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�'-,,,.�'. � o� io: s� <br /> ' °� - CERTI�ICATE OF LIABIL,ITY INSURANCE DATE(MMIDWYYYY) <br /> 03/08/11 <br /> THIS CER7I�ICAT� IS (SSUED AS A MA17ER OF INFORINATION ONLY ANp COkFERS NO RIGN75 CIPON THE CERTIFICATE HOLI?�R. '1'HI$ <br /> CERTIFICATE CaLS NOT AFFIRMATNELY Oli NEGATIVELY AMENC, �XT�ND OR ALTEFi TFfE CpVEFlAGE AFFORDED 8Y tH� POLICIES <br /> BELOW. THIS CERTIFICA'I'� OF INSURANCE GOFS NO7 CQNSTI71J1'� A CONTRACT B�1'WEEN TNE ISSUING INSURER(S), AUTHOIiIZED <br /> IiEPRESBKTATIVE OR PRdDtJCER, AND TH� CERTiFICATE HOLDER. <br /> IMPORTAN7: If the eartlfleate holder is an ADDITIONAL INSURED, the policy(les) must be sndarsad. If SUBROGATION IS WAIVEG, subJeet ko <br /> the tcrms and condltlons of the policy, eartaln policies may raqulre an endorsemer�t. A statement on thls certlficate does not confer rights to tha <br /> certlficate holder In Ileu of such endorseman s. <br /> PRODUCER $s$'�7`$Z �NTACT <br /> Wllliams-He55lnsurance 863-686-3054 P ; '� No : <br /> 1617 E. Gary Rosd ' <br /> Lakaland, FL 338�i Ress: <br /> p. Brandabeny - A02869T �ODVO � WAYN��6 <br /> INSU s AF'FORDING COVeAAGE NAIC M <br /> INSURED yyayne Crawford ConstrucHdn in IN6UR8RA Mid-Cor�tineht Cssual �.O ���5 <br /> Walter Wayne Crawford, Pra� IN9U1tER 6: <br /> 473Z US HWY 98 N INSURERC <br /> Lakeland,l=L 33809 <br /> iNSURER o : <br /> iesu�R � : <br /> iN uaen F : <br /> CoV�IiAGES CBRTIFICATE NUMBER: R�VISION NUMBER: <br /> TNIS IS TO CERTtFY T►�►T TME poUCIES OF INSURnNC� LtSTED sELOW WAVE BEEN �s5u�� �'O THE INSUReb NAMED ABOVE FoR tW� POUCY P�RiOo <br /> INDIGATED. NO'1'WITMSTANDING ANY it�QUIREMENT, TERM OR CONDITION OF' ANY CQNTRACT OR 07HER GOGUMEN'f' WITH RESP�CT TO WNICH TMIS <br /> CERTIFICrATE MAY BE 189U�D OR MAY PERTAIN, THE INSUiiANCE AFFORDEa 9Y 7HE POLICIES D�5CRi8ED HER��N IS SUBJECT TO A�L THE t�WNS, <br /> DcCLUSICINS AND CONDITIONS O� SUCH POLICIF5. LIMITS SHOWN Ak4Y MAVE BEEN REDUC�b BY PAIP GtAIMS. <br /> � TfPE OF INBWtANCE POLICI� NUM R M D Y EF P uMITS <br /> v�NEitpL LIAAIU'I'�' EACH OCCURR�NCE S 1�000�00 <br /> A X con�nn�RClnl OENERA� 4ws�urr GL000788475 0�/28l'l 0 04l261i 1� r i , p a 100 0 <br /> CLa�MSdAAOE � OCCUR MED EXP IArw oM p�rsa�+l S �xCludO <br /> X 600 Pp bOd PER&ONAL & ADV INJUIiY S �r��i <br /> GENERAL AOOREGATE S Zi��A <br /> OEN'L AQOREG�►T� LIMIT APpIJE3 P�R PROOUCTS • COMplbh A00 S Z,�00,0 <br /> X POLICY PRO. � s <br /> AU70M0911E LIABnm COM9INED S�NG�E LIMIT x <br /> (Ea um lesix) <br /> � �� BODILY INJURY (Por par�on) S <br /> ,4�I, pWNED AU7Q$ 80DILY INJURY (per exithnU S <br /> 9CHEOULED AllTpS PROPEI�7Y bAMAGE <br /> MIRE6AUTbs (peracddant) s <br /> NON-01NNED AuTOS � <br /> S <br /> UM9RELIA ultB OCCUR CACH OCCUFtItENCE S <br /> F�CESS LaB CLAIMS�MADE AGGaEGATE S <br /> DEDUCTI9LE � <br /> R NTI N $ <br /> WOpK�h5 COMPEN9ATION WC 37ATU- OTH- <br /> AND BMPLOYLRS' LIABtLITY <br /> M1Y PRDpRI�TORIPAR7NER/ExECtmVC Y � N � A E.�. EACH ACCIDEN7 S <br /> OFFIC6RIM&MBER EXCLUb�b7 <br /> (MYnd111ory In NMy �, L. DISEASE .�,► eMr�or�e a <br /> If , de�crkbe under <br /> Ok� Fi1PTI0N OF OPERp'I'IONS bnlow E.L D13�A3E - PO ICY L1MIT S <br /> DESCRIPTION OF OPEIiATIOMS J LOCATIONS f YpHICLES (AMUeh ACOiiG 101, AddMlenal R�rk� 9dwMUlc, I� mon �p�v I■ �cqulred) <br /> CERTIFICATE HOLD�a CANCELLATION <br /> CTYZEPH <br /> SWOULQ ANY OF THE ABOV� DESCWBED pOUCIES BE CANC�LLED BEFOP <br /> Tha City of 2ephyrhllls �E ���'nON DATE THEREOF, NOTICB WILL. BE DELIV�R�O <br /> �AX 813-700y0021 ACCORDANC� Y1fl'I'FI THE POUCY pitOVtS10NS. <br /> 5335 8th Street <br /> Zephyrhills FL �� AUTHOkKEb RBPRESENTATIVB ' <br /> P. Brandeberry - A028687 + <br /> � 1968-2009 ACOF�b CORP TION. All rlghts re <br /> ACORD 28 (2009l09} The ACOFtD name and logo are registgrad marks of ACORD <br /> i 0/ I O'd 'ON X�� Wd �b ;£0 �f1,L I i OZ-6 <br />