY Y!N <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE � E.l. EACH ACCIDENT $1 OOO,OOO <br /> OFFICERIMEMBER EXCLUDED? <br /> (Mandatory in NH� E.L. DISEASE - EA EMPLOYEE $ 1,OOO,OOO <br /> If yes, desaibe u�der <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY L�MIT $ �,OOO,OOO <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Renwrka Scheduk, if more apace is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS-BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> 5335 8TH STREET EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE <br /> ZEPHYRHILLS, FL 33542 INITH THE POUCY PROVISIONS. <br /> Phone Number 813 780 0020 AUTHORI�D REPRESEHTATNE <br /> C% � (/ � l�" ��"'�J <br /> O 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />