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<br />OP 10: MB
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<br />ACORD CERTIFICATE OF LIABILITY INSURANCE r DATE (MMfDD1YYYY)
<br />'-.---- 02/28/11
<br />I THIS CERTIFICATE IS ISSUED AS A MATfER 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 ISSUING INSURER(S), AUTHORIZED
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />..
<br />IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to
<br />the terms and conditions of the policy, certain policies may require an endorsemenl A statement on this certificate does not confer rights to the
<br />certificate holder in lieu of such endorsement(s).
<br />PRODUCER 813-226-1300 CONTACT
<br /> NAME:
<br />Brown & Brown of Florida, Inc. 813-226-1313 r~N~o Extl: I FAX
<br />I CAlC Nol:
<br />P. O. Box 15519 E-MAIL
<br />Tampa, FL 33684-5519 ADDRESS:
<br />Joseph W. LoPresti ~~~~~~~~ 10#: CROSS-2
<br /> INSURER(S) AFFORDING COVERAGE NAIC/!
<br />INSURED Cross Construction Services, INSURERA:Zurich American Ins. Co. 16535
<br /> Inc., Cross Construction INSURER B: Steadfast Insurance Co. 26387
<br /> Company, Inc. INSURER C :
<br /> 25221 Wesley Chapel Blvd INSURER D:
<br /> Lutz, FL 33559
<br /> INSURER E :
<br /> INSURER F:
<br />
<br />COVERAGES
<br />
<br />CERTIFICATE NUMBER:
<br />
<br />REVISION NUMBER:
<br />
<br />(
<br />
<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. 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 />INSR TYPE OF INSURANCE t~g,ll~~1 POLICY EXP LIMITS
<br />LTR r..~o W\In POLICY NUMBER MMlDD1YYYY1
<br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00[
<br /> -
<br />A X COMMERCIAL GENERAL LIABILITY GL0586754906 03/01/11 03/01/12 ~R~~;SES ?Ea~~~~~encel $ 150,00(
<br /> - :=J CLAIMS-MADE [K] OCCUR 10,OO(
<br /> - MED EXP (Anyone person) $
<br /> PERSONAL & ADV INJURY $ 1,OOO,OO(
<br /> f-- 2,000,OO(
<br /> f-- GENERAL AGGREGATE $
<br /> n'L AGG~EffiE LIMIT APnS PER: PRODUCTS-COM~OPAGG $ 2,000,000
<br />'" POLICY X ~~g LOC $
<br />.,I AUTOMOBILE lIABILllY COMBINED SINGLE LIMIT $ 1,OOO,00(
<br />f-- (Ea accident)
<br />A ~ ANY AUTO BAP586754606 03/01/11 03/01/12
<br /> BODILY INJURY (Per person) $
<br /> ~ ALL OWNED AUTOS BODILY INJURY (Per accident) S
<br /> f-- SCHEDULED AUTOS PROPERTY DAMAGE
<br /> $
<br /> ~ HIRED AUTOS (Per accident)
<br /> ~ NON-OWNED AUTOS $
<br /> $
<br /> UMBRELLA LIAB ~ OCCUR EACH OCCURRENCE $ 5,000,000
<br /> -
<br /> X EXCESS L1AB CLAIMS-MADE AGGREGATE S 5,000,000
<br />8 iSE0586754806 03/01/11 03/01/12
<br /> - DEDUCTIBLE $
<br /> RETENTION $ $
<br /> WORKERS COMPENSATION X I.WCSTATU- I IOTH-
<br /> AND EMPLOYERS' LIABILITY TORY LIMITS ER
<br />A Y/N WC586755106 03/01/11 03/01/12 1,000,000
<br />ANY PROPRIETORlPARTNERlEXECUTIVE D EL. EACH ACCIDENT $
<br /> OFFICER/MEMBER EXCLUDED? N/A
<br /> (Mandatory In NH) EL. DISEASE - EA EMPLOYEE $ 1,000,000
<br /> If yes, describe under EL. DISEASE - POLICY LIMIT $ 1,OOO,00(
<br /> DESCRIPTION OF OPERATIONS below
<br />B Pollution PEC586754306 03/01/11 03/01/12 Ea. Claim 1,OOO,OIX
<br /> Liability Aggregate 2,Ooo,OIX
<br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule. II more space Is required)
<br />See "Cross Construction comcanr' Cross Construction Services, Inc.-
<br />Certificate Attachment" dated -1- 1 attached
<br />
<br />CERTIFICATE HOLDER
<br />
<br />CANCELLATION
<br />
<br />BIDPURP
<br />
<br />(,:
<br />
<br />"Bid Purposes Only"
<br />clo Cross Construction
<br />Services, Inc.
<br />25221 Wesley Chapel Blvd
<br />ILutz. FL 33559
<br />
<br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
<br />THE EXPIRATION DATE THEREOF, NonCE WILL BE DELIVERED IN
<br />ACCORDANCE WITH THE POLICY PROVISIONS.
<br />
<br />AUTHORIZED REPRESENTATIVE
<br />
<br />hl....,,_ 10....<11'.......;
<br />
<br />ACORD 25 (2009/09)
<br />
<br />@ 1988-2009 ACORD CORPORATION. All rights reserved,
<br />The ACORD name and logo are registered marks of ACORD
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