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Client#: 100d010 02SPSTERNINC ACORD,�, CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDlYYYY) 3/06/2012 THIS CER't'IFIG�r4TE.IS lSSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIF�,CATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL►OW.THI'S CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate hoider is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain palicies may require an endorsement.A statement on this certi�cate does not confer rights to the ce�tificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: BB&T Insurance Services, IIIC. PHONE 919 716-9777 F°'x .vc,No eX�: ac,Na: 3605 Glenwood Ave E•MAIL Raleigh, NC 27612 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC p 919 716-9777 — -- -- --- �NSUReR,n Restoration Risk Retention Grou 12209 INSURED �INSURER 6 Chartis Specialty Insurance Co 26883 Sternbrooke Inc. INSURER C StarNet Insurance Company 40045 13911 W. Hillsborough Ave#306 Tampa, FL 33635 INSURER D INSURER E• � � 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 CONDITION OF ANY CONTRACT OR OTHER DOCUMENT �VITH 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 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TR TYPE OF INSURANCE '�ADDLiSUBR POLICY EPF i POLICY EXP INSR i4WD POLICY NUMBER {MM/DDlYYYY)i(MMlDD/YYYY) ' LIMITS q ceNerta�unsiuTV X j RGL081103 10/19/2011�10/19I�.A'I�EACH OCCURRENCE �$1,000,000 X COMM,ERCIAL GENERAL LIABILIN i � !DAMAGE TO RENTED �l� �PREMISES Eaoccurrence) ��$�Q��QQD _ _ JI CLAiMS-MADE `�OCCUR I �MED EXP(Any one person) $rJ i '0 0 0 _ � �PERSONAL&ADV IN,IURY I S��OOO�OOO ---� - _—____ ____. ' I �GENERALAGGREGATE !$Z�OOO�OOO _ GEN'L AGGREGATE LIMIT APPLIES PER: �'�,PRODUCTS-COMP/0P AGG ;$Z�OOO�OOO PRO- i X�POLICY JECT �L�OC � ,,$ � -- --'--- ------ - ' i �, �'� AUTQMOBIIE LIABILITY j ~ � � �COMBWED SINGLE LIMIT ' � �� �- ' � Ea accidemL___ $ ' � ANY AUTO � f 'BODILY INJURY(Per person) ;$ � i ' ---.. - --- � I ALL OWNED � SCHEDULED �� ------�-----�-�-�-- AUTOS �AUTOS �BODILYINJURY(Peraccident)j$ � HIRED AUTOS '� NON-OWNED ��, PR EPO RTY DAMAGE i AUTOS � !(Per acader� �� __ I B_+ I UMBRELLALIAB � ' L— �� $- �X ; occuR t EBU024543133 10/19/2011;10/19(201 eacr+occuRRervice I$1 000 000 '4 X EXCESS_LIAB ; CLAIMS-MADE, i � �AGGREGAiE $'I OOO,OOO � DED i � RETENTION$ � '�, �$ C WORKERS COMPENSATION i BNUWC0115224 1107l2012 i 01/07/2013 X 'WC STATU- ' ''�OTH-' AND EMPIOYERS'LIABIUTY Y�N � TORY L IMIT � ER �� ANY PROPRIETOR/PARTNER/EXECUTIVE� Y� N!A� i � Y j E.L.EACH P,CCIDENT �$rJOO OOO OFFICER/MEMBER EXCLUDED? 1/ I(Mandatory in NH) � Y ' ' 'RPU080790 10/19/2011 10/19/20��E.�.oisease-E.n Er�a�ovEe;$500,000 -'Ifyes,describeunder � �-- —�--- t— .______ DESCRIPTION OF OPERATIONS below _____ _ _ ;E.L.DISEASE-POLICY LIMIT ;$SOQ,OOO A Pollution � � $1,000,000/2,000,000 � ; DESCRIPTION OF OPERATIONS/LOCATIONS(VEHICLES(Attach ACORd 101,Additional Remarks Schedule,if more space is required) "*Workers Gomp Information** Proprietors/Partners/Executive OfficerslMembers Excluded: Amy Richman James Richman (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION City Of Zephyrhilis Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN DePt. ACCORDANCE WITH THE POIICY PROVISIONS. 5335 8th Street Zephyrhills, FL 33542 AUTHORIZED REPRESENTATIVE ��-�-�•� O 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25{2010/05) 1 of 2 The ACORD name and logo are registered marks of ACORD #S82722511M7917412 MF5