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A� °� CERTIFICATE OF LIABILITY INSURANCE B/31/2010 1 ' THIS CERTIFICATE tS ISSUED A3 A MATTER OF INFORMATiON ONLY AND CONFERS NO RIGHT8 UPON THE CERTIFICATE HOLOER. THIS CERTIFICATf DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXYEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOE$ NOT CONSTI7UTE A CONTRACT BETVYEEN THE IS3UING fNSURER(8), AUTHORIZED REPRE8ENTATIVE OR PRODUCER, AND THE CERTiFICATE HOLDER. APORTANT: If tha certiflcate holder is an ADDITIONA� INSUREQ ths po8cy(ies! must be endoreed. If 3U6ROGATION IS WAIVED, subject to che tertns and Conditlo�s of the policy, certain policles may require an e�dorsement. A statement on thia ceKiflcate does not coMer �ights to the certiflcate holde► in lieu of such endorseme s. vROOUCea NAME: • --- - - - - --- -- .._..- --- Work Comp Spacialist � . (800) 508 _9126 __ _ ` F � (877y4 __ ' tuc. No�: PO Box 9435 no�E : . --------..T_._.— ----- —.--. P ER _ —...�." Panama City Bea FL 3241 _ iNSUr�a�a�n�oaaHOCOV�w►oe ! _ . _%uucr INSURED INSURERA:$r1f�g6flAl.d Emp�O Ii1813r8I1CA �1�7�1__ — i INSURER 8: fi88IDa8C9�8� IriC. INBURERC: --- - - -- - ° -•- -----�----------- ----- --- -- - - --- - - - --' - � ----- °- �-- 2 615 E. 7 th Ave . i �� p � --•-----�---_ _ _ _ -_.- -- -- -- — ---� IN3URER E : ---------- --. Tampa FL 33605 INSURERF: COVERAGES CERTIFICATE NtJIIABER:�1083103253 REVI810N NUMBER: THIS IS TO CERTIFY THAT THE POl{CIES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR TH£ POLICY PERIOD INDICATED. N0TIMTHSTANOING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 1MTH RESPECT TO WH1CH 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 POLICIES. LIMITS SHOWN MAY HA VE BEEN REDUCED BY PAIO CLAIMS. L�M TYPE OF INSURANCE � POLICY NUMBER � MMID EF MMWDIYYYY I --. .-- ---- UNITS -- -- GEN£RAL UA6IUTY , � ' EACH OCCURRENCE ; S i , -- COMMERCIAL GENERAL LIABILITY i ! ' I PREMISES (F.a OOOUnlnC01 �_ ------- I � � CLAtM8-MADE � OCCUR I � i MED IXP (MY one Po�son) ' _ - ---- --- - F --- � -- ' ' i ; i --- ------ � I i � PERSOWIL 8 ADV INJURY� Z° --- ---- - --f ---�---- -- i ; , , - .__J .�_�____.__...._... _.--•- --- I GENERALAGGREGATE S --- ---- GEML AGGREGATE UMIT APPLIES PER: I I ' PROOUCTS - COMPlOP AGG � S i PaIICY P � LOC � T S i AUTOMOBII! LIABIUl1' ; � ' COMBINED SINGLE UMtT I s . I ' (Ea ac�Jdent) ~ JWY AUfO i I : I � BOpILY IMJURY (Per peraan S ----- � - -- .-- ALLOwNEUAUTOS i i ! �-"- ' ---._.._�_ SCHEOULED AUTOS 9001LV INJURY (Per aca0ant) � S _-- -- -- i ' i PROPERIY pMAAGE � HIRED HUTOS � � !(Pat aoeidaM) '. : r NON�OWNED /WTOS � � � ' �-- _ _ ` S --.- __ . i • _ - UMOR0.LA UAB OCCUR � � ._ j , EACH OCCURRENCE S � EXCE88 W18 CIAIMSMADE� � � � AGGREGATE --- f� -- —L�._ —J ' __" - - --�----- ---- DE�UCPBlE I � � : RETENr10N S — �— . 'S J� WOfiKERS OOMpHN�ATION � � VYC STATLL OTI+ AND ENP�OYERb' I,JAl1�I7Y � X _��@ ANY PROPRIETO(tlPARTNERlEXECUTiVE Y! N � r E �� q�� = 1-• � OFFICEWMEMBER EXCLUOE07 N � a ' ' 1 OOO , OOO (M�neMloryinNH) ❑! I 830-39771 9/1/Z010 '9/1/2011 --�-�-- ---��_� n yp� aesarw � , , : e.�. as�►sE -�► eMP►.ov� t 1 000 000 OESCRIPTION OF OPERA710N9 bdav I ' E.L. DISEASE POUCY UMT ' t OOO O I I � DESCPoPi10N OF OPERATIONS ! tOCA110N31 VEHICLES (AetaM ACORD 101, Addltlena� R�mrlcs �ehWuM, M mon spac� 1s rputntl) CERTIFICATE HOLOER CANCELLATION (813) 788-3293 SHOUlO ANY OF THE ABOVE DESCRIBED pOLfCIEB BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, N071GE WILL 8E DELIVERED IN C1� of Zepkyrhills ACCORDANCEINITH TlfE POLlCY PROVISIONB. 5335 er.t� st Zophyrhills, FL 33540 AUTHORIZEDREPRESENTATIVE ICovin Campbell/JANIB � � ACORO 25 (2009/09) � f868-2008 ACORD CORPORATION. All Nghta reseroed. IN3o25 �zaoeoe> The ACORD name and logo are registered ma�lcs of ACORD 600f�j XV3 S£�BT TTOZ/6Z/90