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-��`�� CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) �— ii/so/ZOii 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 REPRESENTAT7VE 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, subjec[ to the tertns and conditions of the policy, certain policies may require an endorsement. AsWtement on this certificate does not confer rights to the ceRificate holder in lieu of such endorsement(s�. PRODUCER NAME. Buhl Insurance Agency Inc. a° No, EX,: 813-876-0057 �ac, No> 813-877-8540 P.O. Box 152698. nooRess ktramer@buhlinsure.com Tampa, FL, 33684-2698 INSURER(S) AFFORDING COVERAGE NAIC# INSURER A OHIO CASUALTY INSURANCE CO INSURED �JOR PLUMBING LLC INSURER B �RICAN FIRE AND CASUALTY INSURER C FCBS�I FUND 6050 NODOC RD INSURER D BROOECSVILLE, FL 34609 INSURER E INSURER F COVERAGES CERTIFICATENUMBER: 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 RE�UIREMENT, TERM OR CONDITION OF ANY CONTR,4CT OR OTHER DOCUMENT WITH RESPECT TO WI-IICH 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. I�TR TYPE OF INSURANCE INSR S NND POLICY NUMBER (MMlDD/YYYY) (MMlDD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 OOO OOO �( COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ �.00 OOO I CLAIMSMADE �I OCCUR MED EXP(Anyoneperson) $ lO OOO A BH053761688 10/16/11 10/16/1 PERSONALBADVINJURY $ 1 QQQ QOQ GENERAL AGGREGATE $ 2� OOO � OOO GEN'L AGGREGATE LIMITAPPLIESPER PRODUCTS -COMPIOPAGG $ 2 OOO OOO POLICY X PR � LOC JECT g AUTOMOBILE LIABILITY Ea acadent g 1� 0 � �� 0 x I ANYAUTO BODILY INJURY (Per person) $ ALLOWNED SCHEDULED BAA53761688 O1/15/11 O1/15/12 AUTOS AUTOS BODILY INJURY Per acadent $ B ( ) NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X AUTOS (Per acadent) $ $ x UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 3� OOO � OOO A EXCESSLIAB CLAIMSMADE US053761688 1��16�11 1��16�12 AGGREGATE $ 3� OOO � OOO DED RETENTION $ 1,O OOO $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y � N X TORY LIMITS ER ANV PROPRIETORlPARTNER/EXECUTIVE N � A 47073 04/27/11 04/27/12 EL EACHACCIDENT $ 1 C OFFICER/MEMBER EXCLUDED� � � OOO � OOO (Mandatory inNH) E L DISEASE- EAEMPLOYEE $ 1. � OOO � OOO Ifyes, tlescribe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICV LIMIT $ 1 OOO OOO A SURETY BOND 5037323 10/23/10 10/23/12 $5, 000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101 Additional RemarksSchedule, if morespace is required) REFERENCE GENERAL LIABILITY COVERAGE: SUBJECT TO MASTER PAR PROVISIONS, CERTIFICATE HOLDER IS AN ADDITIONAL INSURED IF REQUIRED BY WRITTEN ARGEEMENT, INCLUDES WAIVER OF TRANSFER OF RIGHTS AGAINTS OTHERS AND THE POLICY IS PRIMARY CERTIFICATE HOLDER CANCELLATION CITY OF ZEPHYRHILLS BUILDING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 5335 STH STREET ACCORDANCE WITH THE POLICY PROVISIONS. ZEPHYRHII�LS, FL 33542 AUTHORIZED REPRESENTATIVE !�;/.n� /raa�. �O 1988-2010 ACORDCORPORATION.AII rights reserved. ACORD25 (2010105) The ACORD name and logo are registered marks of ACORD