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�" OP ID• NS <br /> ���� �`��{���� 1 E VF ���'tLil���� Ei�t��.i��l�.�E AtiTEIMMlDO/YYYY) <br /> osrosi� � <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER. TNIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLlCIES <br /> BELaW. THIS CERTIFICATE OF lNSURANCE D�ES NOT CONSTITUTE A CONTRACT BENVEEN 7HE ISSUfNG INSURERjS), AUTNORIZED <br /> REPRESENTATIVE OR Pi20DUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT• If the certificate liolder is an ADDITIONAL INSURED, the policy(ies} must be endorsed. If SUSROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not �onfer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER 407-644-8689 CONTACT <br /> NAME: <br /> Cooper, Simms, Nelson 8 Mosiey 407-644-9934 PHONE Fnx <br /> 271 West Canton Avenue fAIC, No. Eztl: A1C No : <br /> P 0 Box 1480 E <br /> Winter Park, FL 32790-1480 ADDRESS. _ <br /> James R. Havron, Jr CUSTOM�R ID ri: ADVAN-4 <br /> INSURER(S AFFORDING GOVERAGE ' NAIC p <br /> INSURED Advanced Mechanical Services INSURER k Hanover American Insurance Co. 36064 <br /> of Central Florida, Inc. DBA INSURER B Hanover Insurance Compan ,222g2 <br /> Advanced Mechanical Services INSURER C Bridgefield Emplo ers lns. Co. 10701 <br /> 2475 RegentAvenue <br /> Orlando, FL 32804 iNSURERD, I <br /> INSURER E <br /> INSURER F � <br /> COVERAGES CERTIFICATE NUMSER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE B�EN ISSUED TO THE IhSURED NAMED ABOVE FOR THE PQLICY PERIOD <br /> INDICATED NOTWITHS7ANDING ANY REQUIREMENT, TERIJ� OR GONDITION OF ANY CONTRACT OR OTHER pOCUtv1EN7 WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MHY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUEJECT TG ALL THE TERtJIS <br /> EXCL�SIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN (J�AY HAVE BEEN REDUCED BY PAID ClAIMS <br /> INSR � 7YPE OF INSURANCE ADDLiSUBRi I POUCY EPF POLICY EXP <br /> LTR 1 POLICY NUMBER , IMMIDD/YYYY Idfv7fDOlYYYY) � LIMITS <br /> i GENERAL LIABILfTY ' I EACN OCCURRENCE �' S 'I,OOO,OD <br /> A X� COMMERCIALGENERhLLIABILITY i i ZZJ461383201 O'I/O'II'I'I O'I/O"I/'IZ �AMN6�T R� ENTcC . 'IOO,OO <br /> � PREMISES IEa occurrence <br /> i CLARdS-MADE [� OCCUR ( � i � � fi1ED EXP (Nny one persont £ 5,�� <br /> � � PERSONAL E ADV IhJURY :, $ �I �OOO,OO <br /> ! I � ' I � GENERALAGGREGATE '5� 2,000,00 <br /> ' GEN'� AGGREGH?E LIMIT .4PPUES PER � � <br /> �� PRO� �— � I PRODUCTS - COIvIF10P AGG : Z,OOO,OQ <br /> � POLICY '' 7 I ❑�T LOC j E <br /> � AU70MOBILE UABIIITY � � I COMBINED SINGLE LIMIT �,OOfl�OO <br /> � � (Ea acaoenit <br /> A I ' X nr,� AUTO � � IAZJ453533s01 ovolit� I D1/0V92 1 � <br /> � ALL OWNED ALITOS I � j ( ' BODILY INJUP.1' (Per person� £ <br /> "—' BODILYINJURY(Peracadentj S <br /> SCH�DULED AL'TCS � I �I � i <br /> ; �I ( � j PROPERTY DAMAGE y <br /> X' HiRED AUTOS i � (Per accitlenq <br /> X NON-0WNED AUTOS ( i � <br /> I I ' 1 � I i 5 <br /> x UMBRELLA UAB X pCCUR i I I EACH OCCUP.RENCE � g 4,ODO,OO <br /> � EXCESS LIAB � CLAlIdS-MADE AGvREGATE S 4,000,00 <br /> B • ; UNJ460405401 01101/11 01/Dil12 <br /> I DEDUCTIBLE <br /> X RETENTIOtJ � 'IO,ODO � I � <br /> WORKERS COMPENSATION <br /> AND EMPLOYERS' LIABILITY Y � N ; ; I � X 7 T lf?T, ' �� � <br /> � ( �Y PROPRIETDRlPAP.TNERI�XECUTIVE � 83029592 � 01101111 � D'I /O�/3 Z _ �.L EACH ACCIDENT � 5� '� �0��.0� <br /> I OFRCERltdEMBER EX,CLU�ED� � I N I A � � . <br /> i IMandaiory in NH) . � � o � <br /> � EL DISEASE -_A EM LOYE..I 5 'I.OQO,OO <br /> � If ves descnbe untler - <br /> � CESCRIPTION OF OPERATIONS befow : ( E�S� - POLICY LIA91T I; 'I,OOO,OO <br /> i <br /> I I <br /> ➢ESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES �Attach ACORD'101, Atltlitional Remarks Schedule, if more space is reqwredJ <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYZ-1 <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICiES BE CANCELLED SEFORE <br /> City of Zephyrhills THE EXPIRATION �ATE THEREOF, NOTICE WtLL BE DELIVERED IN <br /> Building Department ACCORDANCE WITH THE POLICY PROVISIDNS. <br /> 5335 8th Street <br /> Zephyrhills, FL 33542 AUTHORIZED REPRESEN7A71VE <br /> � ��, �� <br /> G 1988-2009 ACORD CORPORATION. A!I rights reserved, <br /> ACORD 25 (20Q9/09) The ACORD name and Iogo are registesed marks of ACORD <br />