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05/06/2611 13:�7 7275731852 PAGE 03/03
<br /> ACORD,� CERI`IFtGATE a� LIABILIT'Y INSU�4NCE °"'�""�"°^^��
<br /> vsaouc�t lz zs zo7.o
<br /> phone: �7� 6049 Fax: 7�7 '/�Kg9 THfS CERTIFICA'I'� IS I$SUED AS A MATTER OF 1NFpR�VJ,qTION
<br /> Brown & Brown xrasurance - C].ear.wate.r ONIY AND CONFERS NO RlGHTS UPON TNE CE�27'IFICA7'�
<br /> Q_ O. L�ox 2 4 5 6 H�LbER. TH�S CERTIFiCATE DOES NOT AIM�ND, EXTEND OR
<br /> Suite 6G0 AL7'ER TNE CqV�iiAGE AFFOR�ED BYTHE pOLICIFS BEI.OW.
<br /> Clearwate.r. FL 33757-2456
<br /> - - . INSUREF2S AFFpRQING COHERAGE NAIG #
<br /> (NSURED --• ..'— . .�._ .
<br /> '��omas Sign and Awnin,g Company, Inc. '"su ReRaHartfQ,r�,T ��Co . . ,of th S•E• ?�1_�
<br /> 4590 ZxBth Avenue Nortka. M$uRERe:F?e3Prai Tn�r.ance Com
<br /> Cl.carwater FL 33762 wsuReRC: urance Com an ��g _
<br /> INSURER D:
<br /> INSURERE .. _.. ...._.._ ..�
<br /> COVERAC3ES
<br /> 7.'HE POLICiES OF INSLZtnTTG$ UZSTED SELON HAVE BEI:N iSS[1FA TO THE TN.t,Ut2Eb NAMED 71BOVE FOR TFiF; pp�=Cy � YNDICATED
<br /> OTNITHSTIINDTN(; ANy REQUIREMENT, T�RN OR CpiQDT.'�,T,qN QF p�}y tppTRT1CT OR OTHkT. npCrn�kr.� w.r,TR RggpE�C�r xo �rt.I=c� �xzs
<br /> CERTIFICAT$ MAY $E IS5UED OR M71Y PSRTAtpT, � XN3URANCE AFFORDRp BY THp I.�p[ DiiSCRIBED }�REIN IS SUB�TECT TO AT,i� TKF
<br /> FRM$, EXCLUEIONS RND CONDITION$ pp qUCH POLICIES. 11GGFFCnTF L,T,M�'1,'$ $HO�bI MAY HP.VE BESN REDUCED SY PAIn (:T,ArM�.
<br /> I o v u 0. M�VD �TNE P �p�y �� _.....,._..
<br /> C�„ POLICYNUMBER
<br /> � ��R'""'�`^''� 77.UUNW9594 12/31/207.0 17./31/�p1,�. Encr+xcuiaENCe s 1 Do0
<br /> CpMn��piALGENER'LLU181LITY - • ��'---���
<br /> bIISE3,(Ea aeeurenec) S� 0 0 0 0
<br /> C�4tM5MADE � OCCUR �pExP(Anyaneperoon) S ],
<br /> F'ERSONq� b ApV INJURY S 0 0 0. C QD
<br /> GENERALAGGRE6�TL S 0.,,_O_QO
<br /> G�N7.A4CiREC�ATEl1MITAFPLIESFER PROOUCTS.COMp/pPAOC, f?AQOO,rOOO
<br /> X POLICY ��' LOC
<br /> � 1MM 2MM
<br /> A AUTOM081LE LIA61uTY 21 TJLTNUTJg 5° 4 ]. 2/ 31 / 2 010 12 / 31 / 2 011 CObi81N�0 $INQI,F I ,r�
<br /> ANY auTO (Ga xcidanq + 1, D 0 0, 0 0 0
<br /> �u_L OVVNEC� AUT0.5
<br /> X � BODILYINJURY s
<br /> (P .rc PerAn)
<br /> MREDAUT�
<br /> NON-0WNEOAUI'OS BODILYIWURY s
<br /> (Pqrarty0�nh
<br /> - ' PROhER7Y onnanpe F
<br /> (Perae6tlenl)
<br /> CsARAGB LIABILITY
<br /> AUTOONLY.EAACCIOENT ;
<br /> ANY AU7a
<br /> OTF�RfFWN ��C S
<br /> AU700NCY: AGG S
<br /> B EXCESSNMBREtL4 UABILtfY KO 6 8 0 4 0 8 2 12 / 31 / 2 010 12 / 31 / 2 011 � accur�tcrrcc s
<br /> 5.���.�•
<br /> occuR c�aMS Mnn� AGGRBGh7F s .5 . 0 D
<br /> 0�'uuCY7B4E $ --._ --
<br /> .;
<br /> RETEtJT'ION S _._...___ .. __
<br /> C MIORKER9COMPENSATIOMAND OD1WC08116Q9Q3 a.z/as/zoio i2/3i/aoii �{ ���� �� �
<br /> e�.o�rERS��aaurr ra��cr.s..l_,_. _�
<br /> ANYPROP�trtTpp�pnrtTH6p��,�mvF ELEACFIACCIDENT y
<br /> OFFICERIMEAABER E%CLUDED�
<br /> IFyes dax�e under EL OIS6AS�_ �4 �Mp�pyEp S 5 � Q,�� 0 0
<br /> P CIAIPROVIS1pNgpslpw ELDIEFJISE-POLICI'LIMIT S
<br /> OTliER
<br /> CEeGRIPTtON OF OP�RATIOp3 / LOCAT1WdS! �EN1CIi.S /�XCL{IS�ONS /1ppEp @Y FNppRSEM1EMTf SP6CIAL PROVISpNS
<br /> : Jamc�:� G Thom,�::; �r,scatl,, C, Th�+naq; Cha.r].es g Copp; Matthew w Thomaa as licenae holdexa.
<br /> CERTIFICATE HOLDER CANCELUITION
<br /> SHOCiLD ANY OF T1iE RDOVE DESCRIHSD POLICIBS 88 CANCELLfiD
<br /> City of 2ephyrhalla Bfi�� T� ��=�xZON DnTE THEAEOF, THE ISSUING INSUP�R
<br /> 5335 Bth SCTQ2t wILL BNDEAVOR TO MnIL 30 DAYr v7RITTEN NOTICG TO T[�
<br /> Z�phyrhills, FL 335h0 CERTIFICi1TE liOLDRR NAMED TO THE LEPT, BUT FAILURE TO Dp SO
<br /> SH71Lt, IMPOSF DTO OAT,t(;ATxON QR LIARxI�TT`l pF AIQY K.T.N[) fTPON
<br /> THF, T.NSLTRFR, TT$ A(aFt,1T$ QR R,FpRESENTA'CT.V$$.
<br /> �ur+ow�oae�eF� ExraT+vE
<br /> ACORD 25 (200110� �'� �
<br /> e ACORD CORPORATION 1988
<br />
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