07-7274 - Laserfiche WebLink

Browse Search

ACORD CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIODIYYYY) TM 12/03/2007 PRODUCER (813)752-4155 FAX (813) 752-7681 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Poppell Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 503 W. Martin Luther King Blvd HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR AL TER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P. O. Drawer QQ Plant City, FL 33563-5217 INSURERS AFFORDING COVERAGE NAIC# INSURED JRBL Inc. INSURER A Southern-Owners Insurance 10190 DBA: Restorea 11 INSURER B Progressive Express Ins Comp 10193 4317 W Osborne Ave II,SURER C Auto-Owners Insurance 18988 Tampa, FL 33614 II,SURER D Zenith Insurance Co 054 INSURER E 12/4/2007 4:21 PM FROM: Fax Poppell Insurance Inc. TO: 8824925 PAGE: 001 OF 002 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 MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE Pg~f~ ~XJb~~N LIMITS LTR NSRC DATE (MM/DDIYYl GENERAL lIABllIlY 2067563205 09/27/2007 09/27/2008 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY g~~~~~~F~E~-~-7,~oncp I $ 100,000 I CLAIMS MADE [8] OCCUR MED EXP (I'ny one person) $ 100,000 A PERSONAl" ADV INJURY $ 1, 000, ooe - GENERAl AGGREGATE $ 2,000,000 - GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS COMP/OP AGG $ 2,000,000 I n PRO- nLOC POLICY ,IECT AUTOMOBILE lIABILllY 037039300 09/27/2007 09/27/2008 COMBINED :3INGLE LIMIT - (Ea aCCident! $ ANY AUTO 1,000,000 - ALL OWNED AUTOS BODIL Y INJURY - $ X SCHEDULED AUTOS (Per person) B X HIRED AUTOS BODIL Y INJURY - $ X NON-OWNED AUTOS (Per accldenl) I-- I-- PROPERTY DAMAGE $ (Per aCCldenl) GARAGE L1ABILllY AUTO ONL Y EA ACCIDENT $ R ANY AUTO OTHER THA~I EA ACC $ AUTO ONL Y AGG $ EXCESSlUMBRELLA LIABILITY 4402302401 09/27/2007 09/27/2008 EACH OCCURRENCE $ 2,000,000 tKJ OCCUR D CLAIMS MADE AGGREGATE $ 2,000,000 C $ R DEDUCTIBLE $ RETENTION $ 10,000 $ WORKERS COMPENSATION AND Z066946802 02/01/2007 02/01/2008 X I WC STATU- I X IOTH- TORY LIMITS ER EMPLOYERS' LIABILITY 1,000,000 D ANY PROPRIETOR/PARTNER/EXECUTIVE E L. EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L DISEASE: - EA EMPLOYEE $ 1,000,Ooe II yes. describe under I,OOO,Ooe SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT $ OTHER TIENYI0l209-017 12/31/2006 12/31/2007 $ 1,000,000 Per Pollution Occ ~ontractors Pollution Liability Claims Made $ 1,000,000 Aggregate Limit $ 10,000 Deductible each Occ. DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS awrence ClarkLIC#CGCI508769 ertificate holder included as additional insured with respects to General 1 iabil ity City of Zephyrhills-Building Department 533 58th Zephyrhills, FL 33542 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE J;iV~ 1.1_....1.. n-.___" 'tt..'TrTA