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<br /> CERTIFICATE OF LIABIlITY INSURANCE ln12011
<br />Producer. Lion Insurance Company This Certificate is Issued as a matter of InfonnaUOn only and confers no rights
<br /> 2739 U.S. Highway 19 N. upon the Certificate Holder. This Certificate dOeG not amend,. extend Of' alter
<br /> Holiday, FL 34691 the coverage afforded by the policies below.
<br />.-(', (727) 938-5562 Insurers Affording Coverage NAIC ~
<br />I~U:ed: South East Personnel LeasinQ, Inc, Insurer A: Lion Insurance Comp~n, 11075
<br /> 2739 U.S. Highway 19 N. InSUr&f B:
<br /> Holiday, FL 34691 Insurer c:
<br /> Insurer 0:
<br /> Insurer E:
<br />Coverages
<br />i n., pOCi~S :)oj iri;.sa1.:e ~~~C ~,C'... d'f'\3 tt:'i:n l$iJ?d ro tt1~ If;Su...-I3.j r,c:~ e:t)l.Y(~ Dr ItA:- pe!Ie'i (}l1n,)il :n.Ji'~:~ .~r.'-;IJ\sta1;jn~ ~rrr r?,:p...j~~i.,~~. rClm~ or C0flJl3DO cf fji;Y .;:crnr':Kt (r.clllo?r dO":lIrne.r:t '(tl;[11 res~.::r ro ~,':h
<br />U',.!j ~en.f(Ic:d<:: HIiJ~ t,.,: I~.;{J (01 rrJJi~of-r:am t!...~ Ir~SJ.(ar;(x. aff(ffJt'd t..) 1,(. r.~b:h:~: J,~-!,cr;t(!:J tJ;:r(~ln I';,; ~itJo--':'! ifl .:.t': tr:c ri?ir!'~. i'.:~k..dO(~. ,j(d ((.f.(~~il:::n-:; (.f !;;_.:o:r. pole,;.::!. ~\gJ(-'giJlt ~!7d5 S/lo.__'l maJ his.;€' bt.":ll fG-<:!uc('d v,'
<br />riJ ::'eJ'IlS
<br />.NS;~ AlXt Policy Number Polic) Eff"cb... Policy Expiflltioil Data limits
<br />L If; 1'.l.Jf(D Type of Insurance DIlte
<br /> (MMIDDIYY) (MMJODIi'Y)
<br /> GENERAL LIABILITY FJI-.n Q((I,nerrCe- ~
<br /> -
<br /> Commercial General Liabmty Damag~ to rt}fI[Boj pffilTllS~S (EA
<br /> : tJ Claims Made 0 Occur OiXUrIOOOJ) ~
<br /> .... M.dE:.<p ,.
<br /> - Pel'Sonal AtJv Injury .
<br /> General aggegate ~mit applies per:
<br /> ::J POliCY o proracr 0 Gonoral Aggreg3l.tl Ii
<br /> LOC
<br /> PrQ':iXts . O:lmr>'Qp Agg fI
<br /> AUTOMOBILE lIABILITY Comtll'\OO Smgte L\mlt
<br /> - (EA Accioorn) l
<br /> ",,,,,,,,,,to
<br /> - 8<l,ji~'loJ"ry
<br /> AJl O~~j A.uIDS
<br /> - lP&.I'&~) >
<br /> ScltclliJl~j ,".J..1.O',;j
<br /> I- 8oJc1~'1n;<M'1
<br /> H:r~1 Aut)5,
<br /> I- N)-'l- CW.n;.j ~~'D~ (Pi><" "'CC1~1t1
<br />(' - Propeft{ Da""'~
<br /> (Pill Aeci1f:nt)
<br /> EXCESS/UMBRELLA lIABILITY EaCh Oc currenc~
<br /> ~ OCC~ o Claims M;;iljtr Aggr.gala
<br /> Ce,jUOb'"
<br />A Workers Compensation and we 71949 01,.0112011 01/0112012 x I ~ Statu- I I OTK-
<br /> Employers' L1abllly torv Limits ER
<br /> Any proprietorlpartner lelreclXNe officerhnember E.L Each Accident $1.000.000
<br /> excluded? E.L. Disease - Ea Emplayeo; $1,000,000
<br /> IrYes, desc;ribe undlll' specid prcMsions below. E.L. Diseese . Policy Units $1,000,000
<br /> Other lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616
<br />Descriptions of OparationsJLocationsNehiclesJExclusions added by Endorsement/Specia! Provisions: Client 10: 81-6S-<HO
<br />Coverage only applies to active employee(s) of South East Personnel Leasing, Inc. that are leased to the following "Client Company":
<br /> Coastal Contracting and Devolopment, Inc.
<br />Coverage only applies to injuries incU'red by South East Persomel Leasing, Inc. active employec(s) ( while working in Ronda.
<br />Coverage does not apply to statutory employee(s) or independent contractor(s) of the Client Company or any other entity.
<br />A list of tile active employee{s) leased to the Client Company can be obtained by faxing a request to (727) 937-2138 or by calling (727) 938-5562.
<br />Project Name:
<br />FAX: 954-927-4480 8, 321-383-5700 I ISSUE 01-07-11 (TO)
<br /> Ilmin Oate: 6/1712010
<br />CERTlF1CA TE HOLDER CANCEU.ATlOr~
<br /> Should drr;! oi th~ ObfJ.tJ d:>!5c'lbt'dplJ!I(;l~'i b~ CilflCd"d b~iQf~ th~ ~1plr"tioo datB lt1l:!{~of. th~ iSSLlng, IffilSi:l W1U
<br /> .;IKI"",>,(( to "loll! 30 do,<: v.f:tt.n nCh(B to:11.; (.;rttl,:etB Micer nOO'\ec Il:lllle i<lIl. but le<fJf.; to 00 ;0 sMillfII:)OS6 00
<br />C (,UgEliw or I: ut,lll~ of a~' k':llj upo.; til2J I,",SUtor. Its a~~.t5 0; rBpreS&lrfJ1'.es
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