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10-10408
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2010
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10-10408
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Last modified
2/1/2011 8:21:36 AM
Creation date
2/1/2011 8:21:34 AM
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Building Department
Company Name
MEADOWOOD ESTATES
Building Department - Doc Type
Permit
Permit #
10-10408
Building Department - Name
MALLET,GARY & ELIZABETH
Address
39663 MEADOWOOD LP
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From: Brown & Brown Insurance Date: 4/26/2010 2:27:15 PM <br /> CERTIFICATE OF LIABILITY INSURANCE OPID SW DATE(MM/oDnYW) <br /> RD H &JIN -2 04/26/10 <br /> PRODUCER • 1 t • • ' • • <br /> Brown & Brown Insurance ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 83 Park Place Blvd., Ste 101 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P.O. Box 2456 (33757 - 2456) ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br /> Clearwater FL 33759 <br /> Phone: 727 - 461 - 6044 Fax: 727 442 - 7695 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A. FCCI Commercial Insurance Co 33472 <br /> - - • - • • •. • • INSURER B. <br /> -- • <br /> Air Re-cue Air Conditioning INSURER C. <br /> Tampa FL s336 INSURER D. <br /> 3 6 99 INSURER E. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTW ITHSTANDIVG <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 /> Sit ADD L POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MM/DO/YYYY) DATE (MM/DD/VYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> UAMAOt I KtN ItU <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurence) $ <br /> CLAIMS MADE OCCUR MED EXP (Any one person) $ <br /> PERSONAL & ADV INJURY $ <br /> GENERAL AGGREGATE $ <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ <br /> - 7 POLICY JECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMB <br /> ANY AUTO (Ea accident) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> H IRE D AUTOS <br /> BODILY INJURY <br /> NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> — <br /> ANY AUTO EA ACC $ <br /> OTHER THAN — <br /> AUTO ONLY AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WLSIAIU- U IH- <br /> AND EMPLOYERS' LIABILITY X TORY LIMITS ER <br /> A AF IETOREXCLUOEE ECUTIV ll 001WC09A60920 01/01/10 01/01/11 E.L' EACH ACCIDENT $ 500000 <br /> (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ 500000 <br /> SPES es, describe under PROVISIONS below E.L. DISEASE - POLICY LIMB $ 500000 <br /> CIAL <br /> OTHER - <br /> DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> fax 813 - 780 -0021 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION <br /> CTYZEPH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> City of Zephyrhills IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> Building Department <br /> REPRESENTATIVES. <br /> 5335 8th Street AU IZED REPRES TIVE <br /> Zephyrhills FL 33540 <br /> ACORD 25 (2009/01) © 1988-2009 ACORD CO PORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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