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09-9348
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2009
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09-9348
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Last modified
1/24/2011 9:01:50 AM
Creation date
1/24/2011 9:01:49 AM
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Building Department
Company Name
EASY ACRES
Building Department - Doc Type
Permit
Permit #
09-9348
Building Department - Name
MITCHELL,RONALD & SHEILA
Address
4814 20TH ST
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Air National 8135146458 p.l <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID SW DATE (IAMIDDlYYYY) <br /> AIRNA -1 07/15/09 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 17757 US Highway 19 14, Ste 660 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P.O. Box 2456 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Clearwater FL 33757 -2456 <br /> Phone: 727 -461 -6044 Fax: 727- 442 -7695 INSURERS AFFORDING COVERAGE NAIC <br /> INSURED INSURER A' FvA Mutual lnoutoneo Company 10385 <br /> INSURERS: Auto - Owners Insurance Co* 189B8 <br /> Air National LLC <br /> Barry & Brandi Andrews INSURER C: Owners Insurance Company 32700 <br /> 1002 West336 2h Blvd INSURER 0: <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 DY PAID CLAIMS. <br /> H <br /> IND ppU POLY IC EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR IN • TYPE OF INSURANCE POLIC NUMBER DATE (MRVODIYYI I DATE ( MFVDDIYYI <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE 51000000 <br /> AtNA Iu <br /> C COMMERCIAL GENERAL LIABILITY 09461220718351 03/16/09 03/16/10 pREMI S E urenco) $300000 <br /> CLAIMS MADE f I OCCUR MED EXP (Any ono Person) . 5 10000 <br /> PERSONAL SADV INJURY s 1000000 <br /> GENERAL AGGREGATE 5 2000000 <br /> G EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS• COMP /OP AGO 52000000 <br /> X POLICY n PRO • n LOC <br /> JEC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 5500000 <br /> C © ANY AUTO 4796277600 03/16/09 03/16/10 (Eoeecidonl) <br /> I <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY <br /> SPor person) 5 <br /> HIRED AUTOS BODILY INJURY 5 <br /> NON•OWNEO AUTOS IPor accident) <br /> PROPERTY DAMAGE ! 5 <br /> (Por oceidonl) <br /> GARAGE LIABILITY AUTO ONLY • EA ACCIDENT I S <br /> ANY AUTO OT}IER THAN EA ACC 5 <br /> AUTO ONLY: AGG 5 <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S 1000000 <br /> B X OCCUR n CLAIMS MADE 4796277601 03/16/09 03/16/10 AGGREGATE S <br /> s <br /> DEDUCTIBLE 5 <br /> X RETENTION 5 0 5 <br /> WORKERS COMPENSATION AND XI TOR LIMIT I IDEa <br /> A <br /> EMPLOYERS' LIABILITY WC84000214292009A 01/01/09 01/01/10 E.I. EACH ACCIDENT 5500000 <br /> ANY PROPRIETOR/ <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE 5500000 <br /> Ityoc, doscliboLaMar E.L. DISEASE - POLICY LIMIT S 500000 <br /> SPECIAL PROVISIONS below , <br /> OTHER <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS !VEHICLES l EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS <br /> 813 780 -0000 <br /> CERTIFICATE HOLDER CANCELLATION <br /> CTYZEPH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO DO SO SHALL <br /> City of Zephyrhills IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br /> 5335 8th Street <br /> Zephyrhills FL 33540 REPRESENTATIVES. <br /> AUT RILED REPRESTIV <br /> — <br /> • <br /> ACORD 25 (2001/08) © ACORD CORPORATION 1988 <br />
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