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05-5178
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05-5178
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Last modified
3/6/2009 3:40:25 PM
Creation date
5/1/2007 2:44:03 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
05-5178
Building Department - Name
BARTON,TIFFANY
Address
4623 CHARTER DR
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<br />, , <br /> <br />policy Number: 196B001256 <br /> <br />COMMERCiAL GENERAL LIABILITY <br />SCHEDULE OF CLASSIFICATIONS AND RATES <br /> <br />Named Insured: <br />TERRY PAINTER MOBILE HOME SEt UP & REPAIR INC <br /> <br />Effective Date: 11/03/2004 <br /> <br />Location Address (Premises you own, rent or occupy): <br />SAME <br /> <br />Loc. No. <br />1 <br />Bldg. No, <br /> <br />1 <br />Code No. <br />93003 <br /> <br />County, <br />Borough or <br />Parish <br /> <br />Rating T err. <br /> <br />HILLSBOROU 4 <br /> <br />Classification <br /> <br />Mobile Home Setup and Tie-down On Prepared Site and Hookup to Existing Utility Services- no <br />site preparation - not dealers nor manufacturers - including Products-Completed Operations. <br /> <br />o <br />IKJ <br />o <br />o <br /> <br />Premium is: <br />Adjustable (See <br />Premium AuditConditions) <br />Flat (Not Adjustable) <br />Fully Earned When Written <br />Minimum Premium <br /> <br />PER EACH <br /> <br />Loc, No. Location Address (Premises you own,rentor occupy): <br /> <br />Premium Base <br /> <br />3 EMPLOYEES <br /> <br />Bldg. No. <br /> <br />Code No. <br /> <br />o <br />o <br />o <br />o <br /> <br />Fully Premium is: <br />Adjustable (See <br />Premium AuditConditionsl <br />Flat (Not Adjustable) <br />Fully Earned When Written <br />Minimum Premium <br /> <br />Premium Base <br /> <br /> <br />Rate:Per Each <br /> <br />All Other <br />$FLAT <br /> <br />Advance Premium: $ 1, 050 .00 <br /> <br />Classification <br /> <br /> <br />Rate <br /> <br />Advance Premium: $ <br /> <br />Loc. No. Location Address (Premises you own, rent or occupy): <br /> <br />Bldg. No. <br /> <br />Code No. <br /> <br />o <br />o <br />o <br />tJ <br /> <br />Premium is: <br />Adjustable (See <br />Premium AuditConditions) <br />Flat (Not Adjustable) <br />Fully Earned When Written <br />Minimum Premium <br /> <br />Premium Base <br /> <br />Classification <br /> <br /> <br />Advance Premium: <br /> <br />County, <br />Borough or <br />Parish <br /> <br />All Other <br /> <br />$ <br /> <br />County, <br />Borough or <br />Parish <br /> <br />All Other <br /> <br />$ <br /> <br />Prod.-C.Ops <br />$ FLAT <br /> <br />$ <br /> <br />Rating Terr, <br /> <br />Prod.-C.Ops <br /> <br />$ <br />$ <br /> <br />Rating Terr. <br /> <br />Prod.-C.Ops <br /> <br />$ <br />$ <br /> <br />0' See Schedule of Classifications and Rates (IFG-G-0003) for additional locations you own, rent or <br />occupy and applicable classifications and rates and premiums. <br /> <br />IFG-G-0002-DL 0503 <br /> <br />Page 2 of 2 <br />
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