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• �'""1 LINRROG-01 AUCH '`��_ CERTIFICATE OF LIABILITY INSURANCE DATE(MMlDD/WW) 9l2712011 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 8Y THE POLIqES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSIITUTE A CONTRACT BEIYVEEN THE ISSUING INSURER(S� AUTHORI2ED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the cert'rficate holder is an ADDI110NAL 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 (404) 633-4321 N�E Yates Insurance Agency PHONE Fax 4 Executive Park East, NE uc No en : �ac, No�: Suite 200 xooa�ss: _ Atlanta, GA 30329 INSURER(S►AFFORDING COVERAGE NAIC / INSURERA Travelers Indemnity Company 25658 INSURED Lin R. Rogers Electrical Contractors, If1C. INSURER B Travelers Property Casualty Co of America 25615 Rogers Electric Service Corporation INSURER C National Union Fire Ins Co Pittsbur h PA 19445 Rogers Electric Lighting Corporation INSURERD Travelers Indemni Com an ofAmerica 36161 2050 Marconi Drive, S# 200 INSURER E Alpharetta, GA 30005 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 CONDfTION 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 SHOV4N MAY HAVE BEEN REDUCED BY PAID CLAIMS. �L7R TYPE OF INSURANCE IN POLICY NUMBER MMIDD MMIDDNYYY LIMRS GENERAL LIABILITY EACH OCCURRENCE $ 'I,OOO�OO A X COMMERCIAL GENER.4L LIABILITY VTKCO5787B539 ��2�� 1/1/2012 p�MISES Ea occurrence $ 3 ��e 00 CLAIMS-MADE � OCCUR MED EXP (Any one person) $ �5,�� PERSOnuu 8 aDV INJURY $ 1,000,00 GENERAL AGGREGATE $ Y,OOO,OO GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $ Y�OOO�OO POLICY X PR � l0� $ AUTOMOBILE LUIBILfTY COMBINED SINGLE LIMIT Ea acaderd � r��, B X ANY AUTO VTJCAP5787B540 'II'IIZO'I'I 111/2012 BODILY INJURY (Per person) $ ALL OWNED SCHEDULED 80DILY INJURY (Per accitlent) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DMMGE $ AUTOS Per accident X Hired Physical g UMBRELLA LU1B X OCCUR EACH OCCURRENCE $ 'I S,OOO�OO (�` EXCESSLIAB CLAIMSMADE BE26159418 �I'IIZO'I'I 11112072 AGGREGATE $ 'IS�OOO�OO DED X RETENTION $ 'I O OOO g WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LU181LfTY x TORY LIMITS ER D OFFICERlMEEMBEREXCLUD D �CUTIVE Y � NrA VTC2HUB8571C373 ��2�1� 111I2012 EL EACHACCIDENT $ ��0�� (Mandatory in NH} E � DISEASE - EA EMPLOYEE $ �,000,�� f yes, descnbe under DESCRIPTION OF OPER.4TIONS below E L DISEASE-POLICY LIMIT $ �,OOO,OO B LeasedlRented Equipment QT6600104L715 71112011 11112012 500,00 DESCRIPTION OF OPERATIONS ! LOCAl10NS / VEHICLES (Attach ACORD 107, Addklanal Remarka Schetlule, H more space is required) General Liablllty policy referenced above provldes per project aggregate Ilmlt as requlred by written contract. orkers Compensatlon Includes State of FL In 3A. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEPORE City of Ze h rhills 7'NE EXPIRATION DATE 7HEREOF, NOTICE WILL BE DELNERED IN P Y ACCORDANCE WITH THE POLICY PROVISIONS. 5335 8th Street ZephyrhillS FL 33�Z- AIJT}10RIZEO REPRESENTATIVE _--� _ f , "�'� e ��/°.. .�''+�.� " _ _ _ O 1988-2070 ACORD CORPORATION. All rights reserved. ACORD 25 (2010f05) The ACORD name and logo are reglstered marks of ACORD