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10-10041
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10-10041
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Last modified
1/26/2011 9:20:28 AM
Creation date
1/26/2011 9:20:26 AM
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Template:
Building Department
Building Department - Doc Type
Permit
Permit #
10-10041
Building Department - Name
WHITE,PATRICK & JOAN KAY
Address
5247 3RD ST
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ACORD CERTIFICATE OF LIABILITY INSURANCE OP ID PS GATE IMwooJTTrTN <br /> AMSCBUI 01/14/10 <br /> PROaUaa THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Greg Roe Insurance, Inc. • HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 9851 State Road 54 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> New Port Richey FL 34655 <br /> Phone: 727- 376 -0030 Fax: 727 -376 -2262 INSURERS AFFORDING COVERAGE NAIC fi <br /> wsuAeo NOSU EPA: AmeRAR. 10190 <br /> • <br /> • <br /> • INSURER P: w.a.L :........ e.oA..., <br /> Amaco Builder's , Inc. <br /> Ryan Simmons WORM C: <br /> 7626 West Drive PARROR <br /> Wesley Chapel FL 33544 • <br /> • <br /> COVERAGES <br /> • <br /> THE .olwea or wsuRANCeLoma mow wave g6N 31KVEOTO THE I5UREO r7AMAE0 move regime mum seam INDICATED. N0 ThSYAROwe <br /> ANY REQUIREMENT. TERM OR CONOIIION O?ANY carom= OR OTW00 OOOW0NTWITN RESPECT TO WeICN TIC! CCATMIOATO MAY Ile ISSUED OR <br /> MAY PURTAIN, Twe INDtNANCEAFFORDED BY THE POLICIES 0000D mum a alexoT TO ALL THE TERMS. EXCLUSIONS AND common or sow <br /> raLIGR'A. AGGACGATC WAITS OIOWN AMY IwvE BEEN REDUCED eV PAN) CLAWS. <br /> wog AOOt I rOLlCY erreCTIVe POLICY EXPIRATION <br /> LTR NORD TWA OF NNUAANCE ROLIOT NUMR0R - OA= WANDOmi MATT. awoomq MARC <br /> OFNERALUAeIUYV EACHOOCUA71eNCe s 1000000 <br /> oAwA R Hip <br /> X COWCRUALCeNIRALLMEUM 20714582 01/01/10 01/01/11 menses IE.wR.O.N s 50000 <br /> I CLAIMS MADE OecuR • um IMP ORT S 5000 <br /> _ <br /> PERSONAL AO/ suunv 1 1000000 <br /> • GENERAL AGGREGATE $ 2000000 <br /> 000000CAOCATO UAW ARRI.IESP aua0 <br /> rRO- commaAG0 0 2000000 <br /> P JGY n J n LOC EillR Ben. Excluded <br /> AUTOMOMLO LIAUIMTY <br /> • <br /> c0BgED MOLE UNIY <br /> ANY AUTO IE►JMN..g <br /> ALL OWNEOAUTee <br /> SwLYINAMIY <br /> 4 <br /> GON00tU. AUTOi Ir«ww.1 <br /> MP= Avras <br /> $aDLY INJURY <br /> NaM.OWNE0 AUTOS (ow enano I <br /> • <br /> rgooAAT'O MADE _ <br /> (P... -00,.4 <br /> OAOAOC UAULJn AUTO C RY A001DENT B <br /> ANY AUTO <br /> -- I ( <br /> OTHER MAN <br /> S <br /> AUTO anr: <br /> 400 0 <br /> 0ROeswMaAALLS UUBAJTY 4ACO000URR0NCe S <br /> 7 OCCUR n —...— MAIM AoaaaATe s <br /> n 000vcTIete S <br /> WO ATATU• OTH. <br /> WORM= OONJaNaATN7114$$ • I YaW LAY7E I I 00 <br /> • <br /> eAMLOTCAt UAPAITY <br /> ANYP0O UI0TOMPAN'MOIROMITV4 <br /> E.L. RACK <br /> W S <br /> ORPICidwO0g6R 00 <br /> LL. mum Ile UMPLOYEE 3 <br /> awA e.eR...Ar • <br /> Gr0CIAL mamma 4.N. 04, OIA4AKE.POLICY Low s <br /> 0700 <br /> 8 Builders Rik BR68996539' 10/26/09 10/26/10 <br /> mourner/ oe coca/mom /LOCATIONS/VEHICLES I EXCI.USIOMS Awed SYermoassIaNYI UPEaAL 000VIWONS <br /> •30 DAYS NOTICE OF CANCELLATION EXCEPT 10 DAYS NOTICE OF CANCELLATION FOR <br /> NON - PAYMENT OF PREMIUM. • <br /> • <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITYZEP /4101/1.0 /WV OF 1111 Mite =maim 000OIES OE CAIICELLes SGr011C RIO 01MIOATION <br /> DAM 1000000,701 =API 4 IWORER WIU. enocAV0A TO MAP. ' 40Y3 VAi11TEN <br /> • <br /> CITY OF ZEPRYRHILLS 001100 TRTNEC NTIFIc4T0NOLOesmA MwTOTHELEFT.BHTFAILURemsoso SMALL <br /> BUILDING DEPARTMENT <br /> 5335 8TH STREET • MM000 0e ORUw 7 wNa7 UABAmOFA00w0o wow 100 MINIM Ira 40ENTSon <br /> ZEPHYRHILL2 PL 33543 Ratssert TIV0. <br /> AMINO EraEOENTa e <br /> ACORD 25 (2001108) ® ACORD CORPORATION 1988 <br /> 100 'd Z9ZZ 9LE LL, 'O XVd ONI aoNV If1SNI 3OJ NId OZ : EO nllz /O 1 OZ /f i /NY <br />
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