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08-7666
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2008
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08-7666
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Last modified
3/6/2009 4:46:26 PM
Creation date
5/13/2008 10:56:53 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7666
Building Department - Name
K-MART
Address
7422 GALL BV
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<br />ACORDm CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDIYYYY) <br />03/14/08 <br />PRODUCER D080720 1-407-332-0029 THIS CERTIFICATE IS ISSUED AS A MAlTER OF INFORMATION <br />Insurance Solutions of America, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />910 Belle Avenue, Suite 1140 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Winter Springs, FL 32708 <br />Scott E. Lugering INSURERS AFFORDING COVERAGE NAIC# <br />INSURED INSURER A: Everest Indemnity Insurance COItWany <br />Alliance Fire & Safety, Inc. Alliance Protective Systems <br />Inc., dba Alliance Fire & Safety INSURER B: Travelers Insurance COItWany <br />P.O. Box 637 INSURER C: <br />Venice, FL 34284 INSURER D: <br /> INSURER E: <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, N01WITHSTANDING <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 />INSR DD'L Pgk+~~~~~6g;V~~ Pg~'fJI~~6~~N <br />LTR N"RC POLICY NUMBER LIMITS <br />A ~NERAL LIABILITY RMG6400014 03/02/07 04/27/08 EACH OCCURRENCE $1,000,000 <br /> i"me'" G,""'" ",,"'UN DAMAGE,~ YE RENTeD $ 50,000 <br /> PREMISES Ea occurence) <br /> f--. CLAIMS MADE 0 OCCUR MED EXP (Anyone person) $ 5,000 <br /> f--. PERSONAL & ADV INJURY $ 1,000,000 <br /> f--. GENERAL AGGREGATE $ 2,000,000 <br /> rl'L AGGRE~E LIMIT APn PER: PRODUCTS - COMP/OP AGG $1,000,000 <br /> POLICY X ~~RT LOC <br />B ~.:rOMOBILE LIABILITY 21483 04/28/07 04/28/08 <br /> COMBINED SINGLE LIMIT $1,000,000 <br /> ANY AUTO (Ea accident) <br /> -- <br /> -- ALL OWNED AUTOS BODILY INJURY <br /> X (Per person) $ <br /> -- SCHEDULED AUTOS <br /> X HIRED AUTOS <br /> -- BODILY INJURY $ <br /> X NON-OWNED AUTOS (Per accident) <br /> - <br /> X COItW Ded $500 <br /> PROPERTY DAMAGE $ <br /> X ColI Ded $500 (Per accident) <br /> GARAGE L1ABtLlTY AUTO ONLY - EA ACCIDENT $ <br /> F~ ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> :J OCCUR D CLAIMS MADE AGGREGATE $ <br /> $ <br /> F~ DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I WCSTATU-.1 IOTH- <br /> iORY LIMITS ER <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ <br /> ~p'fd~~~~~vi19gNS below EL DISEASE - POLICY LIMIT $ <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />USA <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITIEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br />REPRESENTATIVES. <br />AUTHORIZED REPRESENTATIVE 1,,- <br />,,() o;t,t [: <br /> <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />City of Zephyrhills <br /> <br />5335 8th Street <br /> <br />Zephyrhills, FL 33542 <br /> <br />ACORD 25 (2001/08) MKollerAFS <br />8308920 - <br />
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