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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 />ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP 10 Lf DATE (~DDIYYYV) <br />K&KEL 1 11/27/06 <br />PROllUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />qrown & Brown of Florida, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />. O. Box 15519 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />~ampa FL 33684-5519 'INSURERS AFFORDING COVERAGE I <br />Phone: 813-226-1300 Fax: 813-226-1313 I NAIC# <br />INSURED INSURER A: SOUTHERN-OWNERS 10190 <br /> INSURER B: AUTO OWNERS INSURANCE 18988 <br /> K&K Electric Inc INSURER c: Bridqefield Emplovers Ins. 10701 <br /> 2517 countX'J Club Rd !INSURER D: Travelers Prop Cas of AIDer 25674 <br /> Sanford FL 2771 <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 />LTRiNSRD TYPE OF INSURANCE POUCYNUMBER ; DATE (.....DD/YY\- DATE'I;.wDrfiii" LIMTS <br /> T T GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> i------, <br />A R3MMERCIAL GENE~IABILITY 20659855 12/01/06 12/01/07 ~~~~s (Ea occurence) $ 300,000 <br /> CLAIMS MADE ~ OCCUR MED EX? (Anyone person) $ 10,000 <br /> PERSONAL & ADV INJURY $ 1,000,000 <br /> i ~ ' GENERAL AGGREGATE $ 2, 000, 000 <br /> I GEN'L AGG~nE LIMIT APPLIES PER: i PRODUCTS. COM PlOP AGG $2,000,000 <br /> ! <br /> Xl . PRO- n . , i <br /> X POLICY ! JECT LOC <br /> I ~TOMOBlLE UABlLlTY , I I COMBINED SINGLE LIMIT <br /> ! $ 1,000,000 <br />B ~ ANY AUTO 4613860301 12/01/06 12/01/07 i (Eaaccldent) <br /> i ALL OWNED AUTOS I BODILY INJURY <br /> ~ SCHEDULED AUTOS i (Per person) $ <br /> I~ HIRED AUTOS I BODILY INJURY $ <br /> ~ NON.OWNED AUTOS I (Per accident) <br />" I PROPERTY DAMAGE <br /> H I (Per accident) $ <br />, ! ~RAGE LIABILITY i I AUTO ONL Y - EA ACCIDENT <br /> $ <br /> I I OTHER THAN <br /> I <br /> , H ANY AUTO EA ACC $ <br /> i ! AUTO ONL Y: AGG $ <br /> i : : <br /> i EXCESS/UMBRELLALIABlUTY I EACH OCCURRENCE $ 1,000,000 <br />B Ii] OCCUR [J CLAIMS MADE 4613860300 12/01/06 12/01/07 AGGREGATE $ 1,000,000 <br /> I $ <br /> ~ DEDUCTIBLE $ <br /> X RETENTION $10,000 I $ <br /> WORKERS COMPENSATION AND I I X I Tg~lLI~if's I IUE~- <br />C EMPLOYERS' LIABILITY 83029562 12/01/06 I 12/01/07 $ 1,000,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL. EACH ACCIDENT <br /> OFFICER/MEMBER EXCLUDED? I E.L. DISEASE - EA EMPLOYEE $ 1,000,000 <br /> ~rc;'~Ls~~~~~~NS below . , E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> J OTHER i i <br />D I Lsd/Rntd Equip QT6604956C571 12/01/06 12/01/07 Lsd/Rntd $100,000 , <br />. , Ded $1,000 <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />E1ectrical Contractor <br /> <br />CERTIFICATE HOLDER <br /> <br />:-- <br /> <br />City of Zephyrhills <br />5335 8th St <br />Zephyrhills FL 33540 <br /> <br />CANCELLATION <br />CITY OF SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN <br />NOTICE TO THE CERTlRCATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHAlL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br />REPR SENTATlVES. <br />AU 0 ESENTATIVE <br />.". <br /> <br /> <br />1 <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br />
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