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05-5178
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2005
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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 />Nov, 18 2005 3:54PM <br /> <br />HP LASERJET 3200 <br /> <br />10.2 <br /> <br />IMPORTANT <br /> <br />If the certificate holder is an ADDITIONAL INSURED, tne policy(ies) must be endorsed, A statement <br />on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s), <br /> <br />If SUBROGATION IS WAIVED. subject to the terms and conditions of the policy, certain policies may <br />require an endol"..ement. A statement on this certificate does not confer rights to the certificate <br />holder in lieu of slJch endorsement(s). <br /> <br />DISCLAIMER <br /> <br />The Certificate of Insurance on the reverse side of this form does not constitute a contract between <br />the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it <br />affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon, <br /> <br />ACORD 25 (2001108) <br />
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