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08-8153
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2008
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08-8153
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Last modified
3/6/2009 4:44:21 PM
Creation date
9/23/2008 9:53:14 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
08-8153
Building Department - Name
WELLESLEY DEVELOPMENT CORP
Address
6134 9TH STREET
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<br />From: Karen Foster At:'Brown a. Brown of Florida Inc, FaxlD: BrownBrownlnsurance To: Alice <br /> <br />Date: 8/512008 04:29 PM Page: 2 of 2 <br /> <br />ACORD~ CERTIFICATE OF LIABILITY INSURANCE OP 10 1~ DATE (MMIDDIYYVY) <br />EHRMA-1 08/05/08 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />Brown & Brown of Florida, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />POBox 548 HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br />273 North Broad Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br />Brooksville FL 34605-0548 <br />Phone: 352-796-8200 Fax: 352-799-1399 INSURERS AFFORDING COVERAGE NAIC# <br />INSURED - <br /> careK A. Ehrman #EROO13583 & INSUF.:ER A FCC I Insurance Co 10178 <br /> CAC1 14472 INSURER B <br /> Ehrman Systems Enterprises Inc It.JSURER c <br /> dba Environmental Contractors <br /> 10221 South Hi~hway 301 INSUREF.' 0 <br /> Dade city FL 3 525 <br /> INSURER E <br /> <br />COVERAGES <br /> <br />THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDIC.n.TED NOTWITHSTA.NDING <br />ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHEr;: DOCUMEI,T WITH RESPECT TO WHICH THIS CERTIFICATE MA.'( BE ISSUED OR <br />MA. Y PERTAIN. THE INSURANCE A.FFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS. EX.CLUSIONS MID CONDITIONS OF SUCH <br />POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL.n,lMS <br />LTR NSRD TYPE OF INSURANCE POLICY NUMBER 'DATE (MMlDDIYY) DATE (MMIDDIYY) LIMITS <br /> GENERAL LIABILITY , EACH OCCURRENCE $ <br /> - u~_,~ "C ,.~ "C," CL' <br /> COMMERCiAl GENERAL lIABILIT'1' PREMISES {Ea occurenc:e) $ <br /> - ~ CLA.lMS MADE D OCCUR <br /> MED EXP (Any onepersonj $ <br /> - <br /> PERSONAL & i'DV INJURY $ <br /> - <br /> GEI,ERAL AGGREGATE $ <br /> - <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP/OP AGG $ <br /> I n PRO- nLOC <br /> POLICY JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> - (Ea accldentj $ <br /> ANY AUTO <br /> - <br /> ALL OWNED AUTOS BODIL Y NJURY <br /> - (Per person) $ <br /> SCHEDULED AUTOS <br /> - <br /> HIRED AUTOS BODILY INJURY <br /> - $ <br /> NON-OWNED AUTOS (PBr aCCident) <br /> - <br /> PROPERTY DAMAGE $ <br /> {Per accidenti <br /> GARAGE LIABILITY AUTO ONLY - EA .A.CCIDEIJl' $ <br /> ~ ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY AGG $ <br /> EXCESS/UMBRELLA L1ABIUTY EACH OCCURRENCE $ <br /> ~ OCCUR D CLAIMS MPDE AGGREGATE $ <br /> I $ <br /> ==i DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND ITOR\tIMI'IT; I IVER- <br />A EMPLOYERS' LIABILITY 30860 04/01/08 04/01/09 $ 100000 <br />ANY PROPRIETORIPARTNER/E><ECUTIVE EL EACH ACCIDENT <br /> OFFICER/MEMBER EX.CLUDED? E L. DISEASE - EA EMPLOYEE $ 100000 <br /> If yes, descnbe under $ 500000 <br /> SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT <br /> OTHER <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> <br />CERTIFICATE HOLDER <br /> <br />CITYOFZ <br /> <br />CANCELLATION <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> <br />City of Zephyrhills <br />Building Dept <br />5335 8th St <br />Zephyrhills FL 33542 <br /> <br />DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 <br /> <br />DAYS WRITTEN <br /> <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br /> <br />ACORD 25 (2001/08) <br /> <br />
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