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10-10200
Zephyrhills
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2010
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10-10200
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Last modified
1/27/2011 11:27:06 AM
Creation date
1/27/2011 11:27:05 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10200
Building Department - Name
CITY OF ZEPHYRHILLS
Address
38116 5TH AVE
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R�® CERTIFICATE OF LIABILITY INSURANCE OP ID PR DATE(MM/DD/YYYY) <br /> ASSO -19 1 03 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Gulfstream Insurance Group Inc HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P.O. Box 8908 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Fort Lauderdale FL 33310 -8908 <br /> Phone : 954 Fax: 954-566-0673 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED <br /> INSURER A: Scottsdale Insurance company 41297 <br /> INSURER B: <br /> Association of Scottish Games <br /> and Festivals Inc. INSURER C: <br /> P.O. Box 245916 <br /> INSURER D: <br /> Pembroke Pines FL 33024 -5926 <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 /> 1NSH AMYL POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRC TYPE OF INSURANCE POLICY NUMBER DATE (MM /DD/YYYY) DATE (MM/DD/YYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1000000 <br /> A X X COMMERCIAL GENERAL LIABILITY CPS1128317 03/01/10 03/01/11 PREMISES (Ea occurence) $ 100000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 <br /> PERSONAL & ADV INJURY $ 100 <br /> GENERAL AGGREGATE $ 3000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 1000000 <br /> X POLICY PRO- <br /> JECT LOC <br /> AUTOMOBILE LIABILITY <br /> ANY AUTO <br /> COMBINED SINGLE LIMIT <br /> (Ea accident) <br /> ALL OWNED AUTOS — — <br /> 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 / UMBRELLA LIABILITY <br /> EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE <br /> — <br /> AGGREGATE <br /> DEDUCTIBLE <br /> r RETENTION $ - <br /> WORKERS COMPENSATION $ <br /> AND EMPLOYERS' LIABILITY WC S I A I U- ! O fH- <br /> Y 1 N TORY LIMITS <br /> ANY PROPRIETOR/PARTNER /EXECUTIV �-- � ER <br /> OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT $ <br /> (Mandatory In NH) - <br /> If yes, describe under E.L. DISEASE - EA EMPLOYEE $ <br /> SPECIAL PROVISIONS below <br /> OTHER <br /> E.L. DISEASE - POLICY LIMIT $ <br /> � l <br /> DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> Insured: Zephyrhills Celtic Festival and Highland Games <br /> Event: Zephyrhills Celtic Festival and Highland Games, March 5 -7, 2010 <br /> Certificate holder is additional insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> ZEPHYRH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> 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 /> City of Zephyrhills REPRESENTATIVES. <br /> 5335 8th St. AU ORIZE REPRESEN TIVE <br /> Zephyrhills FL 33542 <br /> ACORD 25 (2009/01) ©1988 -2009 ACO D CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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