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08-8055
Zephyrhills
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Building Department
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2008
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08-8055
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Last modified
3/6/2009 4:44:38 PM
Creation date
9/19/2008 11:43:46 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-8055
Building Department - Name
ZEPHYR HAVEN
Address
38250 A AV
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<br /> <br />NUMBER <br /> <br />PRODUCER <br /> <br />;436693 <br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO <br />RIGHTS UPON lliE CERTIFICATE HOLDER OlliER THAN lliOSE PROVIDED IN lliE POLICY. <br />llilS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER lliE COVERAGE AFFORDED BY lliE <br />POLICIES DESCRIBED HEREIN. <br />COMPANIES AFFORDING COVERAGE <br />COMPANY A: AI South Insurance Co. <br />COMPANY B: American Home Assurance Co. <br />COMPANY C: Commerce & Industry Ins Co <br />COMPANY D: Illinois National Insurance Co. <br />COMPANY E: Insurance Company of the State of PA <br /> <br />Marsh, Inc. <br />1166 Avenue of the Americas <br />New York, NY 10036 <br />Telephone (212) 345-5000 <br /> <br />INSURED <br /> <br />SimplexGrinnell, LP <br />4701 OAK FAIR BLVD <br />TAMPA, FL 33610 <br />United States <br /> <br /> <br /> <br />COMPANY G: New York Marine & General Insurance Co. (Lead) <br />COMPANY H: White Mountain Insurance Co. <br /> <br />THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE DESCRIBED HEREIN HAVE BEEN ISSUED TO THE INSURED NAMED HEREIN FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIRMENTS, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THE CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE <br />AFFORDED BY THE POLICIES LISTED HEREIN IS SUBJECT TO ALL THE TERMS, CONDITIONS AND EXCLUSIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY <br />PAID CLAIMS. <br /> <br />CO TYPE OF INSURANCE <br />LTR <br /> <br />POLICY NUMBER <br /> <br />POLICY EFFECTIVE POLICY <br />DATE (MMlDDIYY) EXPIRATION <br /> <br />LIMITS <br /> <br /> <br />GENERAL LIABILITY <br />X COMMERCIAL GENERAL <br />CLAIMS MADE [KJ OCCU <br />OWNER'S & CONTRACTOR'S <br /> <br />GL 1595415 <br /> <br />6/29/2007 <br /> <br />10/1/2008 <br /> <br />GENERAL AGGREGATE <br /> <br />PRODUCTS-COM~OPAGG <br /> <br />PERSONAL & ADV INJURY <br /> <br />EACH OCCURRENCE <br /> <br />FIRE DAMAGE (Anyone fire) <br /> <br />$15,000,000,00 <br />15000000.00 <br /> <br />B <br /> <br />10/1/2008 <br />10/1/2008 <br />10/1/2008 <br /> <br />COMBINED SINGLE LIMIT <br /> <br />$7,500,000.00 <br />$1,000,000,00 <br />$10,000,00 <br /> <br />$7,500,000,00 <br /> <br />B <br />B <br />B <br /> <br />AUTOMOBILE LIABILITY <br />X ANY AUTO <br />ALLOWED AUTOS <br />SCHEDULED AUTOS <br /> <br />CA 1606992 (MA) <br />CA 1606993 01A) <br />CA 1606994 (AOS) <br /> <br />6/29/2007 <br />6/29/2007 <br />6/29/2007 <br /> <br /> <br />BODILY INJURY (Per person) <br /> <br />X HIRED AUTOS <br />X <br /> <br />NON-OWNED AUTOS <br /> <br />BODILY INJURY (Per <br />accident) <br /> <br />PROPERTY DAMAGE <br /> <br />PROPERTY <br /> <br />B <br />o <br />A <br />F <br />C <br /> <br />EXCESS LIABILITY <br /> <br />UMBRELLA FORM <br />OTHER THAN UMBRELLA FORM <br /> <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILITY <br /> <br />THE PROPRIETOR! <br />PARTNERs/EXECUTIVE <br />OFFICERS ARE: <br /> <br />OlliER <br /> <br />EACH OCCURRENCE <br />AGGREGATE <br /> <br />SEE PAGE TWO <br /> <br />SEE PAGE TWO <br /> <br />SEE PAGE TWO <br /> <br /> <br />EL EACH ACCIDENT <br />EL DISEASE-POLICY LIMIT <br /> <br />EL DISEASE-EACH <br /> <br />INCL <br /> <br />EXC <br /> <br />DESCRIPTION OF OPERATlONS/LOCATlONSNEHICLESISPECIAL ITEMS <br /> <br />Please see page 2 for additional insureds and any additional language. <br /> <br /> <br />City of Zephyrhills <br />5335 Eighth Street <br />Zephyrhills, FL 33540-4312 <br /> <br />SHOULD ANY OF THE POLICIES DESCRIBED HEREIN BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE <br />INSURER AFFORDING COVERAGE WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER <br />NAMED HEREIN, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br />THF INSI JRFR AFFORnIN~ r.OVFRA(:';F ITS Ar.FNTs OR RFPRFSFNTATIVFS OR THF 1!It.~IJFR OF THIS r.FRTIFIr.ATF <br /> <br /> <br />\ ..:J~ ~ <br /> <br />J <br /> <br />MARSH USA INC. BY: <br />David Kong, Casualty Program <br /> <br />
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