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09-9025
Zephyrhills
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Building Department
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2009
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09-9025
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Last modified
1/12/2011 3:23:22 PM
Creation date
1/12/2011 3:13:54 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
09-9025
Building Department - Name
SMITH,PATRICIA
Address
5741 YORKSHIRE DR
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To: City of 2ephyrhills Building From: Amanda Phone: 991 9 -08 -09 11:39am p. 2 of 2 <br /> L 4/8/2009 <br /> Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> Alliance Insurance Solutions LLC THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE <br /> COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> PO Box 1777 INSURERS AFFORDING COVERAGE <br /> St Petersburg, FL 33731 <br /> INSURER SUNZ Insurance Company <br /> A <br /> 727-497-1247 INSURER <br /> www.ins4biz.com <br /> Insured INSURER <br /> TXRECO, Inc. d /b /a Pinnacle C <br /> Employee Leasing INSURER <br /> Suite 121 D <br /> 115 West Olympia Ave INSURER <br /> Punta Gorda FL 33950 E <br /> THE POLICIES OF INSURANCE LISTE BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD I <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 /> POLICY POLICY <br /> INSR EFFECTIVE EXPIRATION ATE <br /> LTR TYPE OF INSURANCE POLICY NUMBER M D AT E M D AT YY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIAB FIRE DAMAGE (Any one fire) $ <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEPI'L AGG LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ <br /> 1POUCY F1PROJECT f LOC $ <br /> AUTOMOBILE LIABILITY <br /> _ <br /> ANY AUTO COMBINED SINGLE LIMIT $ <br /> _ ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> _ HIRED AUTOS BODILY INJURY <br /> NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> JANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS LIABILITY EACH OCCURRENCE $ <br /> ]OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> A EMPLOYERS' LIABILITY TION WCPE0000000803 6/15/2008 6/15/2009 ✓ 'STATUTORY <br /> ACCIDENT NT TIT I ✓IDTHER $ � <br /> A ACCIN $ 1000000 <br /> EL DISEASE • EA EMPLOYEE $ 1000000 <br /> EL DISEASE • POLICY OMIT $ 1000000 <br /> DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVtSI6NS <br /> Coverage provided for all leased employees but not subcontractors of: Skylighting, LLC <br /> dba The Skylighters Client Effective Date: 08/13/2007 <br /> State of Florida Coverage Only <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL <br /> . 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE <br /> City of Zephyrhills Building LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION <br /> Phone 813- 780 -0020 OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRE- <br /> Fax 813- 780 -0021 SENTATIVES. ' 10 Days for Non - Payment of Premium. <br /> 5335 8th St AUTHORIZED <br /> Zephyrhills FL 33542 REPRESENTATIVE ({ //off -t <br /> Douglas Lilak �gi <br /> y MJI4 S <br /> CERT NC 4759848 CLIENT CODE. PEL 'Amanda Phone: 941- 833 -2065 4/6/2009 11:29:43 AM Page 1 of 1 <br />
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