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08-7722
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08-7722
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Last modified
3/6/2009 4:46:10 PM
Creation date
5/7/2008 10:30:03 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7722
Building Department - Name
STALL,JERRY
Address
37648 GILL AV LT 263
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<br />ACP r. 10. 2008f 8: 08AMICACE REFRIGRATION INC.rv INSURANCE No. 6506TP. 21~wpllIYTYY) <br />un&.(. \I I'{ 11r- II: ur LIADILI 02/20/2008 <br />HtOOUCER (863)688-549~ FAX (863)688-4344 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Herndon & Associates Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />gl Lake Morton Dr. HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />POBox 3608 <br />Lakeland, FL 33802 INSURERS AFFOR.DING COVERAGE NAlC' <br />~~R~ Ace Refrlgerat,on Inc INSURER A: Owners Insurance CoqJany 32700 <br />Ace Air Condition;ng/Elec INSURER B: Auto OWners Ins Co 18988 <br />923 W Memor;a' Blvd INSURER C: Bridgefield Employers Ins Go <br />Lakeland, FL 33aOl INSURER D: <br /> INSURER E: <br /> <br /> S <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />Atl'( REQUIREMENT. TERM OR CONDITION OF Atl'( CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br />MAY PERTAIN, THE INSUAANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE eEEN REDUCED BY PAID CLAIMS. <br />1~~1 TYPE OF INSUAANCE: 'OUCT NUMBER POLICY EFFeCTIVE POlICY EXPIRATION LIMITS <br /> GENERAL UA8lLITY 72673805 01/24/2008 01/24/2009 EACH OCCURRENCE $ 1,000,00( <br /> ~ COMMERC,^L. GENERAL. L.lABllITY OAMAGE TO RENTeD $ 50,00< <br /> I ClAIMS MADE 00 OCCUR MED EXP (""y one pel$OO\) $ 5,00 <br />A PERSONAl.. & AOV INJURY $ 1,000,00 <br /> I-- <br /> GENERAl AGGREGATE $ 2,000,00 <br /> I-- <br /> GENl.AGGREGATE LIMrr ""PUES PER: PRODUCTS - COMPIOP AGG $ 2,000,00 <br /> n POLlCV n ~~ n LOC <br /> AUTOUOlllUi UA8ILrTY 9627664100 01/24/2008 01/24/2009 COMBINEO SINGLE LIMIT <br /> ""X/IoN'(AUTO (Ea acDdenl) $ 500 OO~ <br /> I-- <br /> AlL OWNED AVTOS BODIL.Y INJUR.Y <br /> t-- (Per person) S <br /> SCHEDULED AUTOS <br />B I-- <br /> HIRED AUTOS BODILY INJURY <br /> 1-- (Per BCCfllent) S <br /> NON-CWNED AUTOS <br /> -- <br /> - PROPERTY DAMAGE $ <br /> (Pef aCCidenU <br /> GARAGE UA8ILlTV AUTO ONLY. EA ACCIDENT $ <br /> =l /IoN'( AVTO OTHER THAN EAA.CC $ <br /> AUTO ONL V: AGG $ <br /> EXCISSlUMBReLlA UAIlUTY 9627664101 01/24/2008 01/24/2009 eACH OCCURRENCE S 1,000,00 <br /> :J OCCUR D ClAIMS MADE AGGREGATE $ 1,000,00 <br />B s <br /> M DeOUCTIBLE $ <br /> X RETEHTlON S 10 , OOCl $ <br /> WORKERS COMPENSATION AND 083030040 04/01/2008 04/01/2009 X I WC STATU- 10~. <br /> EMPLOYERS. UAllIUTY EL EACH ACCIDeNT $ 500,00 <br />C ANY PROf'RIETORlPARTNERlEXECVTIVE <br />OFFICERlMEMIIER EXCLUOED? E.'" DISEASE - EA EMPLOVEE S SOO,OOCl <br /> If~. C1esCfibe unClet 500,00 <br /> S ClAl PROVISIONS lHlIow E.L DISEASE - POUCY LIMIT S <br /> OlMEJt <br />DESCRIPTION 0fI OPeRATIONS I LOCAfJONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSeMeNT I $I'@CIAl. 'ROYlSIOMS <br />icense Holders: Susan Will;ams CAC397SS Robert Krus ES0000061 and August Krus , ERoo01269 <br /> <br /> <br />City of Zephyrhills <br />5335 8th St <br />Zephyrhills, FL 34248 <br /> <br />SHOULD ANY OF THE AII0VE DESCRIBED POUClES Be CANCELLeD BEFORE TtE <br />EXPIRATION DAfE "THEREOF. THE ISSUING INliURER WILL ENDEAVOR TO MAIL <br />....!L DAYS MUTTliN 1il0000li TO ntE CERTIFICATE HOLDER NAMl!D TO THE LEFT. <br />BUT FAILURE TO MAIL SUCH NOTICE SH,ALL IMPose NO OBLIGATION OR LlABIl.1TY <br />OF "If'( KIND UPON THE INSURER. rrs AGENTS OR REPRESENTATIVES. <br />AUTttORIZED REPRESENTATIVE <br /> <br />~ ~--=-4' <br /> <br />Gerald Powell BElIND <br /> <br />ACORD 25 (2001/08) <br /> <br />@ACORD CORPORATION 1988 <br />
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