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07-6959
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07-6959
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Last modified
3/6/2009 4:33:30 PM
Creation date
1/10/2008 11:25:13 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
07-6959
Building Department - Name
SMITH,RAY
Address
4801 AIRPORT RD #214
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<br />AUG-16-2007 15:30 <br /> <br />WHITE ALUM HAINES CITY <br /> <br />863 956 5286 <br /> <br />P.03/05 <br /> <br />ACORD. CERTIFICATE OF LIABILITY INSURANCE I DATE (AoWIDOm) <br />04/01/2008 03/30/2007 <br />~ER LOCKTON COMPANJES.LLC-l KANSAS CITY THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 444 W. 47th Street, SUi1e 900 ~pLDE~"~HI~ CERTIFICATE DOES :$I~.~~.I!'iT:~.on~ <br /> Kansas City Me 64112-1906 <br /> (916) 960-9000 INSURERS AFFORDING COVERAGE <br />NSUfWl WHITE ALUMINUM PRODUCTS, LLC INSVRERA: INSURANCE COMPANY OF. <br />1On293 . .ST A TF. n,: . ... <br />2101 EAST MAIN STREET <br /> LEE'SBURG, FL. 34748 <br /> I <br />COVERAGES WHIAL03 B2 THIS CERnFICATE OF INSURANCE DOES NOT C~smuTE A CONTRACT B~EEN THE IS~Y~ <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TtE INSURED NAMED ABOVe I=OR THE POUCY PERIOD NDICAlED, NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDmON OF ANY CONTRACT OR OTHER DOCUMENT WITH REsp\:cr 10 WHICH 1'I-IIS CERTIFICATE MAY Be ISSUED OR <br />MAY PERrA/N. THE INSLlRANCE AFtfOROEO 8'1' THE POLICIES DESCRIBED HEREN IS SUBJECT TO ALL THe TERMS, EXCLUSIONS AND CONDmONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLANS. <br />~ TYPE OF' INSURANce fIOLlCY NUMBER ~ El'f'ECTIVE POUCY EXPIRATION LIMn'S <br /> ~EMLl.M8IUTV i"..,.w $ <br /> 10- nMMEACIAI. GENERAL UASIUTY NOT APPLICABLE ana firg' = XXXXXXX <br /> aJ\IMS MADE 0 OCCUR I w;tlI'WP rsGn' S 2QOOOOO{ <br /> ~ PI1Al!:nOl" I Jil)V INJURY $ XXXXXXX <br /> - GeNE_A' S XXXXXXy <br /> ~:fn;n,~ I'ROOUCTS. COMPIOP AGG S XXXXXXX <br /> ~UAIIIUTY COMSINED SINGU: lIMIT , XXXXXXX <br /> - N4Y AUtO NOT APPLICABLE ,~ 3Cl:ilIanl) <br /> - All OWNeD AUTOS 8OD/L. YIlt/JURY <br /> $ XXXXXXX <br /> - SCHmlJlS) AlITOS (Pet "110ft) <br /> 10- HillED AUTOS BODILY INJURY XXXXXXX <br /> :; <br /> '-- HONoOWNED AUTOS (P", -=ldenl) <br /> PROPERTY DAMAGE $ XXXXXXX <br /> IPer iICIClGInI) <br /> UIUlIiE LIAIIUTT Al1tO OM. V - EA ACt"..oeNT : XXXXXXX <br /> R /<HI' AlJrO NOT APPLlCABL.E OTH&rt THAN EA ACe $ XXXXXXX <br /> AUTO 0Nl v: AGG S XXXXXXX <br /> Uc:eIlS UAIII\JJ\' e~ OCCUFlRENCli $ XXXXXXX <br /> :J OCCUll 0 CLAIMS MACE NOT APPU(:ABLE AGGAEGA,T!; $ XXXXXXX <br /> =l~UCTeU: O~ s XXXXXXX <br /> ~ XXXXXXX <br /> RETENTION fi $ XXXXXXX <br />A WOllKERS COMPBISA'l'lQtl ANO WC342471J 04/01/2007 04/0112008 X Iwe STATU. .1 IgrH- <br /> ~'L./AIIIU!Y E.L EACH ACCIDENT ] 000 000 <br /> S <br /> Ii.L DI.'l..Ia~I'. ~. $ J nnn Ann <br /> EM.. DlliliASE -I'OUCY LIMIT . I 000 000 <br /> antE/It <br />DE~ elf 0f'UA1'lOW&ILOCATIOHSI\IIH/Q.I!SIEXCUJ$laNS ADDED BY BDORSEIIENTISPEaAl.I'AOII1S1ONS <br />Re: C1dJ Coleman License Holder CCC035 167 and CBC 00 '''67 and Kc:ilb Wood License Holder CBC1250625 <br /> ..".. r fADDmONAL IlSURED- INSURER lETTER: ,. .......,.1:1 1 ... nn.. <br /> 2821348 SIIOULD ANY OF THE ABOVE D9CIlIIll!II I'OUCll!S Ill! CAIIICl!l.L!D IIeFOAE THE EXPIAATIOIf <br /> City 01 Zephyrtulls DATE TtlEAEOF. THE ISSUlNG IIilSURER Wll.1. ENDEAVOR TO MAIL ~ DAYS WRm'BI <br /> 53SS Eighth NOTlCETD THE C:smFlCATE IWLDER NAMED TO THE lEFT.BUT FAILURE TO 00 10 SHALL <br /> Zephyrhils FL 33540 "f'OSE NO oeuGATlON OR UAIIlUTY OF ANY KIMI UI'ClN THE INSURER. rrs AB6HrS OR <br /> IlEPRESEII1'ATlVE$. <br /> AUTHORIZ&D REPReSENTATIVE L'f}- --4 -'~ -"'IlL <br /> I - <br />ACORD zs.s (7197) "",--.......-...-.... ..._-~...""""-' ---..-,..........__lIIln. oAeDIm CORPORATION 1988 <br />
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