My WebLink
|
Help
|
About
|
Sign Out
Browse
Search
20-77
Zephyrhills
>
Building Department
>
Permits
>
2020
>
20-77
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/2/2022 8:22:49 AM
Creation date
3/2/2022 8:22:48 AM
Metadata
Fields
Template:
Building Department
Company Name
TNT FIREWORKS WALMART
Building Department - Doc Type
Permit
Permit #
20-77
Building Department - Name
TNT FIREWORKS WALMART
Address
7631 GALL BLVD
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
7
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
AC o® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) <br /> CF11/1/2020 10/31/2019 <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 endorsement(s). <br /> PRODUCER Lockton Companies NAME:CONTACT <br /> 3280 Peachtree Road NE,Suite#250 PHOIAICNE FAX <br /> Atlanta GA 30305 E-MAIL <br /> Ex A/C No <br /> (404)460-3600 ADDRESS: <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:Everest Indemnity Insurance Company 10851 <br /> INSURED American Promotional Events,Inc. INSURER B: <br /> 1359629 DBA TNT Fireworks,Inc. INSURER C: <br /> P.O.BOX 1318 INSURER D: <br /> 4511 Helton Drive <br /> INSURER E <br /> Florence AL 35630 <br /> INSURER F: i <br /> COVERAGES CERTIFICATE NUMBER: 12067057 REVISION NUMBER: XXXXXXX <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 TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMBS <br /> LTR POLICY NUMBER MMIDD MM/DD <br /> COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1000 000 <br /> A X Y N SI8GL00242-191 ll/1/2019 11/1/2020 <br /> CLAIMS-MADE FX]OCCUR PREMISES Ea occurrence $ 500,000 <br /> MED EXP(Any one person) $ 5,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s 21000,000 <br /> POLICY PRO- ❑ <br /> JECT LOC PRODUCTS-COMP/OP AGG $ 2000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITY NOT APPLICABLE COMBINED SINGLE LIMIT $ <br /> Ea accident XXXXXXX <br /> ANY AUTO BODILY INJURY(Per person) $ XXXXXXX <br /> SCHEDAUTOS ONLY AUTOSOWNED <br /> BODILY INJURY(Per accident) $ XXXXXXX <br /> HIRED NON-OWNED PROPERTY DAMAGE $ XXXXXXX <br /> AUTOS ONLY AUTOS ONLY Per accident <br /> $ XXXXXXX <br /> UMBRELLA LIAB OCCUR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX <br /> DED I I RETENTION$ $ XXXXXXX <br /> WORKERS COMPENSATION NOT APPLICABLE PER OTH- <br /> AND EMPLOYERS'LIABILITY STATUTE <br /> Y/N ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ XXXXXXX <br /> OFFICER/MEMBER EXCLUDED? N/A <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ XXXXXXX <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ XXXXXXX <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> City of Zephyrhills and Certificate holder is an additional insured on the General Liability as required by written contract subject to policy terms,conditions, <br /> and exclusions. <br /> CERTIFICATE HOLDER CANCELLATION <br /> 12067057 <br /> Wal-Mart SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> #0706 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 7631 GALL BOULEVARD ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ZEPHYRHILLS FL 33541 <br /> AUTHORIZED REPRESENT 7 VE <br /> 01988--20011 ACORD CORPO TION. All rights reserved. <br /> ACORD 25(2016/03) 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.