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Dec. 5. 2013 1 ; 31 PM No, 0533 P, 2/2 <br /> ACORl7� CERTIFICATE OF LIABILITY INSURANCE DATE�MMIDDIWYY) <br /> �""� 3/29/2013 <br /> THIS CER7IFICATE IS ISSUED AS A MATTER OF INFORMA710N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CER7IFICATE 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), AUTHORIZED <br /> REPRESENTA'TiVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certiflcate holder is an ADDITIONAL INSURED, the policy�fes) must be endorsed. If SUBROGATION IS WAIVED, subJect to <br /> the terms and conditions of the policy,certaln policies may require an endorsement. A statement on this certiflcate does not confer rights to the <br /> certiflcate holder in Ileu of such endorsement s. <br /> PROWCER �ME: Denise DeRemigio <br /> Adcock-Adcock Property & Casualty Aqency, Inc. PHO� . (813)933-6691 FAx (813)932-6287 <br /> rc No: <br /> 315 W. Fletcher Ave. .denised@adcock-insurance.com <br /> INSURER(3)AFFORDING COVERAGE ryp��� <br /> Tampa FL 33612-3414 iNSUr�Ra:Old Do�inion 0231 <br /> INSURED INSURER B. <br /> Jims Electrical 3ervices Inc irisur�Rc <br /> 18302 Eastwyck Drive INSURERD. <br /> IN3URER E. <br /> T EZ 33647 iN3URER F. <br /> COVERAGES CERTiFICATE NUMBER:CL1332905498 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 /> INDICATED NOlWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO VNiICH 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 /> I TR TYPE OF INSURANCE POLICY NUMBER POLICY EFF POLICY EXP <br /> MM1DD MMlDDfYYYY LIM�TS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1�OOO�OOO <br /> X COMMERCIAL GENERAL LIABILITY PREMISES Ee occunence $ 5OO�OOO <br /> a�i CLAIMSMADE �OCCUR G87308 �29/2013 /29/2014 MED EXP(Any ona person) $ 1�,00� <br /> PERSONAL&ADV INJURY $ 1�OOO�OOO <br /> GENERAL AGGREGATE $ 2�OOO�OOO <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/0P AGG $ Z�OOO,OOO <br /> X POLICY PR� LOC <br /> $ <br /> AUTOMOBILE LIABILITY M I IN LI I <br /> Ea acadent <br /> ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS 80DILY INJURY(Per accident) $ <br /> HIRED AUTOS NON-OWNED PROPERTY DAMAGE <br /> AUTOS $ <br /> Per accident <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE <br /> AGGREGATE $ <br /> DED RETENTION$ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY Y f N TORY LIMITS ER <br /> ANY PROPRIETORiPARTNER/EXECUTIVE <br /> OFFICERIMEMBER EXCLUDED� � N/A E L EACH ACCIDENT $ <br /> (M�ndatory In NH) E L DISEASE-EA EMPLOYEE $ <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E L DISEASE-POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS!VEHICLES (Attach ACORD 107,Addklonal Remarks Schedule,if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> �eo-oo2i <br /> SHOULD ANY OF THE ABOVE DE8CRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION OATE THEREOF, N0710E WILL BE DELIVERED IN <br /> City Of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 5335 8th Street <br /> Zephyrhills, EZ 33540 A�M�R�ZEDREPRESENrAT1VE <br /> J Alexander Green, CI � � � <br /> ACORD 25(2010I05) O 1988-2010 ACORD CORPORATION. All rights reserved. <br /> INS025�zo�oos�oi The ACORD name and loqo are reqistered marks of ACORD <br />