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09-9772
Zephyrhills
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Building Department
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2009
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09-9772
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Last modified
1/10/2011 12:47:22 PM
Creation date
1/10/2011 12:47:21 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
09-9772
Building Department - Name
CLEVELAND, PHYLLIS
Address
39114 7TH AVE
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11/18/2009 13:35 7278443737 INSURANCE ONE PAGE 01/01 <br /> A D CERTIFICATE OF LIABILITY INSURANCE 171109 <br /> is <br /> ' now cut • <br /> EXPERTS TRUCK AUTO INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR <br /> 9458 US HIGHWAY 1.9 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> PORT RTCHEY FL 34668 INSURERS AFFORDING COVERAGE <br /> mum swum*: • SEMINOLE CASUALTY INSURANCE. CalyP <br /> ADVANCED AIR SOLUTIONS, INC. IW URERit AEOUICAP INSTTRATNCR COMP <br /> 5432 W CRENSHAW ST STE C INSURER C: <br /> TAMPA FL 33634 INSURItICI: <br /> 1 mama E: <br /> 'COVERAGES <br /> THE POLICIESOF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REOUIREMENT, TERM OR CONORION 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 SEEN REDUCED BY PAID CLMU3. q� <br /> LTA TYPE OF NININANCI POLICY NulaSER DAT��M n /VI 1 D11TE (iIMIODrA ism <br /> GENERAL UASIUTY PACS OCCURRENCE 4 000000 <br /> COMMERCIAL GENERAL UMILITY PIKE DAMAGE (MY ON RIB) 11110111190 <br /> MARIIS MAOE El OCCUR M!D PJQ pay am wan) tow <br /> A SCL- 000305681 -0 07/24/09 07/24 /10 PER5oNALaAOY <br /> GENERALAOOREGATE 000000 <br /> DEAL AOBREOATe LIMIT APPLI!S PEA PRODUCTS - COMPrOP ADO 00(1000 <br /> 7 POLICY n n Lac 1 OO)»uO <br /> f AYTONDBILELMRLITY COMRUNEO 91NGLE LOUT 1 <br /> . ANY AUTO (En nNl <br /> ■ ALL OWNED AUTOS S N,IORY 1 <br /> • mecum A u AuTos • <br /> IN men AIMS e006LY MAW <br /> II 1 <br /> III NON-0WNEO AUTOS <br /> ■ <br /> PROPERTY DAMAGE $ <br /> NON TRUCKING NW <br /> GARAGE U aIU?V AUTO ONLY - EA ACCIDENT $ <br /> . ANY AUTO OTHER TnuN IAAOC 1 <br /> AUTO ONLY: AGG 1 <br /> HirCUU LABNJTY EACH OCCURRENCE $ <br /> ■ OCCUR 17 CLANS MAO! AGGREGATE $ <br /> 1 <br /> • <br /> a aPAUCTIBLE 1 <br /> RETENTION $ ! S <br /> • wcmtERS cOMPNIMTION AND I TDRV NWfa [ !ref` . <br /> WPLOTBIN• el. !ACM ACCIDENT WC07077746 06/19/09 06/19/10 summon 3 �nnGo <br /> E.L.aBEA� . EA EMPLOYEE $ �ryaO <br /> El-DISEASE - PoucY Law $ 100000 <br /> A I PHYSICAL DAMAGE DED S 1000 <br /> I j OUCRNPTION op OPIRATIONMOCATIONNVEilICLEIDEICUISIONS ADDEO BT ENOORSEMINLBPECNL PROYIBIOW <br /> TERMS AND CONDITIONS CONTAINED AND VEHICLE SCHEDULED ON THE POLICY <br /> License holder MAREK STROZ License# CAC - 1814928 <br /> CERTIFICATE HOLDER AIAOOflIoMAL ED :NISURER CANCELLATION <br /> SHOULD ANY OP TEE ASOVE DE _ • POLJC BE CANCELLED BEFORE TEE E1(/IRATION <br /> CITY OF ZEPHYRHILLS -BUILDING DEPT DATE THEREOF. THE ISBINN NEN - • FAVOR TO NAN. 10 DAYS wMTTCN <br /> 5335 8TH ST <br /> ZEPHYRHILLS ,FL 33542 NW1cPTGTEE - HOLDE ' 4.7, • • T. FNMA? TD <br /> PH. (813)780-0020 won NO DILIGA • • OR • ' .1 • ,' ITS AGO" OR <br /> FAX(813)780 0021 RBPNEUENTATI , <br /> AUTHORIZED N . - /Aide <br /> 1 • 1 x.k. 9 <br />
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