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..�-�"'1 OP ID: TM A��RD CERTIFICATE OF LIABILtTY INSURANCE DAT05/09/12�' j TNIS CERTIFICATE'IS ISSUED AS A MATTER OF MIFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS i CERT{FICATE DOES NOT AFFIRMAT{VELY OR NEGAl'NEI.Y AMEND, EXTEND OR ALTER THE CAVERA�E AFFORDED BY THE POUCIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTiTUTE A CONTRACT BETWEEN 7HE ISSUNG MISURER�S), AUTHORIZED � REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HQLDER. IN�ORTANT: fl the certificabe holder is�ADDITiONAL q�fStIRED,the policy(ics)must be endorsed. i(SUBROGATION IS WANED, subject to � the tenns and cw�itions of the poGcy certain po6cies ma�►�quire an endorsernerk. A statement on th�oertificaM does not confer rights to the � certificate holder in i'ieu of such endorserner�t(s). �� 727�'76-0030 � �Rce Ir�urance,lnc. 727-376-2262 �E - i� � -- 885 StaRe Road 54 N° -°-�------ -- -- ----L-�---1-------- New Port Ric�ey,FL 34655 - -- ---- - ,Gregory G,Rce A224149 � ---------- ----------- cusroMeto�COVECOM -- ------ - � msur�qs�,�awwa�e wuc s ;------- - - --- �------ ��o Coven�t Communities, Inc. x,sur�xn:Southern Owners Insurance Co. '10190 ' ----------- ------- --- -- --- -- - -� ----- . t0339 Key Lantern Dr. �e: �� i New Post Richey,FL 34654 ----- - -- ----------- -------— ------ iNSUr�c: ' INSURER D• —----- -------- INSURER E INSURER F: COVERAGES CERTIFlCATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFIf THAT THE POLIGES OF INSURANCE LISTED BELOIN HAVE BEEN ISSUED TO T)f INSURED NAMED ABOVE FOR Tlf POLJCY PERIOD i INDICATED. N011MTHSTAPDING ANY REQUlREI1IlEM,TERM OR CONDRION OF ANY C)OIYiR/1CT OR OTl-ER DOt:UWENT WITH RESPECT TO WHICH THIS ; CERTIFlCATE MAY BE ISSUED OR MAY PERTAIN, Tl-E MISUR/UJCE AFFORDED BY TFE POLK'.IES DESCRIBED FEREIN IS SUBJECT TO ALL THE TERMS, 1 EXCLUSlONS AND CONDITIONS aF SUCH POLJqES_UMlTS SF�ONM MAY HAVE BEEN REOl10ED BY PAID CLAIMS. �R TYPEOflISURAqCE �y� POIICYH-F FOLICYEf� -------LIMRS- -- -- --- - I(i@IHiAL I..MMLIfY � EACt1 OCCXJRRE1rCE �S 1,��0,000 �A X CNYMAERCIALGBdERAL L1ABI�fTY ' � �20140894 � o3nv�2 f 03/�/7$ ! 5�� PRB�SES t6 oaurtence) S e { �cwMSMnoE I X;o�uR I � � i kiEO ocF(Any w,e peraon) -�5----- 5,000 � ! i ; ; � � '; - - ---- --- �-� - - - ------ � � ; ; ( ', �sorlu snoviruuRV—�s— --1,000,000 I ; ;CE/�B2AL AGGREGATE 'S Y,OOO,OOO � f � !GENL AGGREGATE L1MMT APRIES PER: : � � i ;PRODUCTS-CAMP/OP AGG `S Y�OOO�OOO i F---� r �Q �—; ( � ; � � ------{- ---- -- c��cv i � �oc i ' � IEmp Ben. s Excluded AIJfOMO81LE LM9LfTY i % �COMBINED SINGLE LiMIT I,a � � �ANY AtfiO ' � ! :(Ea acciAa�rU -- - ----- - !--� t I � � !BODILY INJURY(Per Pei`'.,on) `;S I � �SCH�UIED AUTOS i ; ' � ! PROPER DAMAGE - �- - --- I ' � i i -fS I � ;HIRED AUTOS , i I � (Per xcde�t) (Per acadent)t --- —-- - - - � $ ' I .�NON-OWNED AIJFOS � ' . --- --- ---- -----~S- ------- i � FS '; , UMBRaLA LY1B : i OCCUR � � ; � ' EACH OCCURRENCE �y S ; ' � I--7 i : i ---- ----- ----, --------- , � �DICESSLYI6 L-- CLAIMSMADEi i � �� ' � ------ -- - S - --- ---- 1---------� i � �AGGREGATE ---- - - . i DEDUGTIBLE j � . � ?s r-� ; � ; : ----- ----. .---'- ----------- - � RETENiION S I � � S � MOORIC6tS COI�BISATION i, j ; ' WC STATU- ',OTH-I ; �AND 6NPLOYBt5 LUIBUTY Y J N ! ( i � TORY LIMITS_�---: ER ti---- - I A ��R�T-��ECUTiVEl��µ/A' IWCYOO6SZ7G�M � 04/14/12 � 04/14N$ . E.LEACHACGDENT $ - --- 'IOO�OOO �(Ma�Matwy in NH) ; El pSERSE-EA EMP�OYE�S_ _ �OO,OOO ��sc,�i�oF o�,rioros n�, � � � E�asEnsE-�icr utirr a 500,000 i � i i I i ; i DESCRIPfION OF OP@tAT10NS f LOCATIONS/V@i1CLES(/dlach I1COftD 701.MdiUorwl R�Scl�ed We.�7 more spaas ia requira� t CERTIFICATE HOLDER CANCELLATION CITYZEP SMOULD/tNY OF THE ABOVE DE�PoBED POLICIES BE CANCELLED BEFORE CITY pF ZEpHYRH1�LS THE EXPtRAT10N DATE THEREOF, NOTICE WIIL 8E OEUVERED IN � FAX#813 780-0021 ACCORDANCE 1NfTH Th�POUCY PROYI.SIONS. ssss sni s�er �PHYRHILLS,FL 33543 aur►+ort�rt�sBrrwmre i � l� m 1988 2009 ACORD CORPORATION. All rights reserved.