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To; 813J800021 From; 9olly Spanglet _ / 9-13-12 3:37pm p. 2 of 2 <br /> V <br /> Aco� � CERTIFICATE OF LIABILITY INSURANCE DATE(MM1DDfYYY`� <br /> `.,.��" 4/13/2012 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CER'i1FICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BE7WEEN THE ISSUING INSURER(S�, AUTHORI2ED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certiflcate holder is an ADDI710NAL INSURED,the policy�ies)must be endorsed. If SUBROGATION!S WAIVED, subJect to <br /> the terms and conditlons oi the pollcy,certain policies may requlre an endorsement. A statement on this certiflcate does not confer rights to the <br /> certiflcate holder in Iieu of such endorsement s. <br /> PRODUCER �ME: Barbara Norman <br /> 3olace Insurance P�� . (800)915-0969 FAC No: �800>915-0970 <br /> 10125 Ulmerton Rd, 3te 200 .bnormanQrestinsured.com <br /> INS S AFFORDING COVERAGE NAIC• <br /> I,argo LrL 33771 irisu�Ra:3tarr Ind�emni & Liabilit Co <br /> iNSU�o iNSU�R s:FUBA <br /> Billy The 3uashiae Pl�mot�er of 3t. inisu�RC. <br /> Petersburq,=ac DBA Silly the Suashine Plumber i�u�o. <br /> 6335 Haiaes Road INSURERE. <br /> 3sint Petersbur FI� 33702 INSURERF. <br /> COVERAGES CERTIFICATE NUMBER:CL1233001324 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOUV HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VMiICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMffS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> L7R TYPE OF INSURANCE POLICY NUABER MMLICY EFF MM�1 XP LIMITS <br /> GENERAL LIABILRY EACH OCCURRENCE $ 1�OOO�OOO <br /> X COMMERCIAL GENERAL L WBILITY PR MISES Ea ocaurence $ 5O,OOO <br /> Pa CLAIMS-MADE a OCCUR IPGGL00136-01 �2/2012 /2/2013 MED EXP(My one person) $ 5,��0 <br /> PERSONAL&ADV IN,AIRY $ 1�OOO�OOO <br /> GENERAL AGGREGATE $ Z�OOO�OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER PROWCTS-COMPlOP AGG $ 2�OOO�OOO <br /> X POLICY PR� LOC 3 <br /> AUTOMOBILE LIABILfTY <br /> Ee acaderd <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED BODILY MJURY(Per ecc.�deM) $ <br /> AUTOS AUTOS <br /> NON-OV�NED PROPERTY DAMAGE <br /> HIREDAUTOS AUTOS Perecaderd $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESSLIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ <br /> $ WORKERS COMPENSA110N X WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY y!N <br /> ANY PROPRIETORiPARTNER�CUTIVE E.L EACH ACCIDENT $ S OOO OOO <br /> OFFICERfMEMBER EXCLUOED? � N�A 0642792 /1/2012 /1/2013 <br /> (Msndrtory In NH) E.L DISEASE-EA EMPL.OYE $ 1 OOO OOO <br /> Ifye s,descriDe under <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 1 OOO OOO <br /> DESCFaPT10N OF OPERATIONS 1 LOCATIONS!VEHICLES�Akech ACORD 101,Addkbnd Rsmvka Seheduls,if mors ap�es i�requiro� <br /> CERTiFICATE HOLDER CANCELLATION <br /> (813)780—0021 SMOULD ANY OF TNE ABOVE DEBCRIBEO POLICIEB BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Zephyrhiils Suildiaq Divisioa ACCORDANCE WITH TNE POLICY PROVISIONB. <br /> 5335 8th street <br /> Zephyrhills, EZ 33542 AVT�wZEDREPRESENfAl1VE <br /> Robert Childress/SPHO �.rfi�� <br /> ACORD 25(2010105) e0 1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025�zo�oos�oi The ACORD name and logo are registered marks of ACORD <br />