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08-7884
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2008
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08-7884
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Last modified
3/6/2009 4:45:17 PM
Creation date
9/19/2008 11:12:48 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7884
Building Department - Name
BRUNNER,JUDITH
Address
6623 NORTH LADE DR
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<br />'iIlV."'IV.'" <br /> <br />~CORQ. CERTIFICATE OF LIABILITY INSURANCE I ~ifn1f'1CATE NO.1 DATE <br /> ACOI. '200'&2-~O?63~ <br /> 03/2S/200& 01:31 ~Pl <br />I'ftODUCER THIS ~FtOATE IS ISSUED AS A MATTER OF INFORM4T10N <br />Highpoint niDk Servicc~ L~C ONLY AND CONPIIRS NO RIGHTS UPON THE CERTlFlCATE <br />14160 DallaD Parkway #500 HOLDER. THIS cmnFICAT~ ~S NOT AM~ND, ~!~~ 2.fi <br />Dallas, TX 75254 <br />(800) 632-5096 INSURERS AFFORDING COVERAGE <br />IN!f(lpjm!" 'tJ!IS" "fi ~lf r INSURER A:. C<Xlln.::ln:1on Pr01Xlrtv and Col8Ualtv Inlllurancl; C <br />J Ii: C CARPENTRY, me. INSURER B; <br />13461 79 CT. NOR~R INSURER 0: <br />WEST PALM BEACH, FL 33412 I'jSURIiR D; <br />(5'1) .3.3.3 -7"04 Fax: ISH) 333-7747 IN.sU~ E: <br />THli POLlClliS OF INSURANCE USTEO BELOW HAVE BEeN ISSUED TO Tlti II'ISURED NAMED A80VE FOR TltE POLICY PERIOD INDICATED, <br />NOTWITHSTANDING <br />ANY Al!QUlRI!MI!NT, 1ll1U" OR CONDITION OF At<< CONTRACT OR OYHER DOCUMENT WITtI RIiIPECT TO WHICH THIll CiRTlFlCATE MAY IE <br />~ 1':11I=1) a~ <br />A TYPf 01' INSUIWfCf POLICYNUMIEft ~ ~ LIMITS <br />~ENI!:AAL UA8IlITY !ACH OCCllAAfNCf . <br />- ~M!"Cv.L Cl!N!l'W. LlMlIUT"I' 1'lRt: DAMAQe (Mil on. "It) , <br />- CLAIMS MAOIi: 0 OCCUM Mt:D l!lI:P lAM OM_Ill S <br />- P';RSONAI. , MN tuURY S <br />,.... GeNel'lAL. AGGIleGot.TI! S <br />nN1. AO<lIleO LIMIT An~ peA: r'l'l00\..I0TS. QCMf'IQ"-'OG S <br /> !'QUC" I ~~ LOO <br />~U'l'OMOgILE UAIlILITY QOI.tIIIN;D $1NG~ LIMIT . <br /> ~A\1TO (I!I IllCIdlnU <br />- <br /> ALl. OWNED AVTOS IIOPII.V INAII'IY <br />- . <br /> SCHCllUU!D AUTOS (P<< Pf"OllJ <br />- <br /> HIHlW AUTOS SODILY1NUI'l"f <br />- d <br />- NOH.~ED AUTOS IPlIt .~n1) <br /> PROPl!RlY DAMAGE $ <br /> (Pet KI:ldanl) <br />RAAGE U~IIILITY AUTO OHI. Y -fA ACCID!NT . <br /> foN'r AUTO OTllI<R THAN ~"'ACC S <br /> AUTO ONLY: AGO , <br />1lXC!SS L1A!IIUTY !AOH OOOUMI!NO! . <br />':: occun DCLAlMSMAOIi: AllOIlfOATl! . <br /> . <br />- <br />- DEPUC:TlllLE $ <br /> 1'IETI!NT10l\1 S ~I $ <br />WORKliAI COMPliNSATION AND 04/01/2009 IOJ:I;I- <br />I!MI'LOYVlS' L1ADlLI'rY WC77779990601 04/01/2008 l!L l!1.CH ACCID!NT' . 1000000 <br />A EL DI8l:A8l! -I!A EM'LOY!l!: . 1000000 <br /> ".1- Dl8I!A$l! . I'OUC'Y UMlY . 1000000 <br />~THIR LIMITS , <br /> UMITS . <br />DUCAIP110N OP' O~TIONSILOCATIONSN~Ql.U5lQN' jlPPiP IV ~1'lSEMENl7SPE<:1AL PAOVl5lONS <br />1. Insured is afforded Occupatio~al ACcident Coverage a8 a co-employer under the policy for employee5 <br />lCAged fr~ AMS StAff Lca3ing, Inc. 2. 'thi. cer~ifica~e remalnc in c~fQct, providod tho clicnt'8 <br />account illl in good IIItanding vtth AMS. Coverago illl not provided for any employee for which the c1i~t <br />~.s not reportiI19' vagea to J\MS. Applies to lOOt of the employeeD ot AMS le~Qcd to J & C CARPENTRY, <br />INC., effective 04/01/2008 <br /> I I &DllI11CNAL INSUAfIl; INSUIIGIl LCTTO: ~JlN~1 I Jl,"",N <br /> SHOULD ANY OF tMC AIIOI/i DIiIOIlIIIiD POLlOIQ -Ii DAIlC&I.1$D I15FOA" M;; 5XPlllAlIOI <br /> DATI: 'l1al~r. ~ ISSUING IIDUll9 WII.L ~YOll TO MAL 30 DAYS WRmIN <br />CITY 010' Z~PHYRHILLS NOTIC:I! TO lHI CIRlI'ICATI HOLDUI IWoMD '1'0 'l'Hf1.U'l'. aln MlUlIlI TO DO 10 IHALl. <br />Pi J J Ii 8 nr STREB'I' IlIPOSl NO o.uGAllON OR LIA8IUTY 01' ANY _D u.oN '!Ita INI~ ~ ~ 01 <br />~~: 813-760-0021 Ai:PIICC&NT"TIVIii- <br />ZE~XL~S, FL 33542 AImIOIIIZm R~PItIHNTATIVK l -~ ~ <br />ACORD 25-S rt19'T) o ACORD CORPoRATION 19 I <br />
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