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08-7233
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2008
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08-7233
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Last modified
3/6/2009 4:48:22 PM
Creation date
10/16/2008 9:03:03 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
08-7233
Building Department - Name
NESTLE WATER NA, INC
Address
4330 20TH STREET
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<br />ACORD... CERTIFICA TEOF LIABILITY INSURANCE OP 10 1~ DATE (MM/DD/YYYY) <br />JSTHO-1 09/25/07 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />Graham-Naylor Agency, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br />1355 Terrell Mill Rd Bldg 1464 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. . <br />Marietta GA 30067 <br />Phone: 770-952-1096 INSURERS AFFORDING COVERAGE NAlC # <br />INSURED INSURER A: Valley Forae Ins CO./eNA 20S08C <br /> INSURER B: National Fire/CNA 20893C <br /> J. S. Thomas Mechanical, LLC INSURER c: Great American Ins Co. <br /> J.B. Thomas ~o., Inc. <br /> 9365 Industr1al Trace INSURER 0: <br /> Alpharetta GA 30004 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 INDICATED. NOlWlTHSTANDING <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 />IILTR waRt TYPE OF INSURANCE POLICY NUMBER DATEIMMlDDIYYI P~"/~ UMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $1,000,000 <br /> - <br />B ~ COMMERCIAL GENERAL LIABILITY 2077716361 09/30/07 09/30/08 ~=:;is lea occurence\ $100,000 <br /> n CLAIMS MADE (iJ OCCUR ~D EXP (Anyone IlBfSOn) $ 10,000 <br /> ~ BLANKET ADD'L INS PERSONAL & ADV INJURY $1,000,000 <br /> ~ XCU Included CONTRACTUAL INCLUDE P GENERAL AGGREGATE $2,000,000 <br /> GEN'l AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG $2,000,000 <br /> n POLICY [Xl ~~8r n LOC Emo Ben. 1,000,000 <br /> AUTOMOBILE UABIUTY COMBINED SINGLE LIMIT $1,000,000 <br /> f-- <br />A ~ Am AUTO 2077716327 09/30/07 09/30/08 (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> - $ <br /> .!... SCHEDULED AUTOS (Per person) <br /> .!... HIRED AUTOS BODILY INJURY <br /> (Per accident) $ <br /> .!... NON-OWNED AUTOS <br /> - PROPERTY DAMAGE $ <br /> (Pet accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ==i ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESSlUMBRELLA LIABILITY EACH OCCURRENCE $5,000,000 <br />C !J OCCUR D CLAIMS MADE SBU596589901 09/30/07 09/30/08 AGGREGATE $5,000,000 <br /> $ <br /> ~ DEDUCTiBlE $ <br /> X RETENTION $10,000 $ <br /> WORKERS COMPENSATION AND Xl~yS~~Ti's I IU~ft <br />A EMPLOYERS' LIABILITY 2077716277 09/30/07 09/30/08 E.L. EACH ACCIDENT $500,000 <br />ANY PROPRIETORlPARTNERlEXECUTIVE <br /> OFFICERlMEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $500,000 <br /> ~~~Mf~~J:~~NS below E.L. DISEASE - POLICY LIMIT $500,000 <br /> OTHER <br />DESCRIPTION OF OPERATIONS I L.OCATlONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br />Project: NWNA zephyrhills Florida Plant, 4330 20th Street, Zephrhills, FL <br />33540 <br /> <br />CERTIFICATE HOLDER <br /> <br />CANCELLAllON <br /> <br />CITY080 <br /> <br />SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br />DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL ~ DAYS WRITTEN <br />NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br />IMPOSE NO OBlIGATION OR UABIUTY OF ANY KIND UPON THE INSURER, rrs AGENTS OR <br />REPRESENTATIVE&. <br />AUTHO <br /> <br /> <br />~ <br />WM. John Graham III, CIC <br />@ ACORD CORPORA TlON 1988 <br /> <br />City of Zephyrhi1ls <br />Fax: 813-780-0021 <br />5335 8th Street <br />Zephyrhills FL 33540 <br /> <br />ACORD 25 (2001/08) <br />
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