10-10600 - Laserfiche WebLink

Browse Search

06/09/2010 WED 14:31 FAX CompuPay WPB 2001 /001 '�''�� CERTIFICATE OF LIABILITY INSURANCE 6[�A9T�(f1111yD0YYY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS ' CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT P DUCER � ompuPay Insurance Services, Inc. NAME: 8 d5 OW 1 1601 Belvedere Road, Suite 105S PHONE 1310 ] UU�� x38`! Y (A/CC,No) :(305) 675 -8141 i West Palm Beach, FL 33406 ADDRESS:WC @ compupay.com PRODUCER CUSTOMER ID #: cal 1 zfiS) l+ .it RDING OVER A(.'E I NAILS 1 INSJRED At c• Par , nc . INSURER A : —_____I DBA: Home -Pro INSURER B : 3930 Tampa Rd. INSURERC. Oldsmar, FL 34677 INSURER D: (813)448-0005 Fax: (813)448 -0015 INSURERS: INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 1 ADD. SUBR POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE INSR VYVD POLICY NUMBER (MM/DONY Y) (MM/DO/YYYY) LIMITS ' GENERAL LIABILITY EACH OCCURRENCE $ UABlL:TY PREMISES (Ea occurrence) $