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HomeMy WebLinkAbout08-8402 CITY OF ZEPHYRHILLS 5335-8th Street (813) 780-0020 8402 ELECTRICAL PERMIT Permit Number: 8402 Address: 5036 6TH ST Permit Type: ELECTRICAL MISC ZEPHYRHILLS, FL. Class of Work: ELECTRIC SERVICE REPLACEMENT Township: Range: Proposed Use: NOT APPLICABLE Lot(s): Block: Section: Contractor: TIDWELL ELECTRIC COMPANY lt i Book: Page: Square Feet: Subdivision: CITY OF ZEPHYRHILLS Est. Value: Parcel Number: 11-26-21-0010-19100-0205 Improv. Cost: 450.00 Date Issued: 10/07/2008 Name: HUMPHRIES, M UMRICE JR Total Fees: 35.00 Address: PO BOX 365 Amount Paid: 35.00 ZEPHYRHILLS, FL. 33539 Date Paid: 10/07/2008 Phone: (813)410-8647 Work Desc: REPLACEMENT OF METER CAN ELECTRICAL FEE 35.00 ____________ r51LQ /o- 9- ROUGH ELECTRIC CONSTRUCTION POLE PRE-METER FINAL REINSPECTION FEES: Reinspection fees will comply with Florida Statute 553.80 (2)(c)when extra inspection trips are necessary due to any one of the following reasons: a)wrong address b)condemned work resulting from faulty construction c)repairs or corrections not made when inspection called d)work not ready for inspection when called e) permit not posted on job site f)plans not at job site g)work not accessible. NOTICE: In addition to the requirements of this permit, there may be additional restrictions applicable to this property that may be found in the public records of this county, and there may be additional permits required from other governmental entities such as water management, state agencies or federal agencies. The payment of inspection fees shall be made before any further permits will be issued to the person owning same. "Warning to owner: Your failure to record a notice of commencement may result in your payin twice for improvements to your property. If you intend to obtain financing, consult with your lender or an attorney before recording your notice of commencement." Complete Plans, Specifications and Fee Must Accompany Application. All work shall be performed in accordance with City Codes and Ordinances. MIV"W� CONTRACTOR PERMIT OFFI R PERMIT EXPIRES IN 6 MONTHS WITHOUT APPROVED INSPECTION CALL FOR INSPECTION - 8 HOUR NOTICE REQUIRED PROTECT CARD FROM WEATHER 813-780-0020 City of Zephyrhills Permit Application Fax-813-780-0021 Building Department (, ') 2' Date Received Phone Contact for Permitting -- Owner's Name e-�-d. e,I I r t i er Phone Number © S Owner's Address 3 Co (' S T ✓O5 2Owner Phone Number Fee Simple Titleholder Name_ 1(4'7✓O 3n r Phone Number Fee Simple Titleholder Address JOB ADDRESS 503 4- S-tT LOT# SUBDIVISION I PARCEL ID# - 2 2' D'( lV O- D (OBTAINED ROM PROPERTY TAX NOTICE) WORK PROPOSED B NEW CONSTR ET ADD/ALT Q SIGN Q MOVE Q DEMOLISH INSTALL REPAIR PROPOSED USE Q SFR COMM 0 OTHER TYPE OF CONSTRUCTION Q 'n,,BLOCK / LI FRAME 0 STEEL Q OTHER DESCRIPTION OF WORK ,V`e�� QA AJ ( e-'L^ BUILDING SIZE I SQ FOOTAGE I HEIGHT 0 BUILDING $ VALUATION OF TOTAL CONSTRUCTION ' ELECTRICAL $ (.L-s2—_ AMP SERVICE Q PROGRESS ENERGY Q W.R.E.C, 0 PLUMBING $ 0 MECHANICAL $ VALUATION OF MECHANICAL INSTALLATION Q GAS El ROOFING Q SPECIALTY Q OTHER FINISHED FLOOR ELEVATIONS FLOOD ZONE AREA =YES =NO ltlflflhllllifl BUILDER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# ELECTRICIAN G� COMPANY SIGNATURE REGISTERED I Y/ N FEE CURRENT I Y/N N Address I 2I t^ JLYç ZJ License# E'C.CU a co I PLUMBER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT J Y/N Address I License# MECHANICAL COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# OTHER COMPANY SIGNATURE REGISTERED I Y/ N I FEE CURRENT I Y/N Address I License# 111111 11111111 IIIIIIIIIIIIIIIIIIIIIII RESIDENTIAL Attach(2)Plot Plans;(2)sets of Building Plans;(1)set of Energy Forms;R-O-W Permit for new construction, Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans w/Silt Fence installed, Sanitary Facilities&1 dumpster;Site Work Permit for subdivisions/large projects