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09-9025
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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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APR- 08- 2009(WED) 17: 18 Watts, Dawson & Associates (FAX)813 685 04Ed P. 002/002 <br /> ACQFID, CERTIFICATE OF LIABILITY INSURANCE OP ID LH DATEIMMIDDMVYY) <br /> EM ELT 04/08/09 , <br /> PRODUCER ' THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION <br /> Watts Dawson 5 Aasoaiatas, Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> IHeme Office HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br /> 3.3008 N. 56th Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Tampa FL 33617 <br /> Phone: 813 -985 -0349 Pax: 813- 989 -3284 INSURERS AFFORDING COVERAGE NAIL 0 <br /> ammo INSURER A: ATLANTA CASUALTY INS CO <br /> INSURER B; ) RCURT CASUALTY INS CO. <br /> • JJ� <br /> SKYLIGHTERB INSURER C: <br /> HE'LL S a ! ROAD INSURER D; <br /> BRANDON INSURER E; <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TD THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDIITON OF ANY CONTRACT OR OTHER DOCUMENT wrrH 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 LIMrre SHOwN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br /> T LTR N �� POLICY NUMBER DA I MM'�) - POLICY (MID orrn <br /> L LIMITS <br /> TR IBRt TY'! or aSURANCi <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> �AINAGIF rvHeNieu $ 50 000 <br /> A X COMMERCIAL GENERAL LIABILITY L083004204 -1 07/30/08 07/30/09 PREMIBES(Ee000urawo , <br /> CLAIMS MADE © OCCUR MED EXP (Any one penmen) $ 5 ( 000 <br /> PERSONAL S ADV INJURY $ 1/000,000 <br /> GENERAL AGOREGATE 12,000,000 <br /> GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS • COMP /OP AGO $ 2,000,000 <br /> l POLICYn Tsi nLOC <br /> AUTOMDSLLi LIABILITY MIIINa SINGLE LIMIT 1 500,000 <br /> ANY AUTO <br /> ALL OWNED AUTOS BODILY INJURY <br /> H X SCHEDULED FLC7009270 -4 02/24/09 02/24/10 (Perperaon) $ <br /> X HIRED AUTOS BODILY INJURY <br /> X NON -OWNED AUTOS (Per accident) 1 <br /> PROPERTY OAMAGE 9 <br /> ^— (Par occident) <br /> GARAGE LABILITY AUTO ONLY • EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ — <br /> AUTO ONLY: AGO $ <br /> EXCESS/UMBRELLALIABILITY EACH OCCURRENCE S <br /> OCCUR E CLAIMS MADE AGGREGATE $ <br /> $ <br /> - <br /> H DEDUCTIBLE 1 <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND ITORV LIMITS I I ER <br /> SMPLOY!RN LIABILITY E.L. EACH ACCIDENT $ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE <br /> OFF ICERIMEMBER EXCLUDED? E.L, DISEASE • EA EMPLOYEE S <br /> N yyea eeUlbe under <br /> 6PE�IA PROVISION! below E.L, DISEASE - POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OP OPERATIONS I LOCATIONS / VEHICLES /'EXCLUSIONS AMMO BY ENDORSEMENT 1 SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYZEp SHOULD ANY OP THE ABOVE DESCRIBED POLICIES B! CANC'ELLSO BOOR! THE EXPIRATION <br /> OATS TH'ER'EOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS wRITT01 <br /> NOTICE TO TAR C'ERTIFICAT'E HOLM NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br /> CITY OF 2$FIT►L6 IMPOSE NO OBLIGATION OR LUIS � OF ANY IMO UPON THE INSURER, IT$ AGENT$ OR <br /> 533 8TH STREET REPRESENTATIVES. <br /> ZZPHYRHILLB FL 33542 AUTHORIZED REPRESENTATIVE ,ii <br /> BRANDON OFFICE c •:Ma <br /> ACORD 25 (2001 106) 0 AC • - I • ' r - PORATION 1988 <br />
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