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<br /> ! ,4cca�� CERTIFICATE O� L�AB1LlTY INSURANCE °"��,"""��"""",
<br /> i s�2z�2o�a
<br /> j THIS C£RTlFIGATE 15 tSSt1ED AS A MATTEi2 OF INF4RMATION NLY AND CONFERS NO R!GliTS UPON THE CEf27iFiCAi'E HOLDER. TNIS
<br /> ! CERTIFICATE DOES NOT AFFiRMAT1VELY OR NEGATIYELY AME D, EXTEND OR ALTER THE GOVEFtAGE AFPORDED BY THE POLICIES
<br /> j BEtdW, THIS CER7IFICATE OF INSURANCE DOES N4'f CON5 TUTE A CONTRACT BETWEEN THE ISSUING lNSUREFt{S), AUTNORIZED
<br /> � REPRESENTATIVE OR Pl20DUGEit,AND TFIE CERTIFIGATE HOLDE .
<br /> � IMPORTANT: If the certificats holder is an ADDfT10MAL It+1SURED,th poiicy(ies}must be endorsed. If SUBROGATION IS WAlYED,subject ta
<br /> the terms and oonditions of the policy,certain poiicies may require a endarsement. A statement on this eertiticate does not confer rights to the
<br /> aertificate hoider in lieu of such endorsemant s.
<br /> PRODUCER �
<br /> �� kAME:--. _ � -----"FAX ---._..�_�
<br /> Britton GaRagher PNONN � 7� -----__'^- 1 NC No:2'� '7�
<br /> � One Cleveland Center,Floor 30 I E.,,,Aa
<br /> t 1375 East 9th Street ADDR£SS.
<br /> ; Clevel�nd OH 44114 � lNSURE S AFFORDINGCOYERAGE.- ----- ------Y� NAiC# __
<br /> __._..__- _..__._._...._.-.
<br /> � ^_. _-.- � iHSURERA./�Jq'' 1 s Ins om tl�..._._..--- i --.-
<br /> � lNSURED I �asur�ea a:Technoloav i�uran..�o_...�...�_--._._.__._.�._,_.
<br /> � USA Nallaween Planei lnc. iNSUReR c: emnitv lnsurance Co___ �y�$��._.__�
<br /> � dba USA Fireworlcs ������R¢
<br /> � 7800 Records St.,Ste.A ------.__._.__ _----__._.______—__--_----. ._._.._._ _----f�---.-
<br /> Indianapolis IN 46226 �nsuREa E. ! ___
<br /> � INSURER F.
<br /> � COVERAGES CER"CIFlCATE NUMBER:�pgg3�Q � REVISION NUMBER:
<br /> THIS!S TO GEFtFIFY THAT THE POLfCtES OF INSURANCE USTED BELOW AVE BEEN ISSUEp TO THE INSURED NAMED A80VE FOR ThlE P011CY PERIOQ
<br /> iND}CATED. NOTWlTHSTANDING ANY REGiUtREMENT,TERM OR CONDITI OF ANY CONTRACT Qf2 OTHER ClOCUMENT WlTH RESPECT Td WliiCii THfS
<br /> CERTtFiCATE MAY BE iSSUED OR MAY PERTAIN,THE INSURANCE AFF� bEQ 6Y TNE PQLlCIES dESCRiBED FIEREtN IS SUBJEGT TO At�l F{iE TERMS,
<br /> � EXCtUSIONS AND CONDITIONS OF SUCH POLIGIES.LIMlTS SNQWN MAY HA E BEEN REDUCED BY PAID CLAtMS. _�_
<br /> IN5R i TYPE OP IN5URANCE ��� �� POLICY EFF i POLiCY EXP � ���S
<br /> LTR. �N R i NND' POUCY NUMBER i NM7DDtYVYY i MM7DD
<br /> C i GENERALUABfLlTY Sf8G�00436-143 �i1112014 /112015 j E4CNQCGURRENCE ;$1;040,4QQ
<br /> ! F� ,
<br /> ' 'X I COMMERCIAL GENERAL LIAB(LIlY ! I , i A AO�ftEN
<br /> �PREMISES(Ea occurrence ��500,00(1 __
<br /> � ���'CLAtMS-MADE !X OCCUR �� i i �MED EXP jAny ane persanj ,5--.- -------�� -
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<br /> � �_. , , , ._ . ...
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<br /> l I � { y 4 � �� I I�PERSONAI&ARV 4N,}URY :51,QOEI.QIJO
<br /> I �—_�.. _.__._. .. � , I � . .._—. ,..,.__.._
<br /> � ' ! � i i ' i GENERAL AGGREGATE , ;$2,000,000
<br /> �. � _.. . .._._.__ .._._._...�.._-.._. .._ � � ._... ._...�._.
<br /> �GEN1.AGGREGATE LiM1T APPI�ES PER� j , !PRODUCTS-CQMPiOP AGG .52,000,000_ __�
<br /> j � �POIICY PRO- ik lOC i ` � , � � - � —
<br /> i AUTOMQ6IlE CfABiLtTY � �!E�a acadent) S
<br /> � � i , �BODILY INJURY(Per person) !5 �
<br /> i �ANV AUTQ . 1 ° __...�
<br /> j��AlL OWNED i'SCHEDUtED � � , ;BODILY iNJURY(Per ar,eident}j 5
<br /> � �AUTOS j�"{NOM-t7WMED � � 'PROPERTY DAIdAGE �
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<br /> I ,_�HIREDAUT03 �...(AU7pS � ' � ' � '�P,�,�ccident} .--._ ;�__.._..-._..--.
<br /> � � S
<br /> � A ��ONBRELLA LI#6 JX 1 pC��R , CEAU7534$B ,1�i1�l2t114 �11l2Q15 j EACN OCCURRENCE �E9,D00,000
<br /> � { �
<br /> j �._-4 DED i ftE7ENTiqN 3 CLAIMS-MADE �I' i � I I AGGREGATE -,---.+'$`_0�600
<br /> �X EXCESSltA6 I � - ._-._._.^..._
<br /> � � i � � ' °- - - �$
<br /> ' �TARIN933$8 IN �l10r2414 �21��f2015 �k ! ��SinTU- ;X OTH-;
<br /> g WORKERB tONPENSATtON i ( )
<br /> � ! MandaW in NH � ; � I � !E.L.OS EASECEA EMP�E S56d.OR0�
<br /> � ,AN6EMPEOYERS'tiABIIJT'V
<br /> ANY PROPRiETORJPARTNER�XECUTNE Y�N I �
<br /> I I OFFIC6PoTrtEMBER EXCWOED7 N J A� `-'
<br /> ' '{ ry } �i 5504,OQ4
<br /> f s�f yes,describe unt}er � � T
<br /> �DESCRIPTION OF OPERATIONS below j E.L.bISEASE-POLiCY UMIT i 5500,000
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<br /> � , �
<br /> � pE$CRtFS40t14F 64'£ftAS44f1S t IUCATiOfiS t 1tEMiiCt.ES(Attach ACORD�Ot,Addtttona3 Remarks cheduit,if more a
<br /> pace Is requlred)
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<br /> � *�AddiCionallnsured**
<br /> Stand Location: 7422 Gal4 Boulevard,Zephyrhilis,F� 33541 i
<br /> Stand Qperator's fVame:Big Bang Fireworks lLG i
<br /> Landownet's Name:Kmart Corporation I
<br /> Addi#ionat fnsured. Cify of Zephyrhiqs �
<br /> i
<br /> � CERTiFICATE HQLDEt2 ANCEt�ATiQN
<br /> i
<br /> " SF14ULb AkY OF THE ABOYE DESCRtBED POUCIES 8E CANCELLED BEFORE
<br /> ; THE EXPIRATION DATE THE#tEflF, NOTiCE WiLt BE 8ELIVERED 1N
<br /> , City of Zephyrhills ACCORDANCE WRtt THE POLICY Pi20Y1SiONS.
<br /> � 5335 8th Stree#
<br /> � Zephyrhilis FL 33542 USHflRl2ED REPRESENTATiYE
<br /> �,v.a�- .;�;p"�.:
<br /> (
<br /> ! O 1988-2U10 ACORQ CORPORATION. A11 rights reserved.
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<br /> � ACORD 25(2010/05) The ACORD name and logo are iregistered marlts of ACORO
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