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10-10508
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2010
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10-10508
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Last modified
2/1/2011 2:30:42 PM
Creation date
2/1/2011 2:30:41 PM
Metadata
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Building Department
Company Name
TREE LANE VILLAGE
Building Department - Doc Type
Permit
Permit #
10-10508
Building Department - Name
TREE LANE LTD C/O TERRACE VILLAG
Address
5820 EXCEL ST
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MAY. 20. 2010 10:18AM A. KILBRIDE INSURANCE, INC, N0. 1651 ;P, 1/1 ,,,,,,x, <br /> A` cI D CERTIFICATE OF LIABILITY INSURANCE 5/20/2010 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON 'THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certflcate holder is an ADDITIONAL INSURED, the pollcy(lee) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsemen s . <br /> PRODUCER N Eric Maples <br /> A .KILBRIDE INSURANCE INC PHONE p 7t 1. (813) 931 -7467 1 FAx <br /> rarC.No1 932 -7336 <br /> 1401 V. Busch Boulevard Ma <br /> Tampa, 21,33612 CUSTO E R I DSk <br /> INSURR(sl APFOROINO CovERAGE NAICW <br /> INSURED INSURER A: Bankers Insurance Comgany , <br /> Page One Electric Inc INSURER 6 <br /> 6424 North 49th Street INSURER C • <br /> Tampa, .FL 33610 INSURER 0 <br /> INSURER E • <br /> INSURER F <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INIR TYPE DP INSURANCE AWOL <br /> NSR Mnro POLICY NUMBER ( Y YVY) ( MM l oO l1 YYYJ LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S 500,000 <br /> X COMMERC. GENERAL LIABILITY PR <br /> UU occurrence) S 100,000 <br /> I CLAMS-MADE I_.I OCCUR MED EXP (Any one person) S 5,000 <br /> A 090005337177502 03/19/10 03/19/11 PERSONAL aAOVINJURY $ 500,000 <br /> GENERAL AGGREGATE S 1 , 000, 000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMP /OP AGG $ 500,000 <br /> X POLICY. PRO- LOC S <br /> AUTOMOBILE LIABILITY COMBINED SINGLE Mil S <br /> (Ea aeeaen) <br /> ANYAUTO BOOILY INJURY (Per parson) $ <br /> ALL OWNED AUTOS BODILY INJURY (Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE S <br /> _ HIRED AUTOS (Per accident) <br /> NON -OWNED AUTOS $ <br /> $ <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE $ <br /> + EXCESS LIAR �I CLAIMS•MADE AGGREGATE $ <br /> DEDUCTIBLE .- <br /> `r RETENTION S ' $ <br /> WORKERS COMPEN$AT10N TORY LI I TS I I <br /> AND EMPLOYERS' LIABILITY YIN <br /> ANY PROPRIETOR/PAWTNERNIXECLmVE ❑ NIA E.L. EACH ACCIDENT $ _ <br /> oFr 10ERMENBEt EXCLuoEm <br /> (Meneuery In NR) E.L. DISEASE • EA EMPLOYEE S <br /> If yes. d und er E.L OISFASE - POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS Wow <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (Altaw ACORD 101. Addilionel Remarks Schedule, if more space is required) <br /> Electrical Contractor <br /> License Qualifier: Eugene McDowell EC13002356 <br /> CERTIFICATE HOLDER CANCELLATION <br /> City Of 2.phyrhills Building Department SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 5335 8th Street THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Zephyrhills , FL 33542 <br /> AUTHORIZED REPRESENTATIVE <br /> Fax: 813.780.0021 r te' )17.164W%' <br /> © 1988-2009 ACORD CORPORATION. All rights reserved. <br /> ACORD25(2009 /09) The ACORD name and Togo are registered marks of ACORD <br />
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