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18-20287
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2018
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18-20287
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Last modified
3/4/2019 11:27:13 AM
Creation date
3/4/2019 11:27:12 AM
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Building Department
Company Name
THE GREAT CATCH
Building Department - Doc Type
Permit
Permit #
18-20287
Building Department - Name
J & G RESTAURANT PROPERTIES LLC
Address
5039 1ST ST
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,09/26/2018 08:41AM 7275276285 CANDHINSLIRANCE PAGE 01/01 <br /> ACC HATE(MMIDDIYYYY) <br /> 1r+" R CERTIFICATE OF LIABILITY INSURANCE 9/26/2018 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO R1014TS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY.OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES , <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED . <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER <br /> IMPORTANT: If the certificate holder Is an ADDITIONAL,INSURED,the policy(ies)most ba endorsed. if SUBRor;ATION IS WAIVED,subject to <br /> the terms and conditions of the pollCy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in Ileu of such endomement(s). <br /> PRODUCER DAVID H MYER, AGENT NONT6 GT David prayer. CERTIFICATE; ITTCTORIA OR AtDNDA <br /> Commercial And Hoare Insurance, Inc, PND� �. (727)527-5700 �AC.No):t72!)027-6285 <br /> 5635 49th Strait N Mnssvbadhanan or aacheaffer @cahinsurance.00m <br /> INSURERS)AFFOROING COVERAGE ` ,NAIC 0 St Petersburg FJ4 33709 INSURERA:CERTAIN UNDERWRITERS Al2 TtAOY173 <br /> INSURED ^_'- INSURER B. -- LONAON <br /> k <br /> SThTE FIRE PROTECTION INC / Theodore MaCeae .,. <br /> P O Box 5354 INSURERD: <br /> INSURERfi: <br /> TAMOO FL 33771-5354 INSURER Ft <br /> COVERAGES CERTIFICATE NUMBER:CL17103101799 REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER100 <br /> INDICATED. NOTWITHSTANDING ANY RRQUIREMENT•TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR N1AY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> _ EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LJUL I TYPEOPINSURANCE i+OLIC1rNUMHER ULIC YY�YY OL D LIMITS <br /> OOMMSRdAL GENERAL <br /> LIABILITY EACH OCCURRENCE S 1,000,000 <br /> A �CLAIMS MODE f RA X OCCUR i pR MISER 9. �...50,000 <br /> k66000210-00 11/1f2017 11/1/2018 MEDEXP(Any0M r� $ 51000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: i GENERAL AGGREGATE , _ <br /> S POLICY a JECOT 7 LOG PRODUCTS-COMPIOP AGO i$ _2,000,000 <br /> (OTHER: E w <br /> AUTOMOBILE LIABILITY M INi3LE LIMIT $ <br /> ANY AUTO BODILY INJURT(P9, <br /> ALL OWNED SCHEDULED BODILY INJURY Mor WiOnt) S r <br /> AUTOS AUTOS _ <br /> HIRED AUTO NoN.OWNED PR4PE�— •-l.-_... _.. <br /> I .S <br /> UMBRELLA LM OCCUR i EACH OGCURFtI NCE $ <br /> EXCESS LIAB CLAIM$4v1A0E AGGREGATE $ <br /> DEC).I I RETE T10N$ l _ $ <br /> WORKERS COMPENSATION ,OTH- <br /> ANDEMFLOYGFWUABIUTY YIN STATUTE <br /> ZANY PROPMETOR/PAWNERGXECUTIVE ON IA <br /> A <br /> E.L.EAC•y ACCIDENT S <br /> (M�dallry In NAderCERIMEMSER F7CClUDED7 _r0 s <br /> yy 5, E.L.DISFA9E•EA Efdlri.OYE $ <br /> ES RIPTION F OPERATIONS DMOW E.L DISEASE-POLICY LIMB t <br /> I <br /> t5E$C1 IPTION Of OPERATIONS(LOCATIONS I VEHICLE$(ACORU 101,Addillwml Romkrkll S01114014,may D4 At4ched It mom spaco Is required) <br /> INST4%ZL 6 SERVICE FIRE EXTINGVISHXJF$ <br /> CERTIFICATE HOLDER CANCEL. TIO <br /> (613)78D-0021 <br /> SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> CITIX Or L'EPHYRRILLS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 5335 8TH STREET ACCORDANCE WffH THE POLICY PROVISIONS. <br /> SLPHYRHILLS, FL 33542 <br /> AUTHORIZED REPRESENTATNE ) <br /> 01988.2014 ACORD CORPORATION. All rights reserved, <br /> ACORD 26(2014101) The ACORD name and logo are registered marks of ACORD <br /> 1NS026(201401) <br />
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