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09-9411
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2009
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09-9411
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Last modified
1/24/2011 10:57:23 AM
Creation date
1/24/2011 10:57:21 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
09-9411
Building Department - Name
MILLER,COLIN
Address
5802 19TH ST
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08/11/2009 10:08 FAX 3525230434 BAUER & ASSOC, INC. a001 <br /> ACC7∎ CERTIFICATE OF LIABILITY INSURANCE "A 08/ 1 /09 Y' <br /> ' <br /> PRODUCER Bauer & Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 12210 US Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Phone (352)567 -3702 Fax (352)523 -0434 INSURERS AFFORDING COVERAGE NAIL # <br /> INSURED Cunningham Construction Co INSURER A: SOUTHERN OWNERS INSURANCE <br /> 12152 Fort King Rd INSURER B: <br /> INSURER C: <br /> Dade City, FL 335255947 INSURER D: <br /> INSURER E: <br /> COVERAGES INSURER F: <br /> THE POLICIES OF INSURANCE LISTED HAVE BEEN ISSUED TO THE INSURED NAKED 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 /> INER ADO L TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD DATE (MMIDDIYY) DATE (MMIDOIYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE 1N1 IL <br /> Q COMMERCIAL GENERAL LIABILITY 20575245 05/05/09 05/05/10 PREM SES (Ea curence) 300,000 <br /> ❑ ❑ CLAIMS MADE © OCCUR MED EXP (Arty one person) 10, 000 <br /> A ❑ ❑ _ PERSONAL & ADV INJURY 1MIL <br /> ❑ GENERAL AGGREGATE 2MIL <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG 2MIL <br /> POLICY ['PROJECT ❑ LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ❑ ANY AUTO (Ea accident) <br /> ❑ ALL OWNED AUTOS <br /> BODILY INJURY <br /> ❑ ❑ SCHEDULED AUTOS (Per person) <br /> ❑ HIRED AUTOS <br /> ❑ NON OWNED AUTOS BODILY INJURY <br /> (Per accident) <br /> ❑ PROPERTY DAMAGE <br /> ❑ _ (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT <br /> ❑ ❑ ANY AUTO OTHER THAN EA ACC^ <br /> ❑ AUTO ONLY: AGG <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE _ <br /> ❑ ❑ OCCUR ❑ CLAIMS MADE AGGREGATE <br /> ❑ DEDUCTIBLE — — <br /> ❑ RETENTION S — <br /> WORKERS COMPENSATION AND ❑ WC STATU ❑ OTH- <br /> EMPLOYERS' LABILITY TORY LIMITS EFL <br /> ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT <br /> OFFICER / MEMBER EXCLUDED? <br /> If yes, describe under E.L. DISEASE: - EA EMPLOYEE <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS <br /> GENERAL CONTRACTOR <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> CITY OF ZEPHYRHILLS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br /> THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> 5335 8TH STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> ZEPHYRHILLS , FL 33542 AUTHORIZED REPRESENT /yilVE <br /> FAX @813 -780 -0021 1 <br /> ACORD 26 (2001/08) QF CO ACO CORPORATION 1988 <br />
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