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From:Michelle Hall FaxID:86�967-7592 Page 2 of 3 Date:05/17/11 12:33 PM Page2 of 3 <br /> ��''�� OP ID: MH <br /> '`�� ° CERTIFICATE OF LIABILITY INSURANCE ° "'�`�"°°"Y'" , <br /> 05H 7111 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA710N ONLY AND CONFERS NO WGHTS UPON THE CERTiFICATE HOLDER. THIS <br /> CERTiFICATE DOES NOT AFFIRMATIVELY OR NEGAIIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. TMS CERTIFICATE OF INSURANCE DOES NOT CONSTiTUTE A CONTRA�CT BElWEEN THE ISSUING INSURER(S�, AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CER7IFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADOITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and corxlitions of the policy, certain policies may require an endorsemeM. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsemeM s <br /> PRODUCER 563-967�.5� CONTACT <br /> NAME: <br /> Mulling InsuranceAgency, Inc. 863-967-7592 P "c ° � Ert: AAC ,r,o: <br /> P O Box 308 208 E Park Street e�a�� - <br /> Aubumdale, FL 33823-0308 noo�ss: <br /> W. Gene Permenter, L.U.T.C.F. <br /> c�r��eR ior. WEND-01 <br /> INSURER�S� AFFORDING COVERAGE NAIC i <br /> INSURED Wendle Sheet Metal, Inc. uasur�n United Fire 8� Casualty 13021 <br /> Deborah Roberts INSURER B <br /> 335 N. Buena Vista Dr. <br /> Lake Alfred, FL 33650 INSURER C <br /> �NSURER D <br /> INSURER E <br /> INSURER F . <br /> COVERAGES CERTIFICATE NUMBER: 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 NOTWITHSTANDMG ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WffH 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, <br /> EXCLUSIONS AND CON04 TIONS OF SUCH POLICIES. LIMffS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS. <br /> INSR 7ypE OF INSURANCE POL�CN EFF POLICY XP -�- - <br /> LTR POLICY NUMBER MMADNYYY MMADlYWY LIMfTS <br /> GENERALLIABIUTY EACH V�CURRENCE $ 'I,OOO,O <br /> A X rnMMER_ryAL�=ENERFd LIABILITi 60385534 �7f���� 07�2��� FREMISE� Eaorr.urren�� � � <br /> CLAIMS-MAL�E [� r� ��.i IR MEG Exp �My pne person) $ r J, <br /> _ PERSnNA18ADV INJURY $ �,OOO,OO <br /> �ENEFALA�>RE��ATE $ Y,OOO�O <br /> vEN'L A�uREtSATE LIMIT A�FUE� FEF' FRVGUCTS- �uMF/VPA�� �I�OOO�OO <br /> � $ <br /> POLICY FR �� - �n�_ <br /> $ <br /> AUtOMO81LE LIABILITY <br /> COMBWED SIN6LE LIMIT <br /> A X ANY AUTU 60388534 07���� �7�28/�� (Ea acadenq g � <br /> BODIIY IN.IIRY (Perp?r5nn) f <br /> ALL OWNEGAi i7r�5 <br /> 6�GIL i INJJk i(Fer acadent) $ <br /> �CHEDULEG AUT! �5 — <br /> HIREDAUTOS PROPERTYDAMAGE � <br /> (Feracuden[� <br /> N i dJ -� � WhJED AI ITO : � <br /> � <br /> UMBRELLA LIA6 n � r � iR <br /> EACH nCr�iRRENCE $ 1�0��� <br /> EXCESSUAB CLAIMS-MAL�E AG�RE�_ATE $ 'I,OOO,OO <br /> A 60385534 07/28/10 07/28N 1 <br /> DEDUCTIBLE <br /> $ <br /> X FeTer�nori g 10,000 $ <br /> WOPo(ERS COMPENSATION Wr gTATU- nTH- <br /> APD EMPLOYERS' LIABILITY Y f N TORY LIMITS ER <br /> ANY PRnpRIETORIPARTNER�EXECUTIVE E L EArH ACCtDENT <br /> OFFICERRdEMBER ExCLUGE _'� ❑ N / A $ <br /> (M�ndttory In NH) E L DI �EASE - EA EMFL�_� r'EE $ <br /> if ves, dws!nbe under <br /> GESCRIPTION JF OFERATIUNS below E L GISEASE - Fi�UC Y LIMIT $ <br /> DESCRIPTION OF OPERATIONS ! LOCATIONS / VEHCLES (Att�ch ACORD 101, AdditlonN R�maMa SchedWa, It mon ap�ce ia roqulrsd) <br /> Metal Goods NOC <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYOZE <br /> SHOULD ANY OF TNE ABOVE DESCR�ED POLICIES BE CANCELLED BEFORE <br /> TF� EXPIRATION DATE THEREOF, N0710E WILL BE DELNERED IN <br /> City of Zephyrhills - Building ACCORDANCE WITH 7HE POLICY PROYISIONS. <br /> Department <br /> 5335 8th St�eet A������$�ArnE <br /> Zephyrhilis, FL 33542 /,!_ s,�-- /f ��� <br /> bYQi�W ��f <br /> O 1968-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2009lb9) The ACORD name and logo are registered marks of ACORD <br />