08-7810 - Laserfiche WebLink

Browse Search

A~CORDTM CERTIFICATE OF LIABILITY INSURANCE I DATE (MM/DDNYVY) 04/03/08 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION BB& Tiler Wall & Shonter ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 800 49th Street North HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. P.O. Box 14448 St Petersburg, Fl 33733 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Southern Owners Insurance Company 10190 Visk Construction Inc. - INSURER B: Auto Owners Insurance Company 18988 12604 Orange lake Drive INSURER C: Bridgefield Employers Insurance 10701 Thonotosassa, Fl 33592 INSURER 0: -- INSURER E: .___-.i Client#. 894791 69VISKCON 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, I PJ>A~~~ri~r~8,w\E p~~fJ/~X':'~~N LTR NSR TYPE OF INSURANCE POLICY NUMBER LIMITS A GENERAL LIABILITY 0446122065318307 06/20/07 06/20/08 EACH OCCURRENCE $1 000000 - ~~~~pE TO RENTE~enra\ X COMMERCIAL GENERAL LIABILITY $100000 l CLAIMS MADE ~ OCCUR MED EXP (Anyone person) $10.000 -- ~ PO Ded:250 PERSONAL & ADV INJURY $1 000 000 -- ~ OCP GENERAL AGGREGATE $2 000 000 GEN'L AGGREnE LIMIT APAS PER: PRODUCTS - COMP/OP AGG $1 000000 Ii PRO- POLICY JECT lOC B ~TOMOBILE LIABILITY 9659430101 06/20/07 06/20/08 COMBINED SINGLE LIMIT ~ ANY AUTO (Ea accident) $1,000,000 ALL OWNED AUTOS BODILY INJURY f-- $ SCHEDULED AUTOS (Per person) - - ~ HIRED AUTOS BODILY INJURY $ ~ NON-OWNED AUTOS (Per accident) ----- - PROPERTY DAMAGE $ (Per accident) RRAGE LIABILITY AUTO ONL Y - EA ACCIDENT $ -- ANY AUTO OTHER THAN EA ACC $ -- AUTO ONL Y: AGG $ B tiJESS/UMBRELLA LIABILITY 9659430102 06/20/07 06/20/08 EACH OCCURRENCE $1 000000 X OCCUR 0 CLAIMS MADE AGGREGATE $1 000 000 $ ~ DEDUCTIBLE $ ----- X RETENTION $ 10000 $ C 83026968 03/01/08 03/01/09 X I WC STATU-, , IOJ~- WORKERS COMPENSATION AND I T;';;'y' ',ArT'- EMPLOYERS' LIABILITY $1,000,000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL, EACH ACCIDENT -- OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $1,000,000 If yes, describe under .--- SPECIAL PROVISIONS below EL, DISEASE POLICY LIMIT $1,000,000 - A OTHER Contr Equip 0446122065318307 06/20/07 06/20/08 $235,681 A Rent/leased Equip 0446122065318307 06/20/07 06/20/08 $30,000 $500 Oed. r ;;;;;;;h-. ~ l.(' ~ cur::' e~ I ~lb --- DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *10 days notice of cancellation for nonpayment of premium. ltlAPR 2 4 ml~ L_,__.....________..._"j City of Zephyrhills .......'.., CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION City Of Zephyrhills-Building DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAil ~ DAYS WRITTEN Dept NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAll 5335 8th Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Zephyrhills, Fl 33542 REPRESENTATIVES, AUTHORI~ED REPRESENt:)V~ 'J'J( ~~.J1. L"- J,.,J ACORD 25 (2001108) 1 of 2 #M2426815 EH2 @ ACORD CORPORATION 1988