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09-9861
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09-9861
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Last modified
1/19/2011 3:14:50 PM
Creation date
1/19/2011 3:14:46 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
09-9861
Building Department - Name
ZEPHYR COMMONS LLC
Address
7780 GALL BLVD
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ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 11/30/09 <br /> PRODUCER 1- 813 - 229 -8021 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> M. E. Wilson Co., Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 300 W. Platt st. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Ste 200 <br /> Tampa, FL 33606 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA:Amerisure Ins Co 19488 <br /> Associated Construction Products, inc. <br /> INSURERB:ASPEN INS UK LTD AA- 1120337 <br /> 25352 Wesley Chapel Blvd INSURERC:Amerisure Mut Ins Co 23396 <br /> Lutz, FL 33559 -7202 INSURERD: <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 /> INSR ADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR INSRD TYPE OF INSURANCE DATE (MM /DD/YY) DATE IMM/DDIYY) <br /> A GENERAL LIABILITY GL2019035 04/01/09 04/01/10 EACH OCCURRENCE $1,000,000 <br /> DAMAGE TO RENTED <br /> X 300,000 <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ <br /> CLAIMS MADE X OCCUR MED EXP (Anyone person) $ 5,000 <br /> X Contractual PERSONAL &ADV INJURY $ 1,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $2,000,000 <br /> 7 POLICY [ 1 77 LOC <br /> A AUTOMOBILE LIABILITY CA2019036 04/01/09 04/01/10 <br /> COMBINED SINGLE LIMIT $1,000,000 <br /> X ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> X HIRED AUTOS 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 OTHERTHAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> B EXCESS /UMBRELLA LIABILITY CXA5D6P09 04/01/09 04/01/10 EACH OCCURRENCE $ 1,000,000 <br /> X OCCUR CLAIMS MADE AGGREGATE $ 1,000,000 <br /> DEDUCTIBLE $ <br /> X RETENTION $ 10,000 $ <br /> C WORKERS COMPENSATION AND WC2019034 04/01/09 04/01/10 X ORYLIMITSI OT ER <br /> EMPLOYERS' LIABILITY 500,000 <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $500,000 <br /> If yes, desce under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> City of Zephyrhills DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> Building Department NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 5335 8th Street <br /> REPRESENTATIVES. <br /> Zephyrhills, FL 33542 AUTHORIZED REPRESENTATIVE Q <br /> USA � .-- -�. s--- <br /> ACORD 25 (2001/08) XE001 © ACORD CORPORATION 1988 <br /> 13697198 <br />
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