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Gevity 9 / 5 / 03 2 : 10 PAGE 2 / 2 RightFAX <br /> Certificate of Insurance <br /> This eertflows Is Issued as a matter of Information only and confers no rights upon you the oerff cats holder. This oertlAeate Ismot an Insurance <br />policy <br /> and does not amend, extend , or alrer to coverage afforded by the policies listed below . <br /> Named Insured(s ) : <br /> GevityInc . and its wholly owned subsidiaries <br /> inciuoing Gevity I L. P . ; Gevity HR IV, L. P . <br /> Gavity HR IX, L . P. ; Gevity HR X, L . P. MARSH <br /> 600 301 Boulevard West <br /> Bradenton , Florida 34206 Insurer Affording Coverage <br /> American Home Assurance Co. , <br /> Coverages: Member of American International Group, lnc(AIG) <br /> The pcllcy( les) of Insurance listed below have been Issued to the Insured named above for the policy period Indicated, The Insurance <br /> afforded by the policy(ies) described heroin is subject to all the terms, exclusions and conditions of such pdicy(ies), <br /> crtmeste Exp. Date <br /> Type of Insurance CONTINUOUS Policy Number Limits <br /> 0 EXTENDED <br /> ,y ® POLICY TERM <br /> Employers Uablllty <br /> Workers' 1 � �2004 RMWC0477162 Bodily Injury By Accident <br /> Compensation RMWCO277163 $110001000 111 Accident <br /> RMWC0077194 <br /> RMWC0977195 Bodily Injury By Disease <br /> RMWCO277166 $110D0' 000 Polloy Limit <br /> Bodlly Injury By Disease <br /> $11000000 iisoh Person <br /> Other : <br /> Employees Leassd To: Effective Date : of - JA119- 4003 <br /> 7094 . Consolidated Resource Recovery Inc <br /> The above referenced workers' compensation policy provides statutory benefits only to employees of the Named Ineured(o) on the policy, rot to employees <br /> , of any Other employer. <br /> If the certlflcata expiration data Is contlnuoua or extended term , you will be rolled If coverage Is to nlnated or reduced before the <br /> certificate expiration date. However, you will not be notified annually of the continuation of coverage, <br /> Notice of Cancellation : Should any of the policies described herein be cancelled before the expiration date thereof, the insurer <br /> affording coverage will endeavor to mail 30 days written notee to the certificate holder named herein , but falure to mail such notice <br /> shall impose no obligation or liability of any kind upon the insurer affording coverage, its agents or representatives, <br /> Certificate Holder <br /> Indlen River Board Of County Commissioners Michael C. Weise <br /> Attn : Polly Kratmen Authorized Represente lve of Marsh USA Inc <br /> 1325 74th Ave SW (8661443.8489 05 - OED - 4003 <br /> Vero Beech , FL 32968 Phone Date Issued <br />