Laserfiche WebLink
ACORD ' CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/1fY1fY) <br /> 9/22/2009 <br /> PRODUCER Phone: 813- 226 -1300 Fax: 813- 226 -1313 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Brown & Brown Tampa ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P. O. Box 15519 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Tampa FL 33684 -5519 <br /> INSURERS AFFORDING COVERAGE HAIL* <br /> INSURED INSURERkZurich American Insurance Co. 16535 <br /> Cross Construction Company Inc (%ERmSteadfast Insurance Co. 26387 <br /> Cross Construction Services Inc <br /> 25221 Wesley Chapel Blvd INSURER C: <br /> Lutz FL 33559 -7201 INSURER D: <br /> INSURER E <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. <br /> NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE <br /> TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD'L POLICY EFFECTIVE POUCY EXPIRATION <br /> LTR IN$RD TYPE OF INSURANCE POLILVNUMBER DATE (MWU YYI DATE (IMIDOIYYI LIMITS <br /> A GEN ERALLIABIUTY GL0586754904 3/1/2009 3/1/2010 EACH OCCURRENCE $ 1, 000, 000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES(Eaoccurence) $150,000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $10,000 <br /> PERSONAL 3ADV INJURY $ 1, 000, 000 <br /> GENERAL AGGREGATE $2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000, 0 0 0 <br /> POLICY I A f JECT LOC <br /> A AUTOMOBILELIABRITY BAP586754604 3/1/2009 3/1/2010 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Ea accident) $1,000,000 <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Peraccidenl) <br /> GARAGE UABIUTY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTOONLY: AGG $ <br /> g EXCESS/UMBRELLAUABI.m SE0586754804 3/1/2009 3/1/2010 EACH OCCURRENCE $5,000,000 <br /> X OCCUR CLAIMS MADE AGGREGATE $5,000,000 <br /> $ <br /> DEDUCTIBLE $ <br /> X RETENTION $10,000 $ <br /> A WORKERS COMPENSATION AND WC586755104 3/1/2009 3/1/2010 X TORY STATU 10TH- <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> EL. EACH ACCIDENT $1,000,000 <br /> OFFICER/MEMBER EXCLUDED? EL DISEASE - EA EMPLOYEE $ 1 , 0 00 , 0 00 <br /> If yes, describe under <br /> SPECIAL PROVISIONS below EL DISEASE - POLICY LIMIT $ 1,000,000 <br /> B OTHER PEC586754304 3/1/2009 3/1/2010 i'ach Claim $1,000,000 <br /> Pollution (Lead Asbestos) , ggregate $2,000,000 <br /> Liability <br /> DESCRIPTION OFOPERATTONS/ LOCATIOMS VEHICLES /EXCLUSIONS ADDED BYENDORSENIENT /SPECIAL PROVISIONS <br /> See Cross Construction Inc, Cross Construction Services Inc - Certificate Attachment dated 3 -1 -09 attached *Except for <br /> 10 days non payment of premium <br /> RE: CERTIFICATE HOLDER - ETHAN T. LILLIBRIDGE CGC1505176 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED <br /> CITY OF ZEPHYRHIT,T.0 BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER <br /> WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE <br /> 5335 8T1 STREET CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO <br /> ZEPHYRHILLS FL 33542 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON <br /> THE INSURER, ITS AGENTS OR REPRESENTATIVES - <br /> AUTHORD'J=D REPRESENTATWE <br /> ACORD 25 (2001108) '. r s1 - '"' "•p A D C RATION 1988 <br />