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06-5554
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2006
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06-5554
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Last modified
3/6/2009 4:21:18 PM
Creation date
5/10/2007 9:13:50 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
06-5554
Building Department - Name
COOK-MARKS,VIRGINIA
Address
5019 18TH ST
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<br />,--A-eORD CERTIFICATE OF LIABILITY INSURANCE \ DATE (MM/DDNYYY) <br />TM 02/03/2006 <br />PRODUCER (352) 732 -45 50 FAX (352)732-0132 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Lossing Insurance Agency, Inc, ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1724 SE 17th Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br />Oca1a, FL 34471 INSURERS AFFORDING COVERAGE NAIC# <br />. <br />INSURED Wi ndow Supply Inc INSURER A: Scottsdale Insurance Co <br />DBA: National Homecraft INSURER B: Owners Insurance Co 32700 <br />PO Box 830157 INSURER C: Bridgefield Employers Ins Co <br />Ocala, FL 34484 INSURER D: <br /> 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 />LTR NSR[ TYPE OF INSURANCE POLICY NUMBER DATE IMM/DDIYYI Pg~fl IMMlDDtrii. LIMITS <br /> GENERAL LIABILITY CLSll09304 02/08/2006 02/08/2007 EACH OCCURRENCE $ 1,000,00( <br /> X COMMERCIAL GENERAL LIABILITY ~~~~~is lEa occurence\ $ 50,00( <br /> I CLAIMS MADE m OCCUR MED EXP (Anyone person) $ 5,00( <br />A X $2500 BI,PD,P&A PERSONAL & ADV INJURY $ 1 , 000 , 00( <br /> Deductible GENERAL AGGREGATE $ 2 ,000 , 00( <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 1,000,00( <br /> -xl .n PRO- n <br /> X POLICY JECT LOC <br /> AUTOMOBILE LIABILITY 4625240301 02/08/2006 02/08/2007 COMBINED SINGLE LIMIT <br /> I-- (Ea accident) $ <br /> ANY AUTO 1,000,001 <br /> T ALL OWNED AUTOS BODILY INJURY <br /> I--- (Per person) $ <br /> X SCHEDULED AUTOS <br />B ~ HIRED AUTOS <br /> BODILY INJURY <br /> I-- (Per accident) $ <br /> X NON-OWNED AUTOS <br /> ~ $500 Comp Ded PROPERTY DAMAGE <br /> I-- $500 Col1 Oed (Per accident) $ <br /> X <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ~ ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> =::J OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> r=1 DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND 830-34542 06/01/2005 06/01/2006 X I TORY LIMITS I IV~R'- <br /> EMPLOYERS' LIABILITY <br />C ANY PROPRIETOR/PARTNERlEXECUTIVE E.L. EACH ACCIDENT $ 100,00 <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100,00 <br /> If yes, describe under 500,00 <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br />Qualifier Name - James Gardner Strickland, Jr <br /> State License Number CCC 1326725 <br />Qual ifier Name - H J McDonald Jr <br /> State License Number CRC 001864 <br /> <br />City of Zephyrhills <br />Building Department <br />5335 Eight Street <br />Zephyrhills, FL 33540 <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />--10.- DAYS WRITTEN NOTICE TO THE CERTIFI <br />BUT FAILURE TO MAIL SUCH NOTICE SHALL lOSE N <br /> <br />CERTIFICATE HOLDER <br /> <br />ACORD 25 (2001/08) <br /> <br /> <br />Kim Sheffi <br />
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