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08-7403
Zephyrhills
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2008
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08-7403
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Last modified
3/6/2009 4:47:53 PM
Creation date
9/19/2008 10:39:19 AM
Metadata
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
08-7403
Building Department - Name
SIXTH AVE LLC
Address
39345 6TH AV
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<br />11CORD~ CERTIFICATE OF LIABILITY INSURANCE OP lOps I DATE (MMfDONYVYj <br />SUNCFIR 01/10/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Greg Roe Insurance, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />New Port Richey FL 34655 <br />Phone: 727-376-0030 Fax: 727-376-2262 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED I NSURER A Kichi.qan Construction IndulItry 10998 <br /> INSURER B MidContinent Inllurance CoIllpOllny 23418 <br /> Suncoast Enterprises, NN, Inc, <br /> DBA Suncoast Fire Safety INSURER C <br /> PO Box 1290 INSURER 0 <br /> New Port Richey FL 34656 <br /> INSURER E <br /> <br />COVERAGES <br /> <br /> THF POLICIES OF INSURANCE LISTED BELOW HA'rr BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOT'MTHSTANDING <br /> ANY REQUIREMENT. TERM OR CONCHlON OF ANY CONTRACT OR OTHER OOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERT AIN, THE INSURANCE AFFORCED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONCHlONS OF SUQ-l <br /> POLICIES AGGREGATE LIMITS SHO'NN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br />'NSR 00' POL.ICY EFFECTIVE POLICY EXPIRATION <br />LTR SRO TYPE OF INSlRANCE POLICY Nl..IMBER DATE (MMIOOIVY) DATE (MMIDOIVY) LIMITS <br /> GEt>ERAL LIABILITY EACH OCCURRENCE I 1000000 <br /> - DAMAGE TO RENTED <br />B ~ COMMERCIAL GENERAL liABiliTY 04GLOO0673651 05/12/07 05/12/08 PREMISES (Ea occurence) $ 100000 <br /> - tJ ClA'MSMAOE 0 OCCUR MED EXP (Anyone person) $ EXCLUDED <br /> !-- PERSONAL & ADV INJURY $ 1000000 <br /> ~ includes XCU Cove GENERAL AGGREGATE $ 2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPIOP AGG $ 2000000 <br /> [POLICY nPRO. nLOC <br /> JEcr <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - , <br /> ANY ",UTO (EaaCCldent) <br /> - <br /> ALL OWNED AUTOS BODlY INJURY <br /> - $ <br /> SCHFDULED AUTOS (Per person) <br /> - <br /> HIRE.D AUTOS 80DL Y INJURY <br /> - l <br /> NON-OWNED AUTOS (PeriKcldent) <br /> I-- <br /> PROPERTY DAMAGE $ <br /> (PeracCldenl) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ~ ANY.'UTO OTHER THAN EAACC $ <br /> AUTO ONLY AGG $ <br /> EXCESSlLIltBRELLA LIABILITY EACH OCCURRENCE $ <br /> =:J OCCUR D CLA,MSMADE AGGREGATE I <br /> . <br /> ~ DEweTlBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND I T~R~ ~~~~TU~ T -laTH- <br /> ER <br /> EMPLOYERS' LIABILITY 03/18/07 <br />A WC100-0012132-2007A 03/18/08 E L EACH ACCIDENT l 100000 <br /> ANY PROFRI!::lORJPARTNERIEXECUTIVc <br /> r:lF~ICERIMEMBER EXCLUCED? E L DSEA5E EA EMPLOYEE $ 100000 <br /> Ifyes,descnbeundH <br /> SPECIAL PROVISIONS below E L DSEASE POLICY LIMIT $ 500000 <br /> OTIER <br />DESCRIPTlON OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENlORSEMENT I SPECIAL PROVISIONS <br />WORKERS COMPENSATION APPLIES TO FLORIDA OPERATIONS ONLY. <br />*30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR <br />NON-PAYMENT OF PREMIUM. <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />CITYZEP <br /> <br />SHOlA.D ANY OF TIE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> <br />CITY OF ZEPHYRHILLS <br />c/o BILL BURGESS, <br />BUILDING OFFICIAL <br />5335 8TH ST <br />ZEPHYRHILLS FL 33542 <br /> <br />DATE THEFa:OF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> <br />* <br /> <br />DAYS WRITTEN <br /> <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> <br />IMPOSE NO OBLIGATION OR LIABILITY OF AN( KIND UPON TIE INSURER, ITS AGENTS OR <br /> <br /> <br />@ ACORD CORPORATION 1988 <br /> <br />ACORD 25 (2001/08) <br />
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