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09-9596
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09-9596
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Last modified
1/18/2011 3:05:11 PM
Creation date
1/18/2011 3:05:08 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
09-9596
Building Department - Name
OLD CASTLE MATT STONE
Address
3749 COPELAND DR
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>;f 10/13/2009 16:50 L ion Insurance LION INSURANCE COMPANY -►CITY OF ZEPHYRHILLS 1/1 <br /> Date <br /> CERTIFICATE OF LIABILITY INSURANCE 1 10/13/2009 <br /> Producer: Lion Insurance Company This Certificate is issued as a matter of information only and confers no rights <br /> 2739 U.S. Highway 19 N. upon the Certificate Bolder. This Certficate does not amend, extend or alter <br /> Holiday, FL 34691 the coverage afforded by the policies below. <br /> 727 - 938 -5562 Insurers Affording Coverage NAIC ft <br /> Insured: South East Personnel Leasing, Inc. Insurer A: Lion Insurance Company 11075 <br /> 2739 U.S. Highway 19 N. Insurer B: <br /> Holiday, FL 34691 Insurer C: <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 poi cy penod indicated. Notwithstanding any requirement, term or condition of any contract or other document oath respect to which <br /> this certificate may be issued or may pertain. the insurance afforded by the policies described herein is subject to all the terms. exclusions, and conditions of such policies. Aggregate limits shown may have been reduced by <br /> paid claims. <br /> INSR ADDL Policy Effective Policy Expiration Date Limits <br /> LTR INSRD Type of Insurance Policy Number Date <br /> (MM/DD/YY) (MM/DD/YY) <br /> GENERAL UABILITY Each Occurrence $ <br /> Commercial General Liability <br /> Damage to rented premises (EA <br /> Claims Made Occur occurrence) $ <br /> Med Exp $ <br /> Personal Adv Injury $ <br /> General aggregate limit applies per: <br /> General Aggregate $ <br /> D Policy ❑ Project ❑ LOC <br /> Products - Comp /Op Agg $ <br /> AUTOMOBILE LIABILITY Combined Single Limit <br /> (EA Accident) $ <br /> Any Auto <br /> Bodi y Injury <br /> All Owned Autos <br /> — (Per Person) $ <br /> Scheduled Autos , <br /> Hired Autos Bodily Injury <br /> Non -Owned Autos <br /> (Per Accident) $ <br /> Property Damage <br /> (Per Accident) $ <br /> EXCESS /UMBRELLA LIABILITY Each Occurrence <br /> Occur ❑ Claims Made Aggregate <br /> Deductible <br /> A Workers Compensation and WC 71949 01/01/2009 01/01/2010 X I WC Statu• I I OTl+ <br /> Employers' Liability tory Limits ER <br /> Any proprietor /partner /executive officer/member E.L. Each Accident $1,000,000 <br />
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