|
'4C°� CERTIFICATE OF LIABILITY INSURANCE DATE�MMIDD/YYYY)
<br /> 11 16 2011
<br /> I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
<br /> CERTIFICATE 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 BETWEEN THE ISSUIING INSURER(S), AUTHORIZED
<br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
<br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
<br /> I the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the
<br /> certificate holder in lieu of such endorsement s.
<br /> PRODUCER
<br /> NAME:
<br /> Britton-Gallagher and Associates, Inc. aHONe - - - - - - Fax-- - — - -
<br /> 6240 SOM Center Rd C N xt:44 -24 -4711 (aiC,N�440-�-1234
<br /> E-MAIL
<br /> iCleveland OH 44139 ADDRESS:
<br /> __ _ _ INSURER�S)AFFORDING COVERAGE NAIC#
<br /> -- -- - - -- -- -- -- - -- - INSURERA��X171��QI1 IR$�d 1S�Q��-��?R�- --- - 1 4_�� --
<br /> INSURED - _
<br /> 5530 INSURERB.j�{1$ Sur�lus_ _Ins Com��n�%_
<br /> American Promotional Events Inc iNSUaertc
<br /> dba TNT Fireworks -- -- - -
<br /> � P. O. BOX 1318 INSURER D- -- --- -- -- ---- - -- --- --- -- � ---- ---
<br /> Florence AL 35631 wsuReke. _ _ _ _ _ �
<br /> INSURER F.
<br /> COVERAGES CERTIFICATE NUMBER:2145633279 REVISION NUMBER:
<br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
<br /> I INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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 LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
<br /> - — - --
<br /> � WSR '�q L U R � I POLICY EFF POLICY EXP
<br /> I� LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMlDD/YYYY MMlDDNYYY LIMITS
<br /> A GENERALLIABILITY � �44272132 ,11/1/2011 1;1,�2012 �I EACHOCCURRENCE
<br /> $1,000,000
<br /> X ��COMMERCIAL GENERAL LIABILITY I� , DAMA E TO RENTED - --
<br /> I � � CLAIMS-MADE rX J OCCUR I �, PREMISES IEa occurrence) 550,000 __ _
<br /> i � MED EXP(P,ny one person) $_ _ _ _
<br /> , C =� I
<br /> ��' PERSONAL&ADVINJURY �$1,000,000
<br /> ' -I- -- - -- - - -- - I I ! GENERALAGGREGATE _ �$2,000,000_
<br /> �_GEN'LAGGREGATELIMITAPPLIESPER �, PRODUCTS-COMP/OPAGG 52,000,000
<br /> '�, POLICY � PRO- LOC � $ - - —-
<br /> AUTOMOBILE LIABILITY ,
<br /> i Ea acadent�_ ' g
<br /> ANY AUTO BODILY INJURY(Perperson) r$
<br /> �--�AUTOS NED � �AUTOSULED , I I - -- - - - _ _ --
<br /> - I — i M1 BODILY INJURY(Peraccident) $
<br /> NON-OWNED
<br /> HIREDAUTOS qUTOS PROPERTYDAMAGE -----
<br /> I � �, , .SPer acadenr�-- - - $- -- —- -- -
<br /> i $
<br /> B I UMBRELLALIAB � OCCUR I� iEAU763757 Ill/1/2011 R1/1/2012
<br /> EACH OCCI,RRENCE $1,000,000
<br /> X EXCESSLIAB i � ------ -
<br /> _ _ _ ___� CLAIMS-MADE i �AGGREGATL �$1,000,000
<br /> � DED RETENTION$ � -- -` -- --- --
<br /> WORKERS COMPENSATION $
<br /> AND EMPLOYERS'LIABILITY � , �, WC ST4TU- OTH-
<br /> TQRY LIMI�___ , ER
<br /> ,ANY PROPRIETOR/PARTNER/EXECUTIVE Y�N �, -- - - -
<br /> I OFFICER/MEMBER EXCLUDED� ❑I N/A I I, I _E L EACH ACCIDENT _ $ _ _ _ __
<br /> (Mandatory in NH) i -—- -- -- -
<br /> If yes,descnbe under �, E L DISEASF-EA EMPLOYEE�$
<br /> DESCRIPTION OF OPERATIONS below � E L DISEASE=-POLICY LIMIT •$
<br /> I -
<br /> II
<br /> DESCRIPTION OF OPERATIONS I LOCA710NS I VEHICLES (Attach ACORD 101,Atlditional Remarks Schedule,H more space is required)
<br /> Certificate holder and City of Zephyrhills are named as additional insureds.
<br /> I
<br /> I CERTIFICATE HOLDER CANCELLATION
<br /> SHOULD ANY OF THE ABOVE DESCRIBED pOLICIES BE CANCELLED BEFORE
<br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
<br /> I Sweetbay ACCORDANCE WITH THE POLICY PROVISIONS.
<br /> 7325 GALL BLVD.
<br /> I ZEPHYRHILLS FL 33541
<br /> AUTHORIZED REPRESENTATIVE
<br /> �4��
<br /> O 1988-2010 ACORD CORPORATION. All rights reserved.
<br /> ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD
<br />
|