CERTIFICATE OF INSURANCE (235)
ACOR~
CERTIFICATE OF LIABILITY INSURANCE
DATE OF ISSUE
01/01/2004
PRODUCER
Insurance Company of the Americas
1 31 0 Utica Street
P.O. Box 855
Oriskany, New York 13424
Tel: (315) 768-2726 Fax: (315) 736-8731
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND
CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES
NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW.
INSURED
Employee Leasing Solutions, Inc.
Formerly Known As: People Leasing, Inc.
LlC/F Other Side Sod Company
1401 Manatee Ave. W. Suite 600
Bradenton, FL 34205
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED
NOTWITHSTANDING ANY REQUIREMENT. TERM 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.
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSURERS AFFORDING COVERAGE
INSURER A: Insurance Company of the Americas
INSURER B:
INSURER c:
INSURER D:
INSURER E:
NAIC#
33030
TYPE OF INSURANCE
POLICY NUMBER
D T MDDYY
LIMITS
LOC
$
$
$
PERSONAL & AOV INJURY $
GENERAL AGGREGATE $
PRODUCTS-COMP/OP AGG $
COMMERCIAL GENERAL liABILITY
CLAIMS MADE 0 OCCUR
~O!@'b~~P SINGLE liMIT $
HIRED AUTOS
NON - OWNED AUTOS
BODilY INJURY
(Per person)
$
----.._- ------..-----.---
BODILY INJURY
(Per person)
$
~~~:C~i~~) DAMAGE $
OTHER THAN
AUTO ONLY
AUTO ONLY - EA ACCIDENT $
$
$
$
$
$
$
$
EA ACC
AGG
CLAIMS MADE
EACH OCCURRENCE
AGGREGATE
WORKERS COMPENSATION AND
EMPLOYERS' LIABILITY
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBER EXCLUDED?
If yes, describe under
SPECIAL PROVISIONS below
WC03010150
$ 1,000,000
1/01/2004 1/01/2005 E,l. DISEASE EA EMPLOYEE $ 1.000,000
E.L, DISEASE-POLICY LIMIT $ 1,000.000
OTHER
OTHE'tlient 10 #2308069
L
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR
TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED
TO THE LEFT. BUT FAILING TO DO SO SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE INSURER. IT'S AGENTS OR
REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
CITY OF CLEARWATER
PO BOX 4748
CLEARWATER, FL 33758-474