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09-9096
Zephyrhills
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2009
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09-9096
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Last modified
1/13/2011 9:37:11 AM
Creation date
1/13/2011 9:37:10 AM
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Building Department
Company Name
SILVER OAKS
Building Department - Doc Type
Permit
Permit #
09-9096
Building Department - Name
JARRETT,GEORGE & SUZANNE
Address
6921 NORTHLAKE DR
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ACORD, CERTIFICATE OF LIABILITY INSURANCE OP ID KF DATE (MM /DD/YYYY) <br /> PRODUCER EHRMA -1 04/08/09 <br /> Brown & Brown of Florida, Inc THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P 0 Box 54 8 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 273 North Broad Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Brooksville FL 34605 -0548 <br /> Phone:352- 796 -8200 Fax:352- 799 -1399 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED <br /> Carey A. Ehrman #ER0013583 & INSURER A: FOCI Insurance Co 10178 <br /> CAC1814 4 7 2 INSURER B: <br /> Ehrman Systems Enterprises Inc <br /> dba Environmental Contractors INSURER C: <br /> 10221 South Highway 301 <br /> INSURER D: <br /> Dade City FL 33525 <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 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 BEEN REDUCED BY PAID CLAIMS. <br /> INSK AUU'L _ <br /> LTR INSRC TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> DATE (MM/DD/YY) DATE (MM/DD/YY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY UAMA(,E I U REN I EU <br /> PREMISES (Ea occurence) $ <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> • <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ <br /> POLICY PRO- <br /> JECT LOC <br /> AUTOMOBILE LIABILITY <br /> COMBINED SINGLE LIMIT <br /> ANY AUTO $ <br /> (Ea accident) <br /> ALL OWNED AUTOS — <br /> SCHEDULED AUTOS BODILY INJURY $ <br /> (Per person) <br /> HIRED AUTOS — — <br /> NON -OWNED AUTOS BODILY INJURY $ <br /> (Per accident) <br /> — <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO — <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS/UMBRELLA LIABILITY <br /> EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE — <br /> RETENTION $ <br /> WORKERS COMPENSATION AND WC S1AIU- 01H- <br /> A EMPLOYERS' LIABILITY TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE 30860 04/01/09 04/01/10 E.L. EACH ACCIDENT $ 100000 <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, describe under E.L. DISEASE - EA EMPLOYEE $ 10 O O O 0 <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> E.L. DISEASE - POLICY LIMIT $ 500000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYOFZ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> City of Zephyrhi 11 s NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Building Dept <br /> 5335 8th St IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Zephyrhills FL 33542 REPRESENTATIVES. <br /> AU O D REPRESENIUTIVE <br /> ACORD 25 (2001108) 'C/il' ACORD CORPORATION 1988 <br />
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