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A� p" CERTIFICATE OF LIABILITY INSURANCE °"TE"�'°°"""" <br /> ioroa�2oi � <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPONTHE CERTIFICATE HOLOER.THIS <br /> CER7IFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTERTHE C01/ERAGE AFFORDED BYTIiE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEENTHE ISSUING INSURER(3), AUTHORIZED <br /> REPRESENTATIVE OH PRODUCER, ANDTIiE CEFtTIFICATE MOLDER. <br /> IMPORTANT: Ii the eertifiate holder is an ADDITIONAL INSURED, the policy(bs) must be endoraed. H SUBROGATION IS WAIVED, subject to <br /> the terms end eondNions of the poliry, oertain policles may rcqulrc an endorsement A statdnent on thb oertifiate does not confer rights to the <br /> artHlcate holder In Ileu of such endoraemenl(s), <br /> PpODUCEp <br /> RiskTranster Prograrns, LLC � � <br /> 219 East Livirgston Street �E . B88-481-9363 F � No : <br /> Orlando, FL 32801 ��� <br /> ADDRE88: <br /> INSURER(8) AFFORDING COVERAGE ��s <br /> �NSUaea A:CastlePoiM Natlonal Insurance Com 40134 <br /> IN6URED <br /> Human Resouroes IIIC. INBURBH B. <br /> /00 SBCOIIdAVB, SOUIh INSURER C. <br /> Suite 303 South <br /> St. Petersburg, FL 33701 INSUpER D. <br /> IN6UpER E <br /> INSURER F . <br /> COVERAGES CERTIFlCATE NUMBER:VDR2NVOA REVISION NUMBER: <br /> THIS ISTO CERTIFYTHATTHE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDINO ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTHACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUB,IECT TO AILTHE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LNu11TS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> I �p TYPEOFINBURANCE P�D�Y PODCYEXP V � <br /> POLICY NUMBER <br /> OENERAL UA8ILRV <br /> EACH OCCURRENCE $ <br /> COMMERCIALGENEFiALLIABILITY PREMISES EaoccuRence S <br /> CLAIMS-MADE � OCCUR MED EXP (Arry one rson) S <br /> PERSONAL 8 ADV INJURY E <br /> GENERALAGGREGATE $ <br /> GEN'L AGGREGA7E LIMR APPLIES PER PRODUCTS - COMP/OP AGG E <br /> POLICY PR � LOC a <br /> AUTOMOBIIE LJA8ILITY <br /> a cd erA <br /> ANVAUTO BODILVINJUHV(Porpe�son) S <br /> ALL OWNED SCHEDULED <br /> AUTOS ALffOS BODILV INJUfiY (PeracaderA) E <br /> HIREDAUTOS NON-OWNED <br /> nuros a <br /> Per accident <br /> $ <br /> UMBpELU WB pCCUR EACH OCCURRENCE E <br /> EXCESS LUB CLAIMS-MADE <br /> AGGREGATE y <br /> DED RETENTION S <br /> A WOpKERECAMPENeATON WSLTHP 0006408 10/01/2011 10/D1/2012 WCSTATU- OTH- <br /> AND EMPLOYERS LIABILITY Y/ N / X <br /> OFFICEWMEMBERXCLUD D XECUTIVE ❑ N/A '/ EL EACHl1CCIOENT a 1,000,000 <br /> ��� ✓ E.L DISEASE-EAEMPLOYEE $ 1,000,000 <br /> Hyec describe under <br /> DESL�RIPTION OF OPERATIONS below E l DISEASE - POL�CY LIMIT y 1,000,000 <br /> $ <br /> S <br /> 5 <br /> a <br /> DESCRIPTIONOFOPEIiATONB/LOCATIONS/VEhNCLEB (A1LehACORD101,AddltlondRem�rk�gcl�SdWe�HmcreaP�oe�a�aq��rad) <br /> Cwerage is extended to the leased employees of altemate employer (Alabama, Colorado, Florida, Gaorgia, Penm3yhrania and Tennesaee Operatio�s Only): ML Moody # <br /> 000201 (C-ifective 1/1/08) <br /> CERTIFICATE HO�DER CANCELLATION <br /> SHOULD ANY OF7HE ABOVE DE3CRIBED POUCIES BE CANCELLED BEFORE <br /> THE EI�IRA710N DATE7HEREOF, NO710E WILL BE DELIVERED MI <br /> ACCORDANCE WI7H7HE POLICY PRONISION3. <br /> CITY OF �PHYRHILLS BUILDING DEPT AUTMORQED REPRESENTATIVE " <br /> 5335 STH ST <br /> ZEPHYRHILLS, FL 33542 .iK:'��''";. • ' <br /> Page i ot � m 1 ggg-2p10 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />