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10-10053
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2010
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10-10053
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Last modified
1/27/2011 8:07:53 AM
Creation date
1/27/2011 8:07:53 AM
Metadata
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Building Department
Company Name
AMERICAN HEART INSTITUTE
Building Department - Doc Type
Permit
Permit #
10-10053
Building Department - Name
DAUGHTERY ROAD PROFESSIONAL CENTER
Address
37914 DAUGHTERY RD
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From Alvina Davis At Roe Insurance FaxID: To: City of Zephyrhills Date: 1/27/2010 05:02 PM Page: 2 of 2 <br /> • <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DATE YVYY) <br /> 1/27/2027 /20 10 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Roe Insurance, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 985' State Rd. 54 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> New Pt. Richey, FL 34655 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURERA :Scottsdale Insurance Co 41297 <br /> A & A Alarms Systems, Inc. <br /> INSURER B: <br /> P.O. Box 1955 <br /> INSURER C: <br /> INSURER 0: <br /> Seffner, 33583 -1955 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 /> INSRADD'L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR /NSRtp TYPE OF INSURANCE , DATE IMMJDDWYI DATE IMM/OD/VV <br /> A GENERAL LIABILITY CPS0983912 3/21/2009 3/21 /2010 EACH OCCURRENCE $ 2,000.000 <br /> DAMAGE TO <br /> X COMMERCIAL GENERAL LIABILITY PREMISES (Ea E occurencel $ 100,000 <br /> J CLAIMS MADE X OCCUR MED EXP (My one person) $ 5,000 <br /> PERSONAL SADVINJURY $ 2,000,000 <br /> GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 <br /> � <br /> I POLICY n , n LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> _ ANY AUTO (Ea accident) $ - <br /> l <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> HIRED AUTOS . in!� In:r,: ,S�CE !$ !a "s:': L•'0'� L! r ; Ua to the 1 0�! BODILY INJURY $ <br /> NON•OWNED AUTOS Ll ri I ' 1 J e rn <br /> r i rsurti'i , I r+T i;'iL 0o 3urpi $ • E r C ion �� " C !! rier s do PROPERTY DAMAGE $ <br /> snr M c I )C: ? ; (Per accident) <br /> r r E IAra+7+r, <br /> GARAGE LIABILITY ' 5 )h , AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG I $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE 1 <br /> J OCCUR 1 CLAIMS MADE AGGREGATE $ <br /> $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- — <br /> TORV I IMITS FR <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE El. EACH ACCIDENT S <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE $ <br /> U yes descri under <br /> SPECIAL PROVISIONS below E.L. DISEASE • POLICY LIMIT $ <br /> OTHER <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> 1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> City of Zephyrhills DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 1 DAYS WRITTEN <br /> 5335 Eighth St NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Zephyrhills, FL 33542 ENTATIVES. <br /> A • , ED REPRESENTATN� / <br /> ACORD 25 (2001/08) ©ACORD CORPORATION 1988 <br />
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