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10-10058
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2010
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10-10058
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Last modified
1/27/2011 8:13:15 AM
Creation date
1/27/2011 8:13:14 AM
Metadata
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Building Department
Company Name
AMERICAN HEART INSTITUTE
Building Department - Doc Type
Permit
Permit #
10-10058
Building Department - Name
DAUGHTERY ROAD PROFESSIONAL CENTER
Address
37914 DAUGHTERY RD
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Wells , B,rgo 1/2U/2010 10 :0 /::.j;3 AM PAUL Z /OC;3 rax berver <br /> Cert ID 21617 <br /> p CORDTN CERTIFICATE E OF LIABILITY I ILU YY <br /> Y INSURANCE I DATE IMDDYY) <br /> 1/26/2010 <br /> UCea THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 1 <br /> ls xa.rga ins services southeast, inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> P u 9nx 3' 6 ,E HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Tampa SL 33631 - 3666 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> (7271 796 - 6666 (727) 799 - 5117 <br /> INSURERS AFFORDING COVERAGE NAIC # <br /> ',NSURED INS LRER A. Indian Harbor Irauxance COmpan j 36940 <br /> ASAP Automatic Sprinklers & Piping, Inc- <br /> 'N3JRER E, AUTO Insurance company 13933 <br /> P.O. Box 20962 I�n'-aE c: -- A <br /> st. Petersburg FL 33742 iNS JRERD <br /> 'I AS USER E- 1 <br /> COVERAGES <br /> THE POLCIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TOME INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDIN31 <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. E W PO <br /> INSR IACO'' POLICY NUMBER I DA7EYME�FDD6 ECLCYIEXgiRT,6N; LIMITS <br /> LTA jwsoni TYPF OF INFI TRANCE /1V pDAATTEE IIJJIIMW '� <br /> 1 <br /> j GENERAL UABILTY EACH OCCURRENCE ' $ 1, 000, 000 <br /> I i DAMAGE TO RENTED <br /> A X I CJ'ONIERC'ALGENERA' RmG640001602 ! 2/27/X09 2/27/2010 � :MEUSE3 (Ea onourence, ; $ 100, : J <br /> ^^ — — <br /> 'SLAMS MADE I X .■ GCCUn M_D E %P :Any ens persen'I I f 5 <br /> PERSONAL 6 ADV INJUR):' :; $ 1, 000, 000 <br /> r-1I GENERALAGSAEu'ATE d 2, 000, 000 <br /> . A'i3REG t Mrr APPLIES PER j PRCDUCT3- CQMP.. .A33 I $ 2, 000, 000 <br /> PC.iCV ! PRO_ , : LOC ! <br /> AUTOMOBILE LIABILITY <br /> , L_ COMBINED SAGLE LIM7 <br /> -. E a a. e, 'dent' t ' $ <br /> B M X ' ANY ? = 9542753901 2/27/X09 2/27/2010 300,000 <br /> I ALL OWNED AUKS <br /> B 71L R^! 3 <br /> :: HECULED AUTOE 1 'Per pe wn; <br /> I HE I K RED A'JTO'a <br /> BODILY INJURY S <br /> ( X rION .OWNED AUTOS • Per aoddent) <br /> ( � I — P ROPERTY DAMAGE 3 <br /> ( Per aoaderY.` <br /> AUTO ONLY - EA ACCIDENT $ <br /> QARAOE UABI LiTY I I <br /> ANY AU?. EA AC $ <br /> • THEn THAN i <br /> I i AUTC • nNL' <br /> AGu $ <br /> EXCESS/UMBRELLA LIABILITY EACH C OCURRENCE $ <br /> 1 . <br /> ! j OCCUR , CLAIMS MADE I AGGREGATE $ <br /> I $ <br /> 1 <br /> i DEDJDTIELE I $ <br /> RETENTION $ 1 $ <br /> WORKERS COMPENSATION AND iNC 3TAT'U• ?N- <br /> XTR L.TSI u ER <br /> EMPLOYERS' LIABILITY ! -- <br /> ANYPPCPR IETCR�'PARTNERIF.XC:;.,TIVE E!. EACH ACCIDENT � $ <br /> CFF,CEPL'MEMEE ?EXCLUDED? E DJ SEAS! - !A EMPLOYEE'$ <br /> ' yyes descibe der 1 <br /> SPECIAL PROVISIONS ceIn, E L. DISEASE - POLICY LIMIT IS <br /> OTHER <br /> I <br /> DESCRIPTION GE OPERATIONS I LOCATIONS ; VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT: SPECIAL PROVISIONS <br /> Florida statute mandates 10 day cancellation notice for nonpayment of premium. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED PQUCIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30_ DAYS WRITTEN <br /> zephyxhilla Building Department <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> 7,P L+ <br /> 5_:�' ><h 5t IMPOSE NO +79LIuA'IQN OR LABILTY OF AM KIND UPON THE ! NSURER. 75 A7EN75 OP <br /> REPRESENTATIVES. <br /> zephyxhille FL 33540 AUTHORZEDREPRE3ENTATIVE % <br /> ACORD 25 (2001;08) a ACORD CORPORATION 1988 <br /> sage 1 of 2 <br />
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