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08-7064
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2008
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08-7064
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Last modified
3/6/2009 4:48:51 PM
Creation date
5/6/2008 2:26:38 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7064
Building Department - Name
CITY OF ZEPHYRHILLS
Address
39421 SOUTH AV
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<br />OCT-09-2007 14:07 <br /> <br />COMMERCIAL INSURACE <br /> <br />770 447 8353 <br /> <br />P . 01/01 <br /> <br />ACORQ.. CERTIFICATE OF LIABILITY INSURANCE I U"II: \MM/UUI1 Tf 'J <br />10/09/2007 <br />PRODUCER (770)447-6547 FAX (770)447-8353 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Commercial Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />POB 2647 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Norcross, GA 30091 <br /> INSURERS AFFORDING COVERAGE NAIC# <br />INSURED Meco of North Florida, Inc. INSURER "- Mid-Continent Casualty Company <br /> 3626 Phoenix Ave. INSURER B National Trust Insurance Co. <br /> Jacksonville, FL 32206 INSURER c: American Alternative Ins Corp <br /> INSURER D: FCCI Insurance Group <br /> INSURER E: <br /> <br />COVERAGES <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 />I~ ~~~~ TYPE Of INSURANCE POLICY NUMBER POlICY EFFECTlVE POLICY EXPlRA llON LIMITS <br /> GENERAL LIABILITY 04GL679248 06/30/2007 06/30/2008 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL LIABiM)I) L INSURED IF REQUIRED ~~~g,~!O RENTED $ 100,000 <br /> 1 CLAIMS MADE [!] OCCUR BY WRITTEN CONTRACT MED EXP (Anyone per50n) $ excluded <br />A ~ Pollution Liab $1,000,000/2,000,000 06/10/2007 06/30/2008 PERSONAL & ADV INJURY $ 1,000,000 <br /> WAIVER OF SUBROGATION GENERAL AGGREGATE $ 2,000,000 <br /> - INCLUDED 2,000,000 <br /> GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ <br /> "I POLICY IX] ~r~T n LOC <br /> AUTOMOBILE UABlLITY CA 0001716 4 06/30/2007 06/30/2008 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea .cciclenl) $ l,OOO.OO(] <br /> - <br /> ALL OWNEO AUTOS BODilY INJURY <br /> - $ <br /> SCHEDULED AUTOS (Per person) <br />B - <br /> ...!.. HIRED AUTOS BOOll Y INJURY <br /> $ <br /> X NON-OWNED AUTOS (Per .CCldenl) <br /> - <br /> -- PROPERTY DAMAGE $ <br /> (~er accldenl) <br /> GARAGE UABILITY AUTO ONLY. EA ACCIDENT S <br /> R ANY AuTO OTHER THAN EA ACC $ <br /> AUTO ONLY AGG S <br /> EXCESS/UMBRELLA UA81LITY 60A2UBOO02680-00 06/30/2007 06/30/2008 EACH OCCURRENCE $ 4,000,000 <br /> !JOCCUR 0 CLAIMS MADE AGGREGATE S 4.000,000 <br />C $ <br /> ~ DEDUCTIBLE $ <br /> X RETENTION $ 10,000 $ <br /> WORKERS COMPENSATION AND 010WC07A56599 06/30/2007 06/30/2008 X I WC STATU- T ID.!,tl- <br /> EMPLOYERS' LIABILITY E,l. EACH ACCIDENT S 1,000,000 <br />D ANY PROPRIETORlPARTNERlEXECUTlVE <br /> OFFICER/MEMBER EXCLUDED? EL. DISEASE - EA EMPLOYEE $ 1,000,000 <br /> If yes. describe under E.L. DISEASE - POLICY LIMIT $ 1,000,000 <br /> SPECIAL PROVISIONS below <br /> OTH~R CPPOO02662630 06/30/2007 06/30/2008 S 200,000 <br /> qUlpment Rented from <br />B :>thers S 1,000 deductible <br />DESCRIPTION OF OPERA llONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> <br /> <br /> <br />SHOULD ~Y OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br />EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br />-.!L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, <br />BUT FAILURE TO MAil SUCH NOTICE SHALL IMPOSE NO OBLlGA nON OR LIABILITY <br />ER,ITS AGENTS OR REPRESENTATlVES. <br /> <br />City of Zephyrhills <br />Attn: Building Dept. <br />5335 8th St. <br />Zephyrhills, FL 33542 <br /> <br /> <br />@ACORDCORPORATlON 1988 <br /> <br />ACORD 25 (2001108) FAX: (813)780-0021 <br /> <br />TOTAL P.Ol <br />
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