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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 /> '. . Policy Number: 196BOO1256 <br />. COMMERCIAL GENERAL LIABILITY <br />IFG Companies DECLARATIONS <br />Named Insured: Effective Date: <br />TERRY PAINTER MOBILE HOME SET UP & REPAIR INC 11/03/2004 <br />Item 1. LIMITS OF INSURANCE <br /> $2, ODD, 000 General Aggregate Limit (Other Than Products - Completed Operations) <br /> $See Form BG-G-173 Products - Completed Operations Aggregate Limit <br /> $1, ODD, 000 Personal and Advertising Injury Limit <br /> $1, 0 0 0 , 0 0 0 Each Occurrence Limit <br /> $50,000 Damage To Premises Rented To You Limit (Any One Premises) <br /> $1,000 Medical Expense Limit (Any One Person) <br /> Refer to individual policy forms and/or endorsements for various coverage sublimits, if applicable. <br />Item 2. AUDIT PERIOD (If Applicable): <br /> [X] Annually o Semi-Annually D Quarterly D Monthly <br />Item 3. FORM(S) AND ENDORSEMENT(S) made a partofthis policyattimeofissue: <br /> See Listing of Forms and Endorsements (lFG-I-0150) <br />Item 4. COMPOSITE RATE <br /> D If box is checked, see Composite Rate Endorsement (IFG-I-O 152) for applicable classification, rates <br /> and premiums. If box is not checked, see page 2 ofthese Declarations for applicable classifications, <br /> rates and premiums, <br />Item 5. RETROACTIVE DATE (CG 0002 only) : <br /> Coverage A of this Insurance does not apply to "bodily injury" or "property damage"which occurs <br /> before the Retroactive Date, if any, shown here: (Enter Date or "None" If no Retroactive Date applies. <br />Item 6. PREMIUMS <br /> $ 1,050.00 Total Coverage Part Advance Premium <br /> $ Coverage Part Minimum Premium (if applicable) <br /> <br />These Declarations are part of the Policy Declarations containing the name of the insured and the policy period, <br /> <br />IFG-G-0002-DL 0503 <br /> <br />Page 1of2 <br />
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