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07-6783
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2007
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07-6783
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Last modified
3/6/2009 4:34:29 PM
Creation date
1/8/2008 11:00:39 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
07-6783
Building Department - Name
JAPAGE PART C/O 7/11
Address
38544 5TH AV
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<br />A CORDm CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDNYYY) <br /> 5/7/2007 <br />"-"'DUCER (407)833-8998 FAX: (407)804-1092 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> ..ihl & Associates Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />605 Crescent Excecutive Court ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Suite 112 <br />Lake Marv FL 32746 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED (407) 290-3010 Fax: (407) 290-1173 INSURER A: Hudson Specialty Ins Co <br />Petroleum Equipment Construction, Inc. INSURER B: <br />P.O. Box 910 INSURER C: <br />7232 Overland Road INSURER 0: <br />Apopka FL 32704-0910 INSURER E: <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING ANY <br />REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, <br />THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREI~!,:IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. <br />A~~RJ:~ATE LIMIT!': !':HnWN May HAVE BEEN REDUCED BY PAID CLAIM . <br />INSR ADD'L TYPE OF INSURANCE POLICY NUMBER P6'1+~~ri~~g8~:= Pgk!fl,~J:~~N LIMITS <br /> ~NERAL LIABILITY EACH OCCI JRRENCE $ 2,000,000 <br /> COMMERCIAL GENERAL LIABILITY ~~~~~~J?E~~~J.7r~nce\ $ <br />A X I CLAIMS MADE D OCCUR FEe 6112184 4/15/2007 4/15/2008 MED EXP (Anv one oersonl $ <br /> ~ Professional Liab PERSONAL & ADV INJURY $ <br /> ~ Pollution Liability GENERAL AGGREGATE $ 2,000,000 <br /> ~'L AGGRnE LIMIT nES PER: PRODUCTS - COMP/OP AGG $ <br /> X POLICY ~~R;: LOC <br /> ~TOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Ea accident) $ <br /> - ANY AUTO <br /> - ALL OWNED AUTOS BODILY INJURY <br /> (Per person) $ <br /> - SCHEDULED AUTOS <br /> - HIRED AUTOS BODILY INJURY <br /> (Per accident) $ <br /> - NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Per accident) <br /> ~RAGE LIABILITY AUTO ONLY- EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA Arc., $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY ~Ar.1-l Nr.~ $ <br /> =:J OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> R DEDUCTIBLE $ <br /> RETENTION ~ $ <br /> WORKERS COMPENSATION AND I T~~~T~W~ I IOJb'- <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETORlPARTNERlEXECUTIVE E:L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E:L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERA TlONSlLOCA TlONSNEHICLESlEXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br />r(813) 780-0021 <br />City Of Zephryhills <br />5335 8th Street <br />Zephryhills, FL 33540 <br /> <br />CANCELLA nON <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 CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br />FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE <br /> <br />INSURER, ITS AGENTS OR REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE <br /> <br />Robert Bowles/DIANED <br /> <br />~~~-_. <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />ACORD 25 (2001/08) <br />INS025 (0108).08a <br /> <br />Page 1 of2 <br />
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