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09-9875
Zephyrhills
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2009
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09-9875
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Last modified
1/11/2011 9:03:53 AM
Creation date
1/11/2011 9:03:40 AM
Metadata
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Building Department
Company Name
ASPEN DENTAL
Building Department - Doc Type
Permit
Permit #
09-9875
Building Department - Name
ASPEN DENTAL
Address
7715 GALL BLVD
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01/08/2010 15:40 727 - 547 -9754 AIRCO MECHANICAL PAGE 03/03 <br /> ACORD TM. CERTIFICATE OF LIABILITY INSURANCE DATE � osDDD <br /> PRODUCER Priam: (013) 98B - 1234 Fax 813 - 988 - 0989 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION <br /> ASSOCIATES AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> PO BOX 16190 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 11470 N. 53RD ST. ALTER THE COVFRAC+F AFFORDED BY THE POLICIES RFI OW. <br /> TEMPLE TERRACE FL 33887 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> Apency U91: R001768 <br /> INSURED INSURER At AUTO OWNERS INSURANCE CO. 18988 <br /> AIRCO MECHANICAL CONTRACTORS, INC. INSURER 6: FCCI INSURANCE CO. 03499 <br /> 6334 118TH AVENUE NORTH INSURER C: AUTO OWNERS INSURANCE CO. 18988 <br /> LARGO FL 33773 <br /> 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, NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> NCR ADD'- TYPE OF INSURANCE POUCY NUMBER POLICY EFFECTIVE ma= Et<PIRATiON UNITS <br /> LT1 INSRD DATE tromearrn DATE IMMOO/YVI <br /> GENERAL LIABILITY 20693418 02/10109 02/10/10 EACH OCCURRENCE $ 1,000,000 <br /> X COMMERCIAL GENERAL UABILrrY � , ) $ 300,000 <br /> CLAIMS MADE n OCCUR MED. EXP (My ana Parson) $ 10,000 <br /> A PERSONAL & ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLES PER: PRODUCTS-COMP /OP AGG. $ 2,000,000 <br /> -1 PO LICY II JECT n (-00 <br /> AUTOMOBILE LIABILITY 4345206801 02/10/09 02/10/10 COMBINED SINGLE LIMIT <br /> X ANY AUTO (Es =Wont) $ 1,000,000 <br /> ALL OWNED AUTOS BODILY INJURY <br /> '---- (Par person) 9 <br /> SCHEDULED AUTOS <br /> A X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> -- { I AUTO ONLY: AGG $ <br /> EXCESS r uMBRBLLA UABILOY 4345208802 02/10/09 02/10110 EACH OCCL RRENCE $ 6,000,000 <br /> - in OCCUR n CLAIMS MADE AGGREGATE $ 5,000,000 <br /> C $ <br /> — <br /> DEDUCTIBLE $ <br /> RETENTION $ 0 $ <br /> WORKERS COMPENSATION AND 001•WC09A -62050 06127/09 06/27/10 X mavu OTHER <br /> EMPLOYERS' Mature E.L EACH ACCIDENT $ 500,000 "TN s , OFFIC IE 0 7 E E.L. DISEASE -EA EMPLOYEE $ 500,000 <br /> Ryas, dassaa¢ under <br /> SPEC PROVISIONS Wow E.L. DISEASE -POLICY LIMIT s 500,000 <br /> OTHER: <br /> 1 <br /> DESCRIPTION OF OPERATIONS /LOCATIONSNEHICLESIEXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> EMPLOYEE BENEFITS LIMIT 1000000 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER IMLL ENDEAVOR TO MAIL 10 DAYS <br /> WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO <br /> City of Zephyrhllls 00 SO SHALL IMPOSE NO OBLIGATION OR UABILrIY OF ANY KIND UPON THE INSURER, ITS <br /> 5536 8th Street AGENTS OR REPRESENTATIVES. <br /> Zephyrhllls, Fl 33642 AUTHORIZED REPRESENTATIVE <br /> • Attention: 760 -0005 Trevor McCarthy <br /> ACORD 25 (2001/08) CertlflcetG # 191581 ® ACORD CORPORATION 1988 <br />
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