COMMERCIAL Attach(3)complete sets of Building Plans plus a Life Safety Page;(1)set of Energy Forms.R-O-W Permit for new construction. Minimum ten(10)working days after submittal date. Required onsite,Construction Plans,Stormwater Plans W/Silt Fence installed, Sanitary Facilities&1 dumpster.Site Work Permit for all new projects.All commercial requirements must meet compliance SIGN PERMIT Attach(2)sets of Engineered Plans. ****PROPERTY SURVEY required for all NEW construction. Directions: Fill out application completely. Owner&Contractor sign back of application,notarized If over$2500,a Notice of Commencement is required. (A/C upgrades over$5000) ** Agent(for the contractor)or Power of Attorney(for the owner)would be someone with notarized letter from owner authorizing same OVER THE COUNTER PERMITTING (Front of Application Only) Reroofs Sewers Service Upgrades A/C Fences(Plot/Survey/Footage) Driveways-Not over Counter if on public roadways..needs ROW NOTICE OF DEED RESTRICTIONS: The undersigned understands that this permit may be subject to"deed" restrictions" which may be more restrictive than County regulations. The undersigned assumes responsibility for compliance with any applicable deed restrictions. UNLICENSED CONTRACTORS AND CONTRACTOR RESPONSIBILITIES: If the owner has hired a contractor or contractors to undertake work, they may be required to be licensed in accordance with state and local regulations. If the contractor is not licensed as required by law, both the owner and contractor may be cited for a misdemeanor violation under state law. If the owner or intended contractor are uncertain as to what licensing requirements may apply for the intended work, they are advised to contact the Pasco County Building Inspection Division—Licensing Section at 727-847- 8009. Furthermore, if the owner has hired a contractor or contractors, he is advised to have the contractor(s) sign portions of the "contractor Block" of this application for which they will be responsible. If you, as the owner sign as the contractor, that may be an indication that he is not properly licensed and is not entitled to permitting privileges in Pasco County. TRANSPORTATION IMPACTIUTILITIES IMPACT AND RESOURCE RECOVERY FEES: The undersigned understands that Transportation Impact Fees and Recourse Recovery Fees may apply to the construction of new buildings, change of use in existing buildings, or expansion of existing buildings, as specified in Pasco County Ordinance number 89-07 and 90-07, as amended. The undersigned also understands, that such fees, as may be due, will be identified at the time of permitting. It is further understood that Transportation Impact Fees and Resource Recovery Fees must be paid prior to receiving a "certificate of occupancy" or final power release. If the project does not involve a certificate of occupancy or final power release, the fees must be paid prior to permit issuance. Furthermore, if Pasco County Water/Sewer Impact fees are due, they must be paid prior to permit issuance in accordance with applicable Pasco County ordinances. CONSTRUCTION LIEN LAW(Chapter 713, Florida Statutes, as amended): If valuation of work is $2,500.00 or more, I certify that I, the applicant, have been provided with a copy of the "Florida Construction Lien Law—Homeowner's Protection Guide" prepared by the Florida Department of Agriculture and Consumer Affairs. If the applicant is someone other than the"owner", I certify that I have obtained a copy of the above described document and promise in good faith to deliver it to the"owner" prior to commencement. CONTRACTOR'S/OWNER'S AFFIDAVIT: I certify that all the information in this application is accurate and that all work will be done in compliance with all applicable laws regulating construction, zoning and land development. Application is hereby made to obtain a permit to do work and installation as indicated. I certify that no work