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08-7400
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2008
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08-7400
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Last modified
3/6/2009 4:47:57 PM
Creation date
4/30/2008 10:04:18 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7400
Building Department - Name
ELISA KEYS,MAYRA
Address
5636 BEECH ST
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<br />, 1/16/2008 09:31 <br /> <br />LION INSURANCE COMPANY <br /> <br />Lion Insurance Company-+Alr National, LLC <br /> <br />III <br /> <br /> Date <br />ACORD TM CERnFICATE OF UABIUTY INSURANCE 1/1612008 <br />Producer: Lion I~. CompllllY This Certlficllllllslssued as a matlllr of Information only and confers no rights <br /> 2739 U.S. Highway 19 N. upon the Certificate Halder. This Certificate does not a_d, extend or ai_ <br /> Holiday, FL 34691 the coverage afforded by the polIcieS below. <br /> Phone: 727-938-5562 FlIX: 727-937-2138 <br /> Insurers Affording Coverage NAtC # <br />Insured: South East Personnel leasing, Inc. Insurer A: Lion Ill$unlnce ComPll ny . 11015 <br /> 2739 US. Highway 19 N. Insurer B: <br /> Holiday, Fl 34691 Insurer C: <br /> Phone: (727)938-5562 Insurer 0: <br /> IllSla'er E: <br />Coverages <br />The policies of Insulance iSlod belowhavs boon issued 10 the i.....od named ab<Ml for the poley period irdcalod. NoMithSlan.ing 01Iti requ;r9l1l9nt. tetm or conci~on of arIi coroad or o1hOf docllTJ9nlwtll 'ElSI>9Ct to which <br />this cor1ificate may be issued or rMypertain. the illSllll/lCB -dedl7fthe palaes _ herem IS sulJfectto 911 the tenns. exckJSions. ancI condl1lonsof such poIaes A!I!I'egaIe~rnls sho\lwlmayhawl been reduced l7f <br />paid claims <br />NSR AOOl Type of Insurance PoNcy NLlYlber PoIiey Effective Policy Expiration Date Umils <br />LTR NSRO Date <br /> (MMIODIYY) (MMIODIYY) <br /> ~NERAL UABILlTY Each OCOJmlnCe $ <br /> Commercial General liability Damage to r9llled prenises (EA <br /> : ::J Claims Made 0 Occur ocCIDence) $ <br /> - Mod Exp $ <br /> - Personal AtN InjuIy $ <br /> General aggregate limit applies per: <br /> ::J Polley o Project 0 General Aggregate $ <br /> LOC <br /> Products. CompIOp Agg <br /> iAUTOMOBILE UABlLlTY Comblned Single Lirril <br /> i- (EA ACCidenl) $ <br /> Arf;AWl <br /> ~ AI OWned AiJlos BodIIyIn;.y <br /> i- (Per Person) $ <br /> Scheduled Allos <br /> i- Hired Allos BodIy Irv; <br /> i- (Per Accident) $ <br /> NOfl-Ov<<led AiJlos <br /> i- <br /> Property Damage <br /> (Per Accidert) $ <br /> GARAGE LIABILITY ALto Orly - Ea Aecident $ <br /> =J Arf; Allo other Than EA Ace $ <br /> ~os 0nI{ AGG $ <br /> EXCESs/UMBRELLA LIABILITY Each OcCW8llCO <br /> - o ClaimsMade <br /> Ocw Aggregate <br /> ~ Deductible <br /> ~ Retention <br /> ..... <br />A Worf(ers Compensation and x I we Statu- I I om <br /> Employers' LlabHIy we 71949 0110112008 0110112009 tory Limits ER <br /> Ant proprielDr!p8ltnerlexecutive officetlmember E.l. ElICh Accident $1000ooo <br /> excluded? E.l. Disease - Ea Employee $1000ooo <br /> I'Yes, describe uncler speci8l plOllisions below. <br /> E.l. Disease - Potiey limls $1000ooo <br /> Other 0665409 <br /> Air National, llC COVERAGE APPLIES ONLY TO THOSE EMPLOYEES lEASED, NOT TO SUBCONTRACTORS. <br />De.criptions OfOp.rationslLocl!ionllV.hlclellE""....lon. added by Endon~ ProvilioM: ADO ONOA1E: 8/14/2006 <br />COVERAGE APPLIES ONLY IN THE STATE OF FLORIDA TO THOSE EMPLOYEES LEASED TO BUT NOT SUBCONTRACTORS OF Air NlIlional, LLC . FAX: 813-514-6458 <br />& 813-780-0021/ISSUE 11-21-01 (SO) I REISSUE 01.14-08 (JOY)/REISSUE 01-16-09 (NM) <br /> Lion Insurance Company is A.M. Best Company rated A- (Excellent). AMB # 12616 <br />ct:RT1FICATE HOLDER CANCelLATION <br /> CITY OF ZEPHYRHILLS Shot.td sryofthe _d9scribedpollCles be eMCeIod beIore Ihe 8l<pinltion dstelllereol.1he iSSlling i_WiI <br /> erd9lMlf to mail 30 days written noIice 10 the cellifiCale holder named 10 the left. bul faiue 10 do so shaI impose ro <br /> BUILDING DEPARTMENT oljgelion or iabilty 01 sry kind upon the insur9f. its __s or representatives. <br /> 5335 9TH ST ..JZ4 ../J~ <br /> ZEPHYRHI LLS FL 33542 <br /> <br />ACORD 25 (1001108) <br /> <br />ACORD CORPORATION 1988 <br />
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