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09-9372
Zephyrhills
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2009
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09-9372
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Last modified
1/24/2011 9:47:58 AM
Creation date
1/24/2011 9:47:58 AM
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Building Department
Company Name
HONG KOMG RESTAURANT
Building Department - Doc Type
Permit
Permit #
09-9372
Building Department - Name
CHINESE TAKE OUT RESTAURANT
Address
7821 GALL BLVD
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ACORD CERTIFICATE OF LIABILITY INSURANCE 1 DATE(MMIDD/YYYY) <br /> 9 <br /> PRODUCER 863.68S. S495 FAX 863.688.4344 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Herndon & Associates Insurance, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P 0 Box 3608 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Lakeland, FL 33802 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED 8 Wayne Enterprises Inc INSURERA: Colony Insuance Group <br /> DBA: Commercial Fire Equipment Company INSURER <br /> P 0 Box 2442 Bridgefield Employers Ins Co <br /> INSURER C: <br /> Brandon, FL 33509 -2442 <br /> INSURER D: <br /> 1 <br /> INSURER <br /> COVERAGES E " <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 COMMON 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 /> INSR POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID (LAMAS. <br /> LIRR II TYPE OF INSURANCE POUCY HUMBER DAI POLFF EFFECTIVE D Y EXPIRATION OMITS <br /> GENES UABIUTY G13254709 02/21/2009 02/21/2010 EACH OCCURRENCE $ 1 <br /> MarERCML GENERAL u " DAMAGE TO RENTED Co ,000 ,000 <br /> CLAIMS MADE X OCCUR PREMISES (Ea ooprrence) $ 100,000 <br /> A ( MED EXP (Arty one person) _ $ 5,000 <br /> PERSONAL & ADV INJURY s 1,000 ,000 <br /> GEN'L AGGREGATE Lim APPUES PER GENERAL AGGREGATE $ 2 ,000 ,000 <br /> n- <br /> o I I .IE n LOC PRODUCTS - COMP/OP AGG_ $ 2 ,000 ,000 <br /> AUTOMOBILE LIABILITY <br /> BINED ANY AUTO (Ea COA S SINGLE LIMIT $ <br /> ALL OWNED AUTOS <br /> SCHEDULED AUTOS BODILY INJURY $ <br /> (Per ) <br /> HIRED AUTOS <br /> NON -OWNED AUTOS BODILY INJURY <br /> (Per ) <br /> (PIN acx $ <br /> GARAGE UABIJTY <br /> ANY AUTO AUTO ONLY - EA ACCIDENT $ <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> EXCESS ! UMBRELLA UABIJTY <br /> 1 OCCUR 1 I CLAIMS MADE EACH OCCURRENCE _ <br /> AGGREGATE <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> PLOYE ER COMPENSATION <br /> Y/N 083028471 01/14/2009 01/14/2010 X ( I s <br /> ANY PROPRETO(yp EX TO RY L <br /> B EL EACH ACCIDENT $ 1,000,000 <br /> (Mandatory <br /> yyeers� describe <br /> un S IAL PROVIS below E.L DISEASE - EA EMPLOYEE $ 1,000,000 <br /> OTHER E.L DISEASE - POUCY utAn $ 1,000,000 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEIICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAN- lO DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> City Of Zephyrhills IMPOSE NO OBL GATION OR UABNJTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> S33S Eighth Street NTATIVES <br /> Zephyrhills, FL 33540 AUTHODREPRESENTATIVE <br /> • <br /> Betty Newsom/BETTY rte <br /> ACORD 25 (2009/01) y <br /> ®1988 -2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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