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01-0701
Zephyrhills
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Building Department
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2001
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01-0701
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Last modified
3/6/2009 2:41:08 PM
Creation date
10/27/2006 9:18:53 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
01-0701
Building Department - Name
FL MEDICAL CLINIC
Address
38135 MARKET SQ
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<br />ACORQM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMlDDIYY) <br />01/Z2/2001 <br />PRODUCER 813-637-8877 FAX 813-637-8484 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Insurance Office of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />P. O. Box 26005 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Tampa, FL 33623 <br /> INSURERS AFFORDING COVERAGE <br />ir:~D Cox Fi re Protection, Inc. INSURER A: United National <br />7910-Professional Place INSURER B: St. Paul Fire & Marine Ins. Co <br />Tampa, FL 33637-6746 INSURER c: Scottsdale Insurance Company <br /> -- <br /> INSURER D: <br />I INSURER E: <br /> <br />COVERAGES <br /> <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br />INSR TYPE OF INSURANCE POLICY NUMBER P~l-+~~~~6g~E Pg~~l,~';~N LIMITS <br />LTR <br /> ~ERAl LIABILITY L7118779 01/21/2001 01/21/2002 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Anyone fire) $ 50,000 <br /> - :J CLAIMS MADE 00 OCCUR <br /> MED EXP (Anyone person) $ excluded <br />A X Per Proj.Aggregate PERSONAL & ADV INJURY $ 1,000,000 <br /> f-- <br /> GENERAL AGGREGATE S 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $ 2,000,000 <br /> n .nPRO. n <br /> POLICY JECT LOC <br /> ~OMOBILE LIABILITY BAOO777469 01/21/2001 01/21/2002 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $ 1,000,000 <br /> - <br /> ALL OWNED AUTOS BODILY INJURY <br /> - $ <br /> SCHEDULED AUTOS (Per person) <br />B - <br /> HIRED AUTOS BODILY INJURY <br /> - (Per accident) $ <br /> NON-0WNED AUTOS <br /> - <br /> - PROPERTY DAMAGE $ <br />(. (Per accident) <br />:.. :'.ARAGE LIABILITY AUTO ONLY - EA ACCIDENT S <br />.~ R ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY ~MSOO05887 01/21/2001 01/21/2002 EACH OCCURRENCE $ 1,000,000 <br /> t:~rOCCUR D CLAIMS MADE AGGREGATE $ 1,000,000 <br />C s <br /> ~ DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I TORY LIMITS I IOJ~- <br /> EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ <br /> EL DISEASE. EA EMPLOYEE $ <br /> EL. DISEASE - POLICY LIMIT $ <br /> OTHER L7118779 01/21/2001 01/21/2002 Independent Contractors Covera <br />A ~Emera 1 Liability Contractual Li abi 1 ity <br />DESCRIPTION OF OPERATIONSlLOCATIONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br />'Florida Operations Only" <br />CERTIFICATE HOLDER I I ADDITIONAL INSURED; INSURER LETTER: CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br />- ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br /> City of Zephyrhills BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY <br />"-.; 5335 - 8th Street OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> Zephyrhills, FL 33540 AUTHORIZED REPRESENTATIVE 7Ul fi/-~. <br /> William Massaro, Jr ./CYNDI <br /> <br />ACORD 25-5 (7/97) <br /> <br />@ACORDCORPORATION 1988 <br />
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