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m:The Valleon Group To:GITY OF ZEPHYRHILLS.pdf - Adobe Acrobat Profess (18137800021) 16:20 07120/11GMT-06 Pg 01-02 CERTIFICATE NO. / DATE ,A�QB�. CERTIFICATE 4F LiABILITY INSURANCE 7/2G/20i1J039-22�07PM PRODUCER THIS CERTIFICATE IS ISSU£D AS A MATTER OF INFORMATiON Highpoint Risk services �.I,C ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 5501 LBJ FREEWAY, svi� 1200 HOLD£R. THlS CERTIFICATE DOES NOT AMEWD, EXTEND OR Dallas, TX 75240 (800) 728-0623 (972) 404-0380 Fax: (972) 404-0380 INSURERS AFFORDING COVERAGE INSURED: �S i/C/f: INSURERA. REGER ELECTRIC SERVICE INSURERB: 1624 ABSHER RD INSURER C: ST. CLOUD, FL 39771 (407) 957-7017 Fax: 1407) 557-071b INSURERD: INSIfRER E. THE POLFCIEB OF INSURANCE USTEO BELOW HAYE BEEN ISSUED TO THE IN8URED NAMED ABOVf FOR TNE POLICY PERIOD INDICATED. NOTWRHSTANOlNG ANY REQUIREMENT, TERM OR COI�RION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTiFICATE MAY BE ISSUED OR ARAY PERTAfN, THE INSURANCE AFFORDED BY THE POUCIES OESCRIBED HERENI 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONORIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $R TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLtCY EXP{RATIO UMRS GE ERAL LIABILIT/ 'cACH OCCURRENCE S COMMERCIAL GENERAL LIABIJTY =1R£ DAMAGE (Arry One Fre) f GLAIMS MAOE � OCCUR MED EXP (/ury one person) S 'ERSOWIL 8 ADV INJURY S GENERALAGGREGATE S GEML AGGREGATE LIMR APPLIES PER: ?ROOUCTS - COMP/OP AGG S POUCY PRO- L� AUTOMOBILE LIABILITY COMBpdED SINGLE LIMR ANY AUTO � Ea acddenq s ALL OKMED AUTOS 30DILV INdURY S SCHEDULED AUTOS �Per person) HIKtU AU 1 US 90DILV INURY g NON-OWNED AUTOS �per yccideM) �ROPER7Y DAMAGE s rPer accidenq GARAGELIABILITY AUTOONLY-EAACCIDEN7 S ANYAUTO EAACC S OTHERTHAN AUTO ONLY A � S EXCESS LIABILITY ,:ACH OCCURRENCE S OCCUR ❑CWMSMADE AGGREGATE S S DEDUCTIBLE S RETENTION S s WottKERSCOMPENBA'nONAND WC3E^727900 09/O1/201i 04/O1/�012 X �STATU - n+ EMPLOYERS' LIABILITY EL.EACHACCIDENT S lOOOOOO A E.L. DISEASE - EA EMPLOYEf f 1000000 cL.DISEASE-POIICYLp�AIT S lOOOOOO OTHER �IMRS $ :fMRS g . This certificate remains in effect, provided the client's account is in ood standin with AMS. overage is n�t provided for any employee for which the c2ient is not repor�ing uaqes to AMS. pplies to 1008 uf the employees of AMS leased to REGER ELECTRIC SERVICE, effective 04/O1/2011. ^ nsured is afforded Workers Compensation � Employers liabi2ity as a co-employer under the policy for mployees leased from AMS. * PLEASE SEE ATTACHED EMPLOYEE ROSTER.*** CERTIFICATE HOLDER A�mONAI INSURED iHSUr�R �rreR: CANCELLATION DATE TXEREOF. TiEE ISEUIN6INSURER YY�I ENDEAVOR TO MAIL 30 DAYS WRRTEN CITY OF ZEFHYRHILLS .. NOTICE TO THE CERTIfICATE HpLDEA HAMED TO TIiE IEFT, BUT PA�LURE TO DO 80 SHALL CONTRACTOR LICENSIt7G IAAFOSE NO OBLHiA710NOR LIABILITY OFANY KM1D UPON THEINSURER, RSAOENT80R 2 $13-730-0020 F 813-780-0021 REPRESENTATiVES. 5335 8TH ST 2EPHYRHILLS, FL 33542 AUTHORIZEDREPRESENTATNE �� � e