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A�' R a OP ID: RM <br /> �.� . CERTIFICATE OF LIABILITY INSURANCE °"'�"""°°'"""' <br /> THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION OI�.Y AND t�ONFERg I�/p RIGHTg UppN TME CERT�FICA F�p� THIS <br /> CERTIFICATE DOES NOT AFFlRMATiVELY OR NEGATiVELY AMEND, EXTENp pR qLTER TNE CpyER/►GE AFFORDED Blf THE ppLiC1ES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NpT CONSTITUT� A CpNTRqC't gETYYEEN TME ISSUING 1���5), AUTHpR1ZED <br /> REPRE3ENTATIVE OR PRODUCER, AND THE CERTIF7C/�TE HpLpER, <br /> IMPORTANT: H ths cerdticata holder is an ADDRIONAL MISURED, fhe Policp(fes) must be andorsed. If BUBROGATION IS WAiVED. subject to <br /> tha tem�s and conditions of the Po1icY� certain polkies may raquire an endorse�r�eM. A staffirneM on this �eaEe does not ca�fer rigt�ts to the <br /> cerdficate holder in Ileu of such endor�men s. <br /> w�oaucER 8�3 rur�: Rani Mahbubani <br /> Insueance Company of Fbrida <br /> 2'7356 Cashford Cir Sbe 102 813-788� PHONE .813-788-1�65 F� <br /> YYesley Chapel, FL 33644 E �� • Nc Ro : 813-884�3626 <br /> Charlfe A Hemandez noor�ss: ran' 'nsurancecpry�panyp}flp�a.� <br /> � � � TRIPL-1 <br /> INSURED Triple Crown Roofing, Inc. $��� Od � '''� � <br /> 37625 St Rd 54 u+s�►r�a n: Endurance American Specialty 41718 <br /> Zephyrhllla, FL 33542 iNSUr�e e: <br /> INSURER C : <br /> iNSURER D : <br /> iP1SURER E : <br /> WSURER F : <br /> COVERAGES CERTIFICATE NUMBER: REViS10N NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR T}{E POLICY PERIOD <br /> INDICATED. NOTIMTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR AAAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICfES DESCRIBED HEREMI IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMiTS SHOV4N MAY HAVE BEEN REDUCED BY PAID CLAIAAS. <br /> INSR <br /> LTR TYPE OF INSURANCE POUCY NUMBHt �Y �F POLICY D� <br /> GENERAL W181LITY �� <br /> EACH OCCURRENCE _ 'I,QQQ� <br /> A X coiuMEaa,n� ceNEwa. uA&urv BC10000625000 10r0U11 10AOU12 <br /> CWMS-MADE X� OCCUR ��� �� s ��� <br /> �o EXP �qny one peison) s 5, <br /> PERSONAL3ADVIWURY S 'I,OOO, <br /> GENERAL AGGREG4TE S 2�000� <br /> GEMI AGGREGATE UMIT APPLIES PER: <br /> POLICY � �pC PRODUCTS-COMPAPAGG S Z,OOO� <br /> AUTOMOBILE lU1�LITY S <br /> COMBINED SINGLE I,pd1T : <br /> ANY AUTO (Ea ao�dak) <br /> AlL OWNED AUTOS BpD�LV INJURY (px personj s <br /> SCHEDULEDAUTOS 8 0DILYINJURY(peraoade�K� j <br /> HIRED AUTpS PROPERTY p,qMqGE <br /> (� aoadent) S <br /> NON-0NMED AUTOS <br /> S <br /> UMBRELLp Llpg S <br /> OCCUR <br /> EXCESS W►B CINMSMADE EACH OCCURRENCE s . <br /> DEDUCTIBLE <br /> AGGREGATE Z <br /> RETENTION E _ <br /> wame�s cora�snno�► s <br /> AND EMPLOYERS' LNBN.�7y Y! N �� ��" <br /> ANY PROPRIEtOWPARTNERIEXECUTNE <br /> OFFICER/MEMBER EXCLUDED? a N! A E.L. EACH qC(�pEtJT j <br /> p�Nnd�1Dry N� Wli) <br /> If yes, deacxibe wWer E.L DISEASE - EA ElAPL S <br /> DESCRIPTION OK ppEWqT10NS bebw <br /> E.L DISEASE - POLICY LJNR = <br /> DESCRIPTION UF OPERATIONS ! LOCATIOMS / VB1K�.ES (Athcf� ACORD 707, Addidontl R�narks SeMdule, Y �eors apao� h <br /> �l <br /> CERTIFICATE HOLDER CANCELLA'T�pN <br /> SFIOULD ANY OF 7HE ABOVE DESC� POLIpE3 BE CANCELLED BEFORE <br /> cte�► of zepnyrn��� �n+E �w►�noN oa►,E ,H�, � w � ee o�uv�o �N <br /> Building Dept A�n�r+cE vw'rH n� Poiacy rrtov� <br /> 5338 8th St <br /> ZePhYmills, FL 33542 C � �n� �sear� <br /> ACORD 25 YOOal09 � 1988-2009 ACORD CORPORATION. AII righb r�sasrvsd. <br /> ( 1 The ACORd name and logo are registered marics of ACORD <br />