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�� OP ID: JM A�RD CERTIFICATE OF LIABILITY INSURANCE DATE�MMIDD/YYYY) 06/02J11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE�DOES NOT AFFIRMATiVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORI2ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate hoider is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and co�ditions of the policy, certain policies may require an endorsement A statemerrt on this certificate does not confer rights to the certificate holder in lieu of such endorsemeM(s). PRODUCER 727-376-0030 �NTACT NAME: Greg Roe Insurance, Inc. �2�-3�6_2262 PHONE Fax 9851 State Road 54 LAIC No, �ct): �NC, No): New Port Richey, FL 34655 E J Persichilli-Mansur A205025 A ��' — PRODUCER gATHKIT CUSTOMER ID #: _ _ INSURER�S) AFFORDING COVERAGE NAIC # INSURED The Bath 8 Kitchen Gailery INSURERA:SOU OWfl @r3 II1 SU1'i1�1C @ CO. � 0�90 Joe Ferrantegennaro ,N B: Michi Commercial Insurance �10998 6406 E Fowler Ave - y Tampa,FL33617 iNSUReRC• _ _ __ INSURER D INSURER E INSURER F ; COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLI CIES. LIMITS SHO MAY HAVE BEEN REDUCED BY PAID CL INSR' �ADDL�3U�RI - ' POLICYEFF POLICYEXP - �7R '� TYPE OF INSURANCE � ppL1CY NUMBER � M MMID LIMRS �' GENERAL LIA&LITY i � EACH OCCURRENCE '', S "I,OOO,OO A X ii COMMERCIALGENERALLIABILITY ZOI2�BI.3 O7/ZZHO ''�, O7/YYI'I'I DANTAZ�i�f6�EN7E6 l PREMISES {Ea occurtence) � 3 3 �� 0 , � � CLAIMS-MADE X OCCUR � MED EXP (Any one person) $ � O,OO r - �, , � PERSO & ADV INJURY a 1 ,000�00 , __ �'�� 'GENERALAGGREGATE $ Z,OOO,OO , GEN'L AGGREGATE LIMIT APPLIES PER- PRODUCTS - COMPlOP AGG 3 Z�OOO�OO �' , POLICY P E � LOC $ i AUTOMOBILE LIABILITY �� COMBINED SWGLE LIMIT (Ea acadent) $ ANY AUTO BODILY INJURY (Per person) $ ALL OWNE� AUTOS - BODILY INJURY (Per acddent) , $ , SCHEDULEDAUTOS -� - ' � PROPERTY DAMAGE $ ' HIREDAUTOS (Peraceident) i NON-OWNEDAUTOS $ ;$ �,UMBRELLALWB � OCCUR EACH OCCURRENCE $ � �. EXCESS LIAB I CLAIMS-MADE AGGREGATE $ ' DEDUCTIBIE $ RETENTION $ $ WORKERS COMPENSATION �� WC STATU- , OTH- I AND EMPLOYERS' LIABILITY Y � N � ' __ TORY LIMI_TS X i ER _ _____ B I, ANYPROPRIETOR/PARTNER/EXECUTIVE !WC1000014251 0��0�/1� 01/01N2 E.L EACHACCIDENT a 1 �� OFFICER/MEMBER EXCLUDED� � N � A � - _ _ _ _— _ - �, (Mandatory in NH) � E L. DISEASE - EA EMPLOYEE�: $ 'I,OOO,OO ��, If yes, desaibe under ' ', -_ DESCRIPTION OF OPERATIONS below � E.L DISEASE - POLICY LIMIT $ 'I,OOO,OO DESCRIPTION OF OPERATiONS / LOCATIONS / VEHICLES Attach ACORD 701, Addkional RemaAcs Schetlule, if more space is required) WORKERS COMP APPLIES TO FLORIDA �PERATIONS ONLY. CERTIFICATE HOLDER CANCELLATION CITYZEP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE CITY OF ZEPHYRHILLS T�'�E �P�R�T�ON DATE THEREOF, NOTICE WILL BE DELIVERED IN FAX# 813-780-0021 ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8TH STREET ZEPHYRHILLS, FL 33543 AUTHORQED REPRESENTATIVE � � O 1988-2009 ACORD CORPORATION. Ail rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD