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Oct 1011 10:16a ELAINE RIEGLER INSURANCE 8137887133 p.2 <br /> Certificate of Insurance <br /> This certifies that 3ta1e Farm Fire and Casualty Company, eioo�con, urr,o� <br /> `T.T' ""." gt�te Farm General Insurance Company, sioorn�nyton, i�ino�s <br /> State Farm Fire and Casualty Company, Aurora, ontario <br /> ,,,,,,�.,�. Stabe Fa�rn Fbrida Insurance Company Wirrter Haven. Florida <br /> ' Statie FaRn Uoyds, Dallas, Texas <br /> insures the foNowing policyholder for the coverages mdicated helaw� <br /> Policyholde� JAMES O MORTON ELECTRIC CO INC <br /> Address of poEicyholder PO BOX 7 537 36906 EIIAND BLVD 2EPHYRHILLS, FL 33542 <br /> Location of operations <br /> Description of ope�ations E�ECTRICAL WORK <br /> The policies listed be�ow have been issued ta the poNcyholder forthe paticy periods shown, The insurance described in these policies is <br /> subject to all the terms, exclusions, and conditions of those policies. The limifs af liability shown may have been reduced by any paid daims. <br /> Poficy Perlod Llmlts of Liability <br /> Pdicy Number Type of Insurance Eftective Dab� : Explratlon Date (at beginning of policy period) <br /> 98 Cornprehensive 03/2?J71 D3/22112 BODILY INJURY AND <br /> Business Liability ; PROPERTY DAMAGE <br /> ..__.__ - -- -- ---...-------�---------------------- <br /> --------•- ------------ ------------- ----- ------- -- --- - <br /> This insurance includes: Products - Completed Oper2tions <br /> Contractual Liabitity Each Occurrence g 1,QOd,000.00 <br /> Personal Injury General Aggregate $ 2,400,000.00 <br /> Advertising Injury <br /> Product Completed $ 2,OOO,Q00.00 <br /> Operations Aggr+egate <br /> Pollcy riod 8(jD1LY INJURY AND P#tOPER Y DAMAGE <br /> Pdicy Number EXCESS LIA$IL[TY E?fecflve Dabe ; Expiration Date (Combined Single Limit) <br /> ❑ �"'�� Each Occurrence $ <br /> � other A99regate $ <br /> Policy Period <br /> EtFectl�e DaLe : Ex radon Date Part I- Workers Compensation - Statuto <br /> Workers' Compensation Part II - Employers �iabiNty <br /> and Employers Liability Each Accident $ <br /> Disease - Each Empl4yee $ <br /> Disease - Policy Limit $ <br /> Pol�y Period Llmlts of Liabifity <br /> Pdicy Number Type of Insurance Eflect�ve qate i Expiration � �at beginning of policy period) <br /> THE CERTIFICATE OF INSURAl+iCE IS NOT A CON7RACT �F INSURANCE AND NEITHER AFFIRMATiVELY N012 NEGATIVELY <br /> AI4A ENpS, EXTENDS OR ALTERS THE COVERAGE APPRaVED BY ANY POLICY DESCRIBED HEREIN. <br /> Name and Address of Certificatian Holder If any of the desaibed poliaes are canceled before <br /> their expiration date, State Farm� will try to mail a <br /> written notice to the certificate holder 30 days <br /> CITY OF ZEPHYRHIL.LS before cancellation. If we fail to rnail such notice, no <br /> 5335 8TH STREET obligation or liabiliiy will be imposed on State Farm ar <br /> ZEPHYRHILLS, FL 33542 its ageMs or representatives. <br /> .` ' ,.r <br /> Signature af A ed R aer►t� <br /> INSURANC CCT REP 10/10l11 <br /> Title �e <br /> ELAlNE RIEGLER <br /> Ayent Name <br /> TelepAone Number (8'�3) 783-8500 <br /> AcenYs Coce Stamp <br /> ABerx Co�e 2456 <br /> AFO Code F975 <br /> 1001Z60 106389.� 03-�640C9 <br />