08-7557 - Laserfiche WebLink

Browse Search

From: Amy Banchs At: Bouchard Insurance Inc FaxIO: To: City of Zephyrhills Date: 2/26/2008 10:34 AM Page: 1 of 2 ACORD. CERTIFICATE OF LIABILITY INSURANCE OP 10 A41 DATE (MMJDDIYYYY) EAGLE-1 02/26/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Bouchard-Clearwater ONL Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR POBox 6090 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Clearwater FL 33758-6090 Phone: 727-447-6481 Fax: 727-449-1267 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A Transport.ation :J:nsurance CO INSURER B Valley Forge Insurance Co Eagle Roofing Contractors, Inc INSURER C Mr Eric Sennott ber.icl.n ca.u.al ty Co of "eaclnq 3701 West Cherry Street INSURER D: Transconti.nental Xnsuranc. Co Tampa FL 33607 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO I'LL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS LTR NsR[ TYPE OF INSURANCE POLICY NUMBER DATE (MMJDDNY) -1>'k+'EY (MMJDDNY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 I- 07/01/07 07/01/08 ~'v,,""'''u D ~ COMMERCII'L GENERAL LIABILITY 2091487362 PREMISES (Ea occurence) $ 100000 I- b CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $ 5000 PERSONAl & I'DV INJURY $ 1000000 I- GENERI'L AGGREGATE $2000000 - GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2000000 --l POLICY !xl j~ n LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ 1000000 C ~ ANY AUTO C2082846198 07/01/07 07/01/08 (Ea ace, dent) - I'LL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) - ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per aCCident) f-- PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONlY - EA ACCIDENT $ R ANY AUTO OTHER THAN EA ACC $ AUTO ONL Y AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ 1000000 A RJ OCCUR 0 CLAIMS MADE CUP2082846265 07/01/07 07/01/08 AGGREGATE $ 1000000 $ ~ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X ITO'R\tiCI'fs I IUE~ B EMPLOYERS' LIABILITY WC2092172401 07/01/07 07/01/08 $ 500000 ANY PROPRIETORIPARTNERlEXECUTIVE EL EACH ACCIDENT OFFICERlMEMBER EXCLUDED? E L DISEASE - EA EMPLOYEE $ 500000 If yes, describe under $ 500000 SPECII'L PROVISIONS below EL. DISEASE - POLICY LIMIT OTHER D Rented Leased Equi C2048146410 07/01/07 07/01/08 L/R Equip 50000 D Installation Float C2048146410 07/01/07 07/01/08 Install F 20000 DESCRIPTION OF OPERATIONS / LOCAllONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS FAX: 813-780-0021 CERTIFICATE HOLDER CANCELLATION CITYOFZ SHOULD AJoN OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION CITY OF ZEPHYRHILLS PERMITTING DEPARTMENT 5335 8TH STREET ZEPHYRHILLS FL 33542 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOllCE TO THE CERTIfICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGAllON OR LIABILITY OF AJoN KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHOR P SENTAT @ACORDCORPORATION1988 ACORD 25 (2001/08)