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08-8010
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08-8010
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Last modified
3/6/2009 4:44:50 PM
Creation date
9/19/2008 11:28:26 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
08-8010
Building Department - Name
BOETTCHER,RICHARD
Address
5548 21ST STREET
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<br /> ACOROM CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) <br /> 11/27/2007 <br />I P,<ODUCER , THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />I ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> KILBRIDE INSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 400 N Parsons ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Brandon, FL 33511 I I <br /> (813)684-7467 INSURERS AFFORDING COVERAGE i NAIC# <br /> INSURED Treehouse Homes, Inc. INSURER A AMERICAN VEHICLE INS , <br /> INSURER B: I I <br /> ; ! <br /> <br />6215 Harney Rd <br /> <br />Tampa, FL 33610 <br /> <br />813-601-4263 <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY 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 /> <br />I~~~ ~o~~ TYPE OF INSURANCE POLICY NUMBER b'1YPM~b'5W~VE P8k+~Y ~~~~~J:.ON I <br /> <br />GENERAL LIABILITY EACH OCCURRENCE <br /> <br />INSURER C. <br /> <br />INSURER D' <br /> <br />INSURER E: <br /> <br />---, <br /> <br />A <br /> <br />----- i <br /> <br />7T477132 <br /> <br />11/15/07 <br /> <br />11/15/08 <br /> <br /> <br />I <br />X. COMMERCIAL GENERAL L.IABllITY 'I' <br />.---r-: r-I <br />, _ CLAIMS MADE L__' OCCUR <br />. i <br /> <br />PERSONAL & ADV INJURY <br /> <br />$ 1 000 000 <br />$ 100 0001 <br />1$ 5 000 <br />1$ 1 000 000 I <br />2,000,000J <br />2,000,0001 <br /> <br /> <br />~5!'l'L AGGR~~~,E p~~I_T A~S PERI' <br />, X . POLICY' 'JECT: LOC <br /> <br />AUTOMOBILE LIABILITY <br /> <br />GENERAL AGGREGATE I $ <br />'-'-r-- <br />! PRODUCTS - COMP/OP AGG : $ <br /> <br /> - I I I COMBINED SINGLE LIMIT 1$ <br /> ANY AUTO (Ea a~cidenl) <br /> I -.-.-------.-1 <br /> ; hi ALL OWNED AUTOS BODILY INJURY $ I <br /> , ! ~~I SCHEDULED AUTOS (Per person) <br /> i ; I <br /> : HIRED AUTOS BODILY INJURY <br /> , $ <br /> I ! NON-OWNED AUTOS (Peraccidenl) 1 <br /> r' --------.-.T . m. ----- .-..-- -I <br /> i I <br /> ~--i ----- PROPERTY DAMAGE 1$ <br /> (Peraccidenl) ; <br /> GARAGE lIAB 11ITY I I AUTO ONL Y - EA ACCIDENT -4-!- I <br /> ! __ ._____.__.0._ .-. 1 <br /> . ANY AUTO OTHER THAN EA ACC I $ i <br /> , .------.- <br /> : i AUTOONL Y: AGG $ <br /> , : EXCESS/UMBRELLA LIABILITY <br /> I 1----1 r--I EACH OCCURRENCE $ <br />i i I i OCCUR I i CLAIMS MADE AGGREGATE $ <br /> 1--- '--- $ <br /> , <br /> r-"--: ---.- <br />i I ~..! DEDUCTIBLE I i$ .._J <br /> ---,.~-------_.- ~_.. <br /> , RETENTION $ $ <br /> WORKERS COMPENSATION AND : I we STATU- I 10TH- I <br /> I TORY LIMITS ER <br /> EMPLOYERS' LIABILITY ____J <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE ! E.L EACH ACCIDENT $ <br /> ; OFFICER/MEMBER EXCLUDED? I E.L DISEASE - EA EMPLOYE $ <br />I ! If yes, describe under E.L DISEASE - POLICY LIMIT <br /> ' SPECIAL PROVISIONS below $ <br />, OTHER I <br />; <br />I I <br />i i I <br />I <br /> <br />DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> <br />For Prensentation Purposes On~y******** <br />Origina~ wi~~ be issued at the request <br />of the insured_ <br /> <br /> <br />THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION, <br />OF, THE ISSUING INSURER WILL ENDEAVO 0 MAIL~ DAYS WRITTEN I <br />NOTICE T TH CERTIFICATE HOLDER NAMED TO THE i FT. BUT FAILURE TO DO SO SHALL i <br />IMPOSE 0 IGATION OR LIABILITY OF Arv,Y KIND PON THE INSURER, ITS AGENTS OR <br />'I VES. / / . <br />PRE ENT IVE <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLATION <br /> <br />ACORD 25(2001/08) <br />
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