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06/23/2011 8:4'�:47 AM -0700 FAXCOM PAGE 3 OF 3 <br /> �,,.�„ ,a3e� <br /> A����� CERTIFICATE OF LIABILITY INSURANCE °"'�`��'°°""""' <br /> �,,.r 6/23/2011 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFlCATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGA71VElY AMEND, EXTEND OR AL7ER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERIIFlCATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE'iWEEN THE ISSUING INSURER(S�, AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CER7IFlCATE HOLDER. <br /> IMPORTANT: If the certiTicate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS W/UVED, subject to <br /> the terms and conditions of the policy, certain policies may requKe an endorsement. A statement on this certificate does not confer riphts to the <br /> certificate holder in lieu ofsuch endorsement(s). <br /> PRODUCER � Certificate Department <br /> Commeraal Lines - (813) 6393000 <br /> Wells Fargo Insurance Services USA, Inc. �� E,c : $13.639.3000 F � No : 813.639.7180 <br /> E•Ma� clw_certre ues welisfar ois.cam <br /> 2502 N. Rodcy Pdnt Drive, Suite 400 nooaess: q �@ 9 <br /> INSURER�S) AFFORDINO COVERAOE NAIC • <br /> Tampa, FL 33607 INSURER A Hartfard Casualty Insurance Company 29424 <br /> iNSU�o Massey Metals Company, Inc. Massey Fabricetars, Inc. �sur�a e. Zenith Insurance Company 13269 <br /> P O Box 89297 INSURER C. <br /> INSURER D <br /> INSURER E . <br /> Tampa FL 33689 <br /> INSURER F . <br /> COVERAGES CERTIFICATE NUMBER: 2901152 REV1310N NUMBER: See below <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. NOTUVITHSTANDING ANY REQUIRETAENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUAAENT 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, <br /> D(CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR 7ypE OF INSURANCE <br /> LTR POLICY NUMBER MIDDiYYYY MIDD LIMITS <br /> A GENERALLIABILITY 21UUNUT4163 11/01/2��� 11/01/2011 �CHOCCURRENCE $ 1.DOD.000 <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ee occurrence S 3 �•� <br /> CLAIMSauIADE � OCCUR MED EXP (My one person) $ 10,000 <br /> PERSONAL &ADV INJURY $ 1,00O,OOD <br /> GENERAL AGGREGATE 5 2.�00.000 <br /> GEN'LAGGREGAiELIMITAPPLIESPER PRODUCTS-COMPlOPAGG � 2.000,000 <br /> POLICY X PR � LOC S <br /> /.� AUTOMOBILELtA81LITY 21UUNUT4163 11/01/2010 �1/01/2011 �aec �p�� <br /> X ANYAUTO BODILYINJURY(Perpeison) $ <br /> AILOWNED �SCHEDULED BODILYINJURY(Peracddenq S <br /> AUTOS AUT0.S PROPERNDAMAGE <br /> NON-0WNED <br /> HIREDAUT0.S I AU7O8 erecciden[ � <br /> i � <br /> A X UMBRELLALIAB X OCCUR 21RHUTT9000K3 11/01/2010 ��/�1/2011 EACHOCCURRENCE y 3,000,000 <br /> EXCESS LIAB CLAIMS�IADE AGGREGATE y 3,000,000 <br /> DED x RETENTION 10 ,� y <br /> 1NORKERS COMPENSATION x WC STATU- O7H- <br /> B ANDEMPLOYERSLIABILITY yrN Z830729821 3l31/2011 3/31/2012 <br /> ANY PFZOPRIETOR7PARTNERIIXECUTNE 1.000.000 <br /> OFFICEWMEMBEREXCLUDED� � N1A EL EACHACCIDENT y <br /> (M�daOOry In NH) E L DISEASE -EA EMPLOYEE 5 ���•�� <br /> Ifyea, deecnbe under <br /> DESCRIPTION OF OPERATIONS belax E L DISEASE -POLICY LIMIT � �•�•�� <br /> DESCRIPTION OF OPERATION51 LOCATIONS I VEHICLES (Attadt ACORD 101, Addidonal Ranarks Schsduls, if mors spaes is roqufrod) <br /> Proof of Coverage. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF 7HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> City Of ZephyfiillS 7HE EXPIRA710N DATE THEREOF, NOTICE WILL BE DELNERED IN <br /> Attn Kalvin SYvitzer ACCORDANCE WI7H THE POLICY PROVISIONS. <br /> 5335 Eigth Street pUTHOR12E0 REPRESENTATIVE <br /> Zephyrhills, FL 33542 <br /> 9� �- <br /> The ACORD name and logo are registered marks ofACORD m 1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2010/05) <br />