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��1 HUCA A��RO ' CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DD/YYYY) 7/26/2011 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), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: T Carol n Hunter BancorpSouth Insurance Services, Inc. ac No eM: 501 614-1178 a Na: 501 614-1478 P.O. Box 251510 n carol n.hunte bxsins.com Little Rock, AR 72225 pR cusTOMeR i� a INSURER�S) AFFORDING COVERAGE NAIC # INSURED Staley II1C. INSURER A.A111Q�IC8fl GU8�8tlt@@ S� LI8b1I1 26247 Staley Electric, LLC �NSUReR e:Continental Casual Com an 20443 Staley Technologies, LLC �r,suReRC.Zurich American Insurance Co 16535 3400 J E Davis Drive INSURER D Little Rock, AR 72209 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 NOTIMTHSTANDING 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 POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE ADDL SU POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYW LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 'I,OOO,OO 14 X COMMERCIAL GENERAL LIABILITY CP0926380601 4/19l2011 4/�9/2012 pREMISES Ea occurrence $ �,��,�� CLAIMS-MADE [X] OCCUR MED EXP (Any one person) $ � �,�� PERSONAL 8 ADV INJURY $ 'I,OOO�OO GENERALAGGREGATE $ Y,OOO,OO GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ Z,OOO,OO POLICY X PR � X LOC $ AUTOMOBILE LIABILITV COMBINED SINGLE LIMIT A X ANYAUTO CP0926380601 4/19/2011 4/19/2012 �Eaaccident) $ 1,000,00 BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE HIRED AUTOS $ (Per accident) NON-OWNED AUTOS g $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 'IO,OOO,OO EXCESS LIAB CLAIMS-MADE AGGREGATE $ 'IO�OOO,OO B 4024504243 M19J2011 M19/2012 DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND EMPLOYERS' LIABILIN Y � N X TORY LIMITS �ER C OFFICER/MEMBERlEXCLUDED�ECUTIVE ❑ NrA WC926380701 4/19/2011 4N9/2012 �00 E.L. EACH ACCIDENT $ �,OOO (Mandatory in NH) E L DISEASE - EA EMPLOYE $ �,0��,�� If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 'I,OOO,OO DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Zephyrhills- Building Dept. THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 5335 8th street ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills, FL 33542- AUTHORIZED REPRESENTATIVE i�� I . � � �� O 1988-2009 ACORD CORPORATION. Ali rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD