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20-100
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2020
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20-100
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Last modified
3/2/2022 8:40:11 AM
Creation date
3/2/2022 8:40:11 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
20-100
Building Department - Name
MILLER,MICHAEL
Address
39588 MEADOWOOD LOOP
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ASTON-1 OP ID: KA <br /> DATE(MM/DDIYYYY) <br /> �.r CERTIFICATE OF LIABILITY INSURANCE 05/12/2020 <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 727-586-1601 CONTACT Jennifer Barjas <br /> Brown Insurance and Financial PHONE 727-586-1601 FAX 727-518-0002 <br /> A031711 A/C,No,Ext): (Arc,No): <br /> 2401 West Bay Drive Suite 603 E-MAIL ertificates rown nsurance ervlces.com <br /> Largo,FL 33770 ADDRESS: <br /> Chris Bradley INSURERS AFFORDING COVERAGE NAIC# <br /> INSURER A:Southern-Owners Insurance Comp 10190 <br /> HN�URED INSURER B:FCBI 15764 <br /> illsborPlumbing gg uCompany of Auto-Owners Insurance 18988 <br /> dba EthicaTAir <br /> INSURERC: <br /> 245 S 78th Street INSURER D: <br /> Tampa,FL 33619 <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 TYPE OF INSURANCE DDL UBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> LTR A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> CLAIMS-MADE OCCUR 20616566 02/07/2020 02/07/2021 DAMAGE TO RENTED 300,000 <br /> PREMISES Ea occurrence) $ <br /> MED EXP(Any oneperson) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICY❑X jE o �X LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> F1 OTHER: <br /> C AUTOMOBILE LIABILITY Ea BIKED SINGLE LIMIT $ 1,000,000 <br /> X ANY AUTO 51-61P-566-00 02/07/2020 02/07/2021 BODILY INJURY Perperson) $ <br /> OWNED SCHEDULED <br /> AUTOS ONLY AUTOS BODILY INJURY Per accident <br /> HIRED NON-OyyNED PROPERTY DAMAGE <br /> AUTOS ONLY AUTOS ONLY Per accident $ <br /> X Hired kx Non Owned <br /> A X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 <br /> EXCESS LIAB CLAIMS-MADE 51-616566-01 02/07/2020 02/07/2021 AGGREGATE 1,000,000 <br /> DED I X I RETENTION$ 0 <br /> B WORKERS COMPENSATIONPER <br /> AND EMPLOYERS'LIABILITY YIN X STATUTE ERH <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE 10661151-2019 02/07/2020 02/0712021 1,000,000 <br /> 0pFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ <br /> (Mandatory in NH) E.L.DISEASE-EA EMPLOYE 1,000,000 <br /> If yes,describe under 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT <br /> DESCRIPTION OF OPERATIONS I LOCATIONS r VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> City of Zephyrhills ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 5335 8th St <br /> Zephyrhills,FL 33542 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 />
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