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<br />'" <br />~'al Liability Declarations Page <br /> <br />Agent Name: <br /> <br />Agent Phone #: <br /> <br />Named Insured: <br />Mailing Address: <br /> <br />Policy Nwnber: <br /> <br />Previous Policy ID: <br /> <br />Effectiv(, Dates: <br /> <br />Activity: <br /> <br />Business T)'Pe: <br /> <br />Coverages and <br />PremiuDlS: <br /> <br />Location Address: <br /> <br />Forms and <br /> <br />Endorsements: <br /> <br />Important Notice to <br />Policyholders: <br /> <br />Neigh~rhood Ins Services Inc. <br />14949 N Florida Ave <br />., <br />Tampa, FL 33613 <br /> <br />,;,m" Dec'",:.MI <br /> <br />American <br />StRU<jit <br />J~an(f <br /> <br />(813) 935-1561 <br /> <br />. -AgeocyCode: 412280 <br /> <br />Wesley Chapel Electric LLC <br />25678 INKWOOD PL <br />WESLEY CHAPEL, FL 33544 <br /> <br />Insuring Company: <br />American Strategic Insurance Corp <br />805 Executive Center Drive W Suite 300 <br />Saint Petersburg, FL 33702 <br />Phone: (727) 374-2502 <br /> <br />FLR34253 <br />FLR34253 <br /> <br />From: 01105/2008' To: 6'l1~ <br />At 12:01 AM Standard'"Fime'aMhe'3geltt~, <br /> <br />Renewal - General Liability <br /> <br />J1;t'reeti?e.~tIIilbcT""n.2Cfia..: <br /> <br />ltil.2l.108 <br /> <br />Corporation <br /> <br />Coverage for liability per referenced forms and endorsements is provided only where a limit of liability is shown or a premimn <br />is stated. <br /> <br />25678 lnkwood PL <br />Wesley Chapel, FL 33544 <br /> <br />Asr C 0002 10 04 <br />ASI GL 0006 10 02 <br />AS! RISC 0001 1002 <br />CG 21 47 07 98 <br />CG 21 67 12 04 <br />ASI RISC 0002 12 04 <br /> <br />ASI GL 0003 07 03 <br />ASI GL 0007 10 02 <br />CGOOOI1204 <br />CG 2149 09 99 <br />IL09 85 01 03 <br />CG22 941001 <br /> <br />ASI GL 0004 10 02 <br />CG 21 86 12 04 <br />CG 02 20 11 06 <br />ILOO21 0702 <br />CG 24 260704 <br />CG 21 70 11 02 <br /> <br />AS! GL 0005 10 02 <br />AS! GL 0009 10 02 <br />CG21 460798 <br />CG 03000196 <br />ASI C 000110 02 <br /> <br />THIS INSURANCE APPLIES ONLY TO WORK ARISING OUT OF OPERATIONS WIDCH ARE CUSTOMARY <br />TO THE CLASSIFICATIONSHOWNIN THE CLASSIFICATION SCHEDULE WHETHER OR NOT <br />INCIDENTAL. <br /> <br />IF YOU SUBCONTRACT WORK TO OTHERS, YOU MUST OBTAIN A CERTIFICATE OF INSURANCE <br />FROM THE SUBCONTRACTOR DEMONSTRATING GENERAL LIABILITY COVERAGE INCLUDING <br />PRODUCTS AND COMPLETED OPERATIONS COVERAGE WITH LIMITS NOT LESS THAN $100,000. <br />OPERA nONS PERFORMED BY SUBCONTRACTORS WITHOUT ADEQUATE INSURANCE SHALL BE <br />CLASSIFIED AND RATED IN THE SAME MANNER AS THOUGH WORK WAS PERFORMED BY YOUR <br />Etl.1PLOYEES. <br /> <br />THESE DECLARATIONS, TOGETHER WITH POLICY CONDITIONS AND COVERAGE FORM(S) AND <br />A.l'<J\'ENDORSEMENT(S), COMPLETE.THE ABOVE NUMBEREDPOLIC\'. <br /> <br />I(~~ U:l1! <br /> <br /> <br />Countersigned by Authorized Representative ST. Pet~ Florida <br /> <br />Date: 11105/2007 ASI GL DEe 12 03 <br />