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Jun 03 il 02:�2p Lg Edwards Ins 3525676766 <br /> p. i <br /> A °R °� � CERTIFICATE OF �P ID: KS <br /> LIABILITY INSURANCE oare��aMroomrvy <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION �NLY AND COWFERS NO RIGHTS UPON THE CERTIFICATE HUS E THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVEIY AMEND, EXTENO OR ALTER THE COVERAGE AFFORDEd 8Y THE POLICIES <br /> BEL�W. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND TWE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIOWAL INSURED, the policy(ies) must be endorsed, If SUBROGATION IS WAIVED, subJect to <br /> the terms and conditions of the policy, certain pollcles may require an endorsement A statement on this certificate does not confer rights to tl�e <br /> certificate holder in lieu of such endorsemen s. t <br /> PRODt1CBR 352 �NTACT <br /> L.G. Edwards Insurance Agency nnME: Karerl Surratt <br /> P.O. Box 1548 352-5B7-6766 P �" o�• 352-567-6751 F� <br /> Dade City, FL 33526-1548 �,�� _,� NC qo: 352-567-6766 <br /> aoaRess: karensurra bmp rr com <br /> Y�.CR <br /> CUSTOMER ID p: B�ANC^� — <br /> INSURED Peter Bianco Construction Inc INSURE S AFFORDING COVERAGE NAIC N <br /> 15147 Myrtle St �NSUR�xn: American Vehicle Ins Co <br /> Dade City, FL 33523 INSURER B: <br /> INSURER C . <br /> INSURER D : <br /> INSURER E; <br /> COVERAGES �NSURER F : <br /> CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED 70 THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATEO NO7WITHSTANDING ANY REQUiREMENT, TERM OR GONDITION OF ANY CONTRACT OR QTHER DpCUMENT WITH RESF'ECT TO �/VHICH 7HIS <br /> CERTIFICATE MAY BE ISSUEO OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES OESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXClUS10NS AND COPIDITIONS OF SUCH POLlCIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAIMS. <br /> INSR <br /> l7R TYPE OF IN3URANCE POLICY NUMBER Pa POLICY FSCA <br /> GENERqL LIllBWTY MMroD/YYYY Mfk/DD/YYYY ' LIMITS <br /> A, X COMMERCIA� GENERAL LIABfLITY GL0521018752-00 ; 03lo7J11 O$IO7H 2 �CH OCCURRENCE S SOO,OO <br /> CtA1MS-MADE a OCCUR PREMISES fEa oowrcencel • S �aO,�O <br /> , � M£D EXP IAny one person) S 5,Q�0 <br /> PERSONAL & ADV INJURY S SOO�OO <br /> GENERALqGGREGATE E �,OOO,OO <br /> GEN'L AGGREGATE LIMIT APPLIES PER: <br /> X P ����Y PR � LOC PRODUCTS - COMPlOP AGG $ 'I �OOO�OO <br /> . AUTOMOBILE LG481LITY i <br /> ANY AU70 ' . COM�INED SINGLE LIMIT $ <br /> ' (Ea acddeM) <br /> ALL OWNED AUTOS , � BOOILY INJURY (Per peraon) g <br /> SCHEDULEDAUTOS BOOIIYINJURY(Peracc�tlenQ 8 <br /> HIREDAUI'DS PROPERTYDAMAGE a <br /> (Per acciderH) <br /> NON-0WNEOAUTOS <br /> i <br /> 11MBRELLA LIAB OCCUR $ <br /> ��� �� C WMS-MADE EACH OCCURRENCE S <br /> DEDUCTIBLE AGGREGA7E �y <br /> RETENTION S s <br /> WORKERS COMPENSATION f <br /> ; AND EI4tPLOYER5 UABILI7Y WC STATU• OTH• <br /> ANY PROPRiE70R/PARTNERlEJCECUTIVE Y � N ' �� <br /> OFFICER/MEMBER EXCLUDEp7 a N/ A � E L EACH ACCIDENT g <br /> (Mandafory in NH) <br /> Ifyea desaibe under � E.l. DISEASE - EA EMPIOYEE 5 <br /> DESCRIPTION OF OPERATIDNS belw� ' <br /> E.L. OISEASE - POLICY LIMiT S <br /> DESCRIPTIpN OF OPERATIpNS / LOCATIONS / VEH1CiES (Attaeh ACpRD 101, Adaidonal RertNrks Schedule, N more apaca Is <br /> requlrodJ <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYOFZ <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> CfTY OF ZEPHYRHILLS THE EXPIRATION DATE 7HEREOF, N0710E WILL BE DELIVERED iN <br /> 813-780-0021 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 5335 8TH STREET <br /> ZEPHYRHILLS, FL 33541 AUTHOR2ED REPRESENTATIVE "' <br /> � (;� `." „ _ ,9 <br /> AC�RD 25 2009/09 01988-2009 ACORD CORPORATfON. All rights reserved. <br /> ( ) The ACpRD name and logo are registered marks of ACORD <br />