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10-10569
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2010
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10-10569
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Last modified
2/2/2011 9:32:17 AM
Creation date
2/2/2011 9:32:14 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10569
Building Department - Name
SYNC II LLC
Address
6620 GALL BLVD
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A o IJ 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 certificate holder is an ADDITIONAL INSURED, the policy(ies) 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 endorsement(s). <br /> PRODUCER NAME: Adrienne Decker <br /> A KILBRIDE INSURANCE INC (a °ND .Ext) (813) 931 -7467 <br /> 1401 W. Busch Boulevard E -MAIL F ac,ND) ( 813 ) 932 -7336 <br /> Tampa, FL 33612 ADDREsEAdrienne @akilbride.com <br /> CUSTOMER ID #: <br /> INSURERIS) AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A : Bankers Insurance Company <br /> Special Ops Builders Inc. INSURER B : <br /> 37731 Kossik Road INSURER C : <br /> Zephyrhills, FL 33541 INSURER D : <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 /> INSR ADDL SUBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MM/DD/YYYY) (MM /DD/YYYY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 300,000 <br /> DAMAGE N <br /> X COMMERCIAL GENERAL LIABILITY PREMISES O (Ee ccur $ 100,000 <br /> CLAIMS -MADE IX I OCCUR MED EXP (Any one person) $ 5,000 <br /> A 090470000526200 05/20/10 05/20/11 PERSONAL &ADVINJURY $ 300,000 <br /> GENERAL AGGREGATE $ 600,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 600,000 <br /> X I POLICY n PRO- LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ <br /> ANYAUTO (Ea accident) <br /> BODILY INJURY (Per person) $ <br /> ALL OWNED AUTOS <br /> BODILY INJURY (Per accident) $ <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> HIRED AUTOS (Per accident) $ <br /> NON -OWNED AUTOS $ <br /> UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ <br /> — <br /> EXCESS LIAB CLAIMS -MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS LIABILITY Y/N TORY LIMITS ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? N / A <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ <br /> If yes, describe under <br /> DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br /> Certified Building Contractor #CBC1255197 <br /> License qualifier: Kenneth Prickett <br /> CERTIFICATE HOLDER CANCELLATION <br /> City of Zephyrhills Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 5335 8th Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> Zephyrhills, FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Phone (813) 780-0020 AUTHORIZED REPRESENTATIVE <br /> Fax(813)780-0021 <br /> ©1988 - 2009 ACORD CORPORATION. All rights reserved. <br /> ACORD25 (2009/09) The ACORD name and logo are registered marks of ACORD <br />
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