My WebLink
|
Help
|
About
|
Sign Out
Browse
Search
19-21588
Zephyrhills
>
Building Department
>
Permits
>
2019
>
19-21588
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
6/22/2021 8:09:59 AM
Creation date
3/24/2021 11:15:58 AM
Metadata
Fields
Template:
Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
19-21588
Building Department - Name
CITY OF ZEPHYRHILLS
Address
6585 SIMONS RD
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
76
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
.•�� PRIMAVS-01 CCOSTA <br /> '441.�:Ra� CERTIFICATE OF LIABILITY INSURANCE DATE <br /> A E(MMID020 DNYYY) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS 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)must have ADDITIONAL INSURED provisions or be endorsed. <br /> If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on <br /> this certificate does not confer rights to the certificate holder in lieu of such endorsements. <br /> PRODUCER C EACT <br /> All Insurance Underwriters Inc. PAHiC°,"r o,Ext; 813 343-3100 FAX <br /> 2600 Sumerian Drive ( ) FAX <br /> No:(813)343-3090 <br /> Suite 101 a oRE s policy@aiuinc.com <br /> Land O Lakes,FL 34638 <br /> INSURER S AFFORDING COVERAGE NAIC B <br /> INSURER A:Clear Blue Insurance Company <br /> INSURED INSURER B:NorGuard 31470 <br /> Prime AVS,LLC INSURER C: <br /> 4209 Knoilpoint Dr INSURER D: <br /> Wesley Chapel,FL 33544 <br /> INSURER E <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY 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 /> INSR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXPLTR LIMITS <br /> A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE [X OCCUR X X BGFL0020043800 9/25/2019 9/25/2020 DAEMAGETORENTEDe�— 100,000 <br /> MED EXP(Any oneperson) 5,000 <br /> PERSONAL&ADV INJURY 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE 2,000,000 <br /> POLICY❑X PRO-CT LOC PRODUCTS-COMP/OP AGG 2,000,d00 <br /> JE <br /> OTHER <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANY AUTO BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS <br /> BODILY INJURY Per accident $ <br /> AUTOS ONLY AUTOS ONLY Pe�acudentDAMAGE $ <br /> UMBRELLA LIAB HOCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE <br /> DED RETENTION$ <br /> B WORKERS COMPENSATION PTALITEX ERH- <br /> AND EMPLOYERS'LIABILITY N PRWC064646 11/2012019 1112012020 100,000 <br /> ANY PROPRIETORIPARTNEIECUTIVE YIN N/A E.L.EACH ACCIDENTOFFICE WEMSER EXCLUDED? 100,000 <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE <br /> If yes,describe under 500,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> Blanket additional insured and waiver of subrogation applies to General Liability Policy <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPTION DATE THEREOF, <br /> City of Zephyrhills-Building Dept ACCORDANCE WITH THE POLICY P OVISIONSCE WILL BE DELIVERED IN <br /> 5335 8th Street <br /> Zephyrhills,FL 33542 <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.