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itr 3/15/2006 09:49 Lion Insurance Company LION INSURANCE -*INDIAN RIVER CO 1/1 <br />ACORD TN CERTIFICATE OF LIABILITY INSURANCE <br />3nsn006 <br />Producer: Lion Insurance Comp" <br />2739 U.S. HigMray 19 N. <br />Holiday, FL 34691 <br />Phone: 727-938-5562 Fax: 727-9374138 <br />This CereRcate Is Issued as a matter of Information only and confers no rights <br />upon the Certificate Holder. This Certificate does not amend, extend or alter <br />the coverage afforded by the policies below. <br />Insurers Affording Coverage <br />NAIC # <br />Insured: South East Personnel Leasing, Inc. <br />2739 U.S. Highway 19 N. <br />Holiday, FL 34691 <br />Phone: (727)938-5562 <br />Insumr A: Lion Insurance Company <br />11075 <br />Insurer 6: <br />Insurer C: <br />Insurer 0: <br />nsumr E: <br />Coverages <br />po OBa insmarce ere low a ears Issue w Prawn name ewe wmep iry period in care Notwn math any requirement, helm or cori of any contract or aft r docunrunt with respect which <br />his ce'eficate may be issued or may pattern. me insurance afforded by the pdicie9 described herein is subjecm al me rertns, exclusions, and condmote of such policies. Aggregate limits shown may hare been reduced Cry <br />padclaims. <br />MSR <br />LTR <br />ADDI. <br />wsRD <br />Type of Insurance <br />Policy Number <br />Polity Effective <br />Data <br />(MM/DD/YY) <br />Policy Expiration Data <br />(MM/DD/YY) <br />Limits <br />GENERAL <br />LIABILITY <br />TCommerclal General Uabifity <br />Claims Mede Occur <br />Each Occurrence <br />$ <br />Damage ro ranted petNses (EA <br />ocmnenca) <br />$ <br />Med Exp <br />$ <br />Personal Adv Injury <br />$ <br />arsenal aggregate limit applies per: <br />POliry ❑ Pr%act ❑ IOC <br />6eneralA9gregev <br />8 <br />Produce-ComprOp Agg <br />E <br />AUTOMOBILE LIABILITY <br />Ani <br />At Owned Autos <br />Scheduled Autos <br />Hired Aurae <br />Nor- med Autos <br />Combined Engle umd <br />(EA Accident) <br />$ <br />Bodily njury <br />iPer Peri <br />$ <br />Body I^1ury <br />(Per Accident) <br />Property Damage <br />(Per Accident) <br />$ <br />GARAGE <br />LIABILITY <br />AM Auto <br />Amo Only Ea Accident <br />Omer inch EA Acc. <br />Autos OMy. AGG. <br />s <br />8 <br />EXCESSIUMBRELLA LIABILITY <br />Occur ❑Claims Mede <br />Dewcnbl6 <br />Retention <br />Each occurrence <br />Aggregate <br />A <br />Workers Compensation andWC <br />Employers' Liability <br />Any pmpriamryper!rear/execuliw officer/memberE.L. <br />excluded? <br />ee underspcial provisionsba <br />IfYs, describe lalow. <br />71849 <br />0101/01/2006 <br />011012007 <br />X <br />WC usr: <br />tory limits <br />OTH. <br />ER <br />Eaeh Aceident <br />81000000 <br />E.L. Disseae-Ee Employer <br />410000W <br />E.L. Disease - Policy Limas <br />l liunl 00 <br />Orae 1167260 <br />PJ's Land Clearing & Excavating <br />COVERAGE APPLIES ONLY TO THOSE EMPLOYEES LEASED, NOT TO SUBCONTRACTORS. <br />Descriptions of OperatlanaLocstlonsNeMCNSIEsclwbna eased by EMoreemorNspsdsl Provisions: ADD ON DATE: 7/19/2000 <br />COVERAGE APPLIES ONLY IN THE STATE OF FLORIDA TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF PJ's Land Clearing & Excavating' FAX: <br />561-740-9981 & 772-226-1989 ASSUE 03.1 Si (TO) <br />Lion Insurance Company is A.M. Best Company rated A- (Excellent), AMB # 12616 <br />CERTIFICATE HOLDER <br />CANCELLATION <br />INDIAN RIVER COUNTY <br />1840 26TH STREET <br />VERO BEACH FL 32960 <br />ShOm any oidN above described po4cles be cancelled beforese emirmon data marea, uw isaung Insurer Mn <br />endeavorto mail 30 dayswniten were to the certificate Felder named tote lee, ord failure to do so 9484 impose M <br />coronation or 4ebiliry of ant i0M Won me insurer, its agents or represonc eves. <br />IW) ACORD CORPORATION 1988 <br />