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09-9457
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09-9457
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Last modified
1/24/2011 2:44:49 PM
Creation date
1/24/2011 2:44:46 PM
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
09-9457
Building Department - Name
CITY OF ZEPHYRHILLS
Address
39450 SOUTH AVE
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09/02/2009 WED 13:53 FAX 863 293 5862 Insure America Group j001/001 <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMJDD/YYYY) <br /> TP <br /> 09/02/2009 <br /> PRODUCER FAX (863)293 -5862 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> CertiSure, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 1801 Hobbs Road HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Auburndale, FL 33823 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED F &L Electric Company, Inc. INSURER A: Bridgefield Employers Ins Co <br /> PO Box 1957 INSURER B: <br /> Ruskin, FL 33575 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 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 AMYL TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> DATE (MMIDDJYYYY) DATE (MMIDDIYYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> PREMISES (Ea occurrence) $ <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL 8 ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ <br /> POLICY 1 PRO- <br /> OLICY LOC <br /> JECT <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC $ <br /> AUTO ONLY'. AGG $ <br /> EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE • AGGREGATE $ <br /> $ <br /> DEDUCTIBLE <br /> $ <br /> RETENTION S $ <br /> WORKERS COMPENSATION WC STATU- O7H- <br /> AND EMPLOYERS' LIABILITY X TORY LIMITS ER <br /> A AN P O MEM ER EXCLUDEE I ECUTIVE J N 0830 -08834 04/01/2009 04/01/2010 E.L. EACH ACCIDENT $ 100,000 <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 100, 000 <br /> yes. describe 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 /> • <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE MOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 5O SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> City of Zephyrh i 11 s REPRESENTATIVES. <br /> 5335 8th Street AUTHORIZED REPRESENTATIVE X1 <br /> Zephyr hills, FL 33542 James Knight /ROBYNE <br /> ACORD 25 (2009101) FAX: 813. 780.0021 ©1988 -2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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