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08-7804
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2008
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08-7804
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Last modified
3/6/2009 4:45:45 PM
Creation date
8/20/2008 10:43:19 AM
Metadata
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
08-7804
Building Department - Name
HCR MANOR CARE
Address
38220 HENRY DR
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<br />A L.Urn,( ~t:K III-I~A I t: UI- LIAtslLl1 IN~UKAN~t: I 04/14/2008 <br />PItDDUCER (352)126-3818 FAX (8")883-8680 THIS CERTIFICATE I8I8SUED AS A MATTER OF INFORMATION <br />L.ssiter-~are Insurance ONLY AND CONFERS NO RIGHT8 UPON THE CERTIFICATE <br /> HOLDER. &~IS ~~r~~IICATE DOES NOT A~~AhglE'~~. <br />of Citrus County ALTER TH COV RA E AFFORDED BV TH P S B . <br />PO Box 1209 <br />Inv.rn.n, FL 34451 INSURERS AFFORDING COVERAGE NAIe II <br />INSUR&D INSURER A Burlington Insurance Co.pany 123620 <br />Eveready Fire .. Securi ty INSURER B <br />P.O. BOK 250 INSURER c: <br />no.osassa Springs, FL 34441 INSURER 0: <br /> NSURER E: <br /> <br />From; SSS-SS3-S6S0 <br /> <br />To: 13526211222 <br /> <br />Pre: '213 <br /> <br />Date. 41141200S 3'22'42 PM <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOlWlTHSTANDING <br />Nf( REQUIREMENT. TERM OR CONDITION OF Nf( 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 />_ l'i'I"IIll' INSUJltANCI! PDLICYNUMBM ~~ LIMITS <br />IH!NIIW. LIAIUTV HGl.0018203 03/06/200lJ 03/06 2009 EACH OCCURRENCE S 500.0od <br />I-- <br />X COMMERCIAL GENERAL LIABlLfTY DAMAGE TO RENTED $ 50. OM <br /> I CLAIMS MADE [!J OCCUR MED EXP (Afri one person) $ 1,_ <br />A PERSONAL 8. ADV INJURY S 500.001. <br />- 1. 000. OO( <br /> GENERAL AGGREGATE $ <br />- 500,001, <br />GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS. COMPIOP AGG S <br />I POLICY n ~8t n LOC <br />~MOIILI LIABILITY COMBINED SINGLE LIMIT S <br /> ANi AUTO (Ee eccident) <br />- <br /> ALL OWNED AlJTOS BOOlL Y INJURY <br />- $ <br /> SCHEDULED AUTOS (Per person) <br />- <br /> HIRED AlJTOS BODILY INJURV <br />- $ <br /> NON-OWNED AlJTOS (Per accident) <br />- <br />- PROPERlY DAMAGE S <br /> (Per accident) <br />OAAA~I LIABILITY AUTO ONLY. EA ACCIDENT S <br />=i Am AlJTO OTHER THAN !!AACC $ <br /> AUTO ONL v: AGG $ <br />I!XCI!SSAlM8RiLLA LIABILI1Y EACH OCCURRENCE S <br />=:J . OCCUR 0 CLAIMS MADE AGGReGATE $ <br /> S <br />=i DEDUCilBLE $ <br /> RETENilON $ $ <br />WOIV(I!lUI CDMPI!NlATION AND I iORYl.iMrl'S I lo~r <br />IIIPLOYIiA8' LIABILITY E.L. EACH ACCIDENT $ <br />ANYPROPR~O~ARTNE~CunVE <br />OFFICERIM BER EXCLUD 01 E1. DISEASE. EA EMPLOTEE S <br />~r.t't~~~~~~~NS below E.L. DISEASE. POLICY LIMIT $ <br />[Illol1!1t <br />DUCRlPTlON OF OPERATlONII LOCATIONIIVlHICLEI/IXCLUIIONI ADDED IV INDORIIMENT IIPICIAL PROVIIIONl <br /> <br /> <br />City of Zepbyrhills Building Depart.."t <br />5335 8th Street <br />Z~hyrhills, FL 33542 <br /> <br />CA ELLA N <br />IHOULD AN( OF THE AIM DIICRIIED POLlCIllIE CANCELLED IPORl THE <br />EXPIRATION DATI! THI!IlEO~, THE ISIUING INSUlUiIt WLL I!NDIAVDR TO MAIL <br />-1lL. DAVI Wltl'TTl!N NOTICE TO THE CIImFICATI! HOlDER NAMID TO THE LiFT, <br />IUT FAILURE TO MAIL IUCH NOTICE lHALL IMl'OtI NO OBLIGATION OR LIABlLn'V <br />OF AH't KIND UPDN THE INSURI!R, ITlI AGB'lTI DR ItEPRliHNTATIIIH. <br />AUTHOItlZI!D IU!PUII!NTAT1VI! . "1/; '.1 . fr' /, <br />r!lhlr.1I'1. i'r~' 'Y',.J.' <br />if ' (.1 <br /> <br />ACORD 25 (2001108) FAX: (813)180-0021 <br /> <br /> <br />MCORD CORPORATION 1888 <br />
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