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10-10236
Zephyrhills
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2010
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10-10236
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Last modified
1/27/2011 1:58:01 PM
Creation date
1/27/2011 1:57:59 PM
Metadata
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Building Department
Company Name
PINECREST M.H.P.
Building Department - Doc Type
Permit
Permit #
10-10236
Building Department - Name
PINECREST MHP CLUBHOUSE
Address
6043 HARRIET ST
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DATE(MMIOOIYWY) <br /> ACORD . CERTIFICATE OF LIABILITY INSURANCE 3/5/2010 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> LEE REED INSURANCE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> PO Box 908 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Zephyrhills, FL 33539 - 0908 <br /> (813) 782 - 5502 INSURERS AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A: Southern- Owners Ins. Co. <br /> Mooney Contracting Inc. INSURER B: Owners Ins. Co. <br /> 5140 Englewood Lane INSURER C: <br /> Zephyrhills, FL 33541 INSURER D: <br /> I 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 UMITSSHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> LTP W0 D1 POLICY NUMBER DA Ep. $ of D S <br /> LTI Mho TYPE OF INSURANCE <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1 000 0 0 0 <br /> ]( COMMERCIAL GENERAL LIABILITY PREMBEB (Ea oowwMa) <br /> 8 50,000 <br /> CLAP/SPODE © OCCUR MED E P(Nry ollol+oison) s 5,000 <br /> A 072312 - 20719189 9/22/09 9/22/10 PERSONAL a/DVINJURY $ 1, 000, 000 <br /> — <br /> GENERAL AGGREGATE $ 1,000,000 <br /> GEHL AGGREGATE UMT APPLIES PER RO <br /> PDUCTS - COMV/OP AGG ,$ 1,000.000 <br /> —X-1 POLICY n .RGT n . <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> (Essooidwd) s <br /> ANVAUTO <br /> — ALL OVUPEO AUTOS t I LV� ) Y 8 100,000 <br /> J{ SCHEDULED AUTOS — <br /> B HIRED AUTOS 47- 277 - 169 -01 10/14/09 10/14/10 $0 LYINJURY s 300,000 <br /> NON-0YM ®AUTOS <br /> —" PROPERTY DAMAGE S 100,000 <br /> (Perovidord) <br /> GARAGE LIABILITY AUTO ONLY- EAACCIDENT S <br /> ANYAUTO EA ACC E <br /> OTHER THAN <br /> MJTOON.Y: AGO S <br /> EXCESS/UMBRELLA UABIRY EACH OCCURRENCE S <br /> 7 OCCUR CwMSMADE AGGREGATE $ <br /> s <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> W0RKERSc0MPENSATIONAND r S L A M% I H <br /> EMPLOYERS LIABILITY E.L EACH ACCIDENT S 100,000 <br /> A °"'E 091712- 20004974 10/19/09 10/19/10 E.L.OISEASE- EAEMPLOYEE s 100,000 <br /> IfYoo.dwodbudor <br /> SPECIAL PROVISIONS below E.L DISEASE - POUCY UMT $ 500,000 <br /> OTHER <br /> DESCRIPTOR OF OPERATIONS /LOCATIONS /VEHICLES f EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRBED POUCIES BE CANCELLE° BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 Q DAYS wRI17EN <br /> City of Zephyrhills <br /> NOTICE TO TIE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHALL <br /> Building Department <br /> IMPOSE NO OBUGATION OR LIABILITY OF ANY KIND UPON THE INSURER ITS AGENTS OR <br /> 5335 8th St. <br /> REPRESENTATIVES. <br /> Zephyrhills, FL 33542 AUTFDRQED REPRESENTATP,E • <br /> ACORD25(2001/08) <br /> 0ACORD CORPORATION MS <br />
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