or installation has commenced prior to issuance of a permit and that all work will be performed to meet standards of all laws regulating construction, County and City codes, zoning regulations, and land development regulations in the jurisdiction. I also certify that I understand that the regulations of other government agencies may apply to the intended work, and that it is my responsibility to identify what actions I must take to be in compliance. Such agencies include but are not limited to: - Department of Environmental Protection-Cypress Bayheads, Wetland Areas and Environmentally Sensitive Lands, Water/Wastewater Treatment. - Southwest Florida Water Management District-Wells, Cypress Bayheads, Wetland Areas, Altering Watercourses. - Army Corps of Engineers-Seawalls, Docks, Navigable Waterways. - Department of Health & Rehabilitative Services/Environmental Health Unit-Wells, Wastewater Treatment, Septic Tanks. - US Environmental Protection Agency-Asbestos abatement. Federal Aviation Authority-Runways. I understand that the following restrictions apply to the use of fill: - Use of fill is not allowed in Flood Zone"V" unless expressly permitted. - If the fill material is to be used in Flood Zone "A", it is understood that a drainage plan addressing a "compensating volume" will be submitted at time of permitting which is prepared by a professional engineer licensed by the State of Florida. - If the fill material is to be used in Flood Zone "A" in connection with a permitted building using stem wall construction, I certify that fill will be used only to fill the area within the stem wall. - If fill material is to be used in any area, I certify that use of such fill will not adversely affect adjacent properties. If use of fill is found to adversely affect adjacent properties, the owner may be cited for violating the conditions of the building permit issued under the attached permit application, for lots less than one (1) acre which are elevated by fill, an engineered drainage plan is required. If I am the AGENT FOR THE OWNER, I promise in good faith to inform the owner of the permitting conditions set forth in this affidavit prior to commencing construction. I understand that a separate permit may be required for electrical work, plumbing, signs, wells, pools, air conditioning, gas, or other installations not specifically included in the application. A permit issued shall be construed to be a license to proceed with the work and not as authority to,violate, cancel, alter, or set aside any provisions of the technical codes, nor shall issuance of a permit prevent the Building Official from thereafter requiring a correction of errors in plans, construction or violations of any codes. Every permit issued shall become invalid unless the work authorized by such permit is commenced within six months of permit issuance, or if work authorized by the permit is suspended or abandoned for a period of six(6) months after the time the work is commenced. An extension may be requested, in writing, from the Building Official for a period not to exceed ninety (90) days and will demonstrate the job is considered abandoned. justifiable cause for the extension. If work ceases for ninety(90)consecutive days, WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF C MENCEMENT. FLORIDA JURAT(F S. 11 77 ) OWNER OR AGENT CONTRACTOR S bscribed rib d and sworn affirmed 4 me this Subscribed apg sworn to(or affi med before me this /! Yj by fGrvl r [�GtwE t _ %0 �7-U�bY �.rr e.� �k��,�C.L/ Who Is/are personalI known to me or has/have produced Who is/are personally known toe or has/have produced L+� as identification. ( C as identification. J B ES blic � Notary Public Notary Pu ' Expires December 12,2010 a JACQUELINE BOGES / =;�•• c ?;.� �n,, oaes•2!L _—_ Commission No..=•. 1 mmis Nab"" ,,Tr„yFainlwu,a",o9oExpires December 12,2010 N FOFf' gyp. �oMed ed, rinted or stampe 701q Name of Notary typed,printed or stamped Name of Notary typ P /07/2008 10 E 11:46 FAX 863 293 5862 Insure America Grou 001/001 A�.UhV TN CERTIFICATE OF LIABILITY INSJRANCE Ilo�o7�ioo8 PRODUCER (863)293-4653 FAX (863)293-5862 THIS CERTIFICATE IS ISSUED ASAMATTEROFINFORMATION Insure America Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P 0 Box 7641 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Winter Haven, FL 33883-7641 INSURERS AFFORDING COVERAGE NAIC# INSURED Tidwell Electric Company, Inc. INSURERA. FCCI Insurance Company 2317 N. Falkenburg Road INSURERS Bridgefield Employers Insurance Co Tampa, FL 33619 INSURERC INSURER D: INSURER E. 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. INSR DD TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTNE POLICY EXPIRATION LIMITS GENERAL LIABILITY GL0005681 05/02/2008 05/02/2009 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE Q OCCUR MED EXP(Any one person) $ 5,000 A PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2 000 000 X POLICY fl PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY ALTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ❑CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION S $ WORKERS COMPENSATION AND 0830-28581 02/07/2008 02/07/2009 X wcsrATu• OTH- EMPLOYERS'LIABILITY B ANYIPROPRIEIORPARTNEJEEXCLUDED ECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFE L.DISEASE.EA EMPLOYE $ 500,000 It yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, City of Zephyrhi 11 s BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 5335 8th St OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. Zephyrhills, FL 33542 AUTHORIZED REPRESENTATIVE James Kni ht BARBAR ACORD 25(2001108) FAX: (813)780-0021 ©ACORD CORPORATION 1988 Sc --D- T\/?/t 3L1 ft r2fl 1 1(1, sr•=:;; :.ai;,a toy ;'_aa ..._._..... • ..__._...... " "- .... 6161-0PL(fi8) oot'Z-0bL(E18) 6 i 9EE tPuoid dU i. 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With this license you become one of the nearly one million STATEOFFLORIDA AC# 3807b5" Floridians licensed by the Department of Business and Professional Regulation. DPPARTME T OF BUSINESS AND Our professionals and businesses range from architects to yacht brokers,from PROFESSIONAL REGULATION boxers to barbeque restaurants,and they keep Florida's economy strong. BC0002506 06/04/08 07816036'i Every day we work to improve the way we do business in order to serve you better. For information about our services,please log onto www.myfloridalleense.com. CERTIFIED ELECTRICAL CONTRACTOR There you can find more information about our divisions and the regulations that TIDWELL, FRANK I impact you,subscribe to department newsletters and learn more about the TIDWELL ELECTRIC COMPANY INC Department's initiatives. Our mission at the Department is:License Efficiently, Regulate Fairly.We constantly strive to serve you better so that you can serve your customers. Thank you for doing business in Florida,and congratulations on your new license! IS CSD nna.r the provision of cti.489 F5 "Pi:ati m dat.data: AQG 31, 2010 L08060400679 DETACH HERE AC# 3807850 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION ELECTRICAL CONTRACTORS LICENSING BOARD SEQ#L08.0604006.7 �• - LICENSE NBR 106/04/2008 1078160369 IEC0002506 The ELECTRICAL CONTRACTOR Named below IS CERTIFIED Under the provisions of Chapter 489; .FS. Expiration date: AUG 31, 2010 . TIDWELL, FRANK I TIDWELL ELECTRIC COMPANY ING.. 2317 N FALKENBURG RD TAMPA FL 33619 CHARLIE CRIST CHUCK DRAGO Oct 07 08 11 : 48a p. 4 HILLSBOROUGH COUNTY BUSINESS TAX RENEWAL INSTRUCTIONS Chapter 205.0535(5)Florida Statutes requires one of the following: FEDERAL EMPLOYER IDENTIFICATION NUMBER OR SOCIAL SECURITY NUMBER 1. SIGN and return entire form in enclosed envelope. Your validated Business Tax receipt will be returned to you. 2. Business Tax receipts expire midnight, September 30th. Failure to display a valid Business Tax receipt after September 30th is a violation of Hillsborough County Ordinance 95-4, as amended by 02-5. MAKE CHECK PAYABLE TO: DOUG BELDEN, TAX COLLECTOR PO Box 172920 TAMPA, FL 33672-0920 2008-2009 HILLSBOROUGH COUNTY BUSINESS TAX RECEIPT EXPIRES 9-30-2009 FOLIO NO. --TAGunExarrRIe �TrracrrLs — 0 103160 0 1 H.W STE TAX OCC.CODE BUSINESS TYPE SURCHARGE 090.031 CONTRACTOR-MASTER ELECTRICIAN 18.00 BUSINESS 2317 N FALKENBURG RD LOCATION TAMPA 33619 NAME TIDWELL FRANK I/DBA/TIDWELL ELECTRIC MAILING 2317 N FALKENBURG RD ADDRESS TAMPA FL 33619 Business Tax TOW Bou ilelden, Kii1sboioug1 0UA ilax c Batch ;t: 19975 012 brown B t1 S I N ESS TAX Trans 4: 10 Receipt 0: 017052 DOUG BELDEN,, DR TAX COLLECTOR Pcct: 11031600E Pay Code: 4106 HAS HEREBY PAID A PRIVILEGE TAX TO ENGAGE 813-635-5200 07/09/2008 22 2009 $18.01? IN BUSINESS,PROFESSION.OR OCCUPATION SPECIFIED HEREON. THIS BECOMES A TAX RECEIPT WHEN VAUOATED. 0351 1usine55 Tax $16.00 CLek d. a . 4106 10316000008 000018002 000000000 Oct 07 08 11 : 48a P. 5 R001268308 RECEIPT OF PA YMENT t _ 6 Hillsborough County BUILDING SERVICES DIVISION CERTIFICATE OF COMPETENCY �p�i�:/ Qu (/w�w rnir CS:pp s� o4d S R^LYr •w _ '" a '4eni.isY -Lo aasr vier s tic:+.ali.n`k.6 sbue6eS V rrr L .LRAC. 11130/2010 Certificate Number License Expiration Date Issued to: " . >`_ AK C L Dba: TflWEI.jELECTRIC INC Workers Comp. 02/u7/?009 Issuing Officer DESCRIPTION AMOUNT Registration Fee $0.00 Renewal Fee $0.00 Delinquency Fee $0.00 Reciprocity Fee $0.00 Replacement Fee $0.00 Total Charges $151.68 Oct 07 08 11 :49a p. 6 A Xiki CERTIFICATE QF LIABILITY INSURANCE I PROWLER 10/07/2008 (*63)293.4653 FAX (863)293-5862 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Insure America Group, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P 0 Box 7641 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Winter Haven, FL 33883-7641 INSURERS AFFORDING COVERAGE NAIC N INsuREo Tidwell Electric Company, Inc. ,NSURERA: FCCI Insurance Company 2317 N. Falkenburg Road INsmss: Bridgefield Employers Insurance Co Tampa, FL 33619 ,NstmsR c -- INs1RER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.MAY PERTAIN.THE INSURANCEAFFORDEDO BY OF THE POLICES DCT ES RIBF ED HE DOCUMENT IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONSPECT TO WHICH THIS CERTIFICATE MAY BE S OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. MX 0' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERAL LIABILITY GL0005681 05/02/2008 05/02/2009 EACH OCCURRENCE E 1,000.000 X COMMERCIAL GENERAL LIAB4.RY DAMAGE TO RENTED f !00.000 CLAIMS MADE OCCUR MED EXP(Any one Perron) 3 5,000 A PERSONAL A ADV INJURY $ 1,000•OOO GENERAL AGGREGATE $ 2,000•000 GEh L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMPICP AGO 3 2,000•000 X POLICY% JEd IT LOC AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMB (Ea accident ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY f (Per Person) HIRED AUTOS BODILY INJURY NON•pYYNED AUTOS (Per accident) $ PROPERTY DAMAGE (Per acciden1) GARAGE LIABILITY AUTO ONLY•EA ACCIDENT S ANY AUTO OTHER THAN EA ACC 3 AUTO ONLY' AGO S EXCESSIUMBRELLA LIABILITY EACH OCCIJRRGNCC 3 OCCUR CLAIMS MADE AGGREGATE DEDUCTIBLE f RETENTION S L WORKERS COMPENSATION AND 0830-28581 02/07/2003 02/07/2009 X 14I wcsTATU• OTH- EMPLOYERS•LIABILITY B O RNY EWMEMBFIR EXCLUC D)ECUfIVE E.L.EACH ACCIDENT $ 500,000 II Yes.describe under EL.DISEASE-EA EMPLOYE S 500,OOO SPECIAL PROVISIONS below EL.DISEASE.POLICY LIMIT $ 500 000 OTHER DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION O SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1D DAYS WRrrTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. City of Zephyrhills BUT FAILURE TO WAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY S335 8th St OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES, 2ephyrhills, FL 33542 AUTHORIZED REPRESENTATIVE ACORD 25 2001!08 FAX: James Knight RBAR I 1 (813)780-0021 CACORD CORPORATION 1988 I $. ti f � aQ { f�,