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'4CORp� CERTIFICATE �� OF LIABILITY INSURANCE °"""' THIS CERTIFiCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL ER.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 REPRESENTATNE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER phone: (407)332-0033 Fax: (407)332-0030 CONTACT �nsurance Solutions of America,Inc. INSURANCE SOLUTIONS OF AMERICA,INC. """"E PHONE -�� DBA:ISU-INSURANCE SOLUTIONS OF AMERICA cac,rio,en� (407)332-0033 r�,��, (40�332-0030 910 BELLE AVENUE,SUITE 1140 E-�nAa __ ___— _ ADORESS WINTER SPRINGS FL 32708 �ooucea 16�� _________ CUSTOMER ID. INSUREO INSURER(S) AFFORDING COVERAGE B.WAYNE ENTERPRISES�WC. INSURERA Arch Insurance Co. — ��*- DBA COMMERCAIL FIRE EQUIPMENT COMPANY INSURER 8 Harteysville Mutual Insurence Co. P.O.BOX 2442 INSURER C Bridgefield Employers Ins.Company 10701 BRANDON FL 33509 iNSUaea o INSURER E COVERAGES �NSURER F CERTIFICATE NUMBER: 19185 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE �ISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM'ED ABOVEMBOR'THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 7ERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH 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, INSR� AppL SUBR. _LiR TYPE OF INSURANCE INSR wvD POLICY NUMBER POUCV EFF ppugy�p A GENERAL LIABILITY lN!�D-D/1'YYYI__ (MWDDryyyy) LIMITS MFGL07210001 09/08112 09/08113 EACH OCCURRENCE a 1,000,000 X �COMMERCIAL GENERAL LIABIUTY DAMAGE TO RENTED-- �-- j CLAIMS-MADE X OCCUR P��"!��Sl��!9�!�el—__ _+a JrO�OOO Meo.exa�nny«re�so�� ;�_ 5,000 PERSON,q�&ADV IWURY a 'I,(�OO,OOO GEN'L AGGREGATE LIMIT APPLIES PER� GENERqL AGGREGATE �� I,OOO,OOO L--- X POLICY P�� OC PRODUCTS-COMP/OP AGG $ Z�OOO�OOO JECT - . _ B AU70M081LE LIABILI7Y $ — BAOOO00012414P O9/O8/12 09/O8/13 COMBINED SINGIE LIMIT � —"--- X ANY AUTO (Ea acddenq � � �,QQQ,��Q ALL OWNED AUTOS BOOILY INJURY(Per pgrson) � S SCHEDULED AU70S BODILY INJURY(Per acddent) $ HIRED AUTOS PROPERTY OAMqGE � --- (Peraccident) a NON-OWNEDAUTOS _ __ _ �_ _ a - - UMBREILA LIAB OCCUR _ _ __ __ - i S__ �_ Excess �we CLAIMSMADE EACH OCCURRENCE '� - - --�-t--- AGGREGATE DEDUCTIBLE .- _ _ _ ____i$ _ RETEN710N S _---- -- ---'-�— ---� A WORKERS COMPENSATION - ( � S AND EMPLOYERS' LU181lITY HSO-ZH47� O9IOH/��I O9IOH/�.3 �( � W�STATU- � !-QTM ANY PROPRI£TOR/PARiNER1EXECUTIVE r�N __.TORY UMITS__ � GR.�; OFF�cERM�uBER EXCLUDEmr N 1 A E.l.EACH ACCIDEN7 _ i a �,OOO�OOO (Mandalvry in NH� _-__ rc yes.aesc�ee wwe� E.L.DISEASE-EA EMPLOYEE �E 1,000,000 DESCRIP710N OP OPERATIONS bebw r E.L.DiSEASE-POLICYLIMIT �I$ ��QQO,OOO -t---- i DESCRIPTION OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 101,Additional Remarks 5chequle,if more space is required) i -�- -�-- -�-- CERTIFICATE HOLDER CANCELLATION City of Zephyrhilis SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 5335 Eighth Street THE EXPIRATION DA7E THEREOF, NOTICE WILL BE DELNERED IN Zephyrhilis,FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. Fax-813-780-0021 AUTHORIZED REPRESENTATIVE —� — ---- Attention: ACORD 25(2009/09) The ACORD name and logo are registered ma�rks of ACORDCORD CORPORATION. Ali rights reserved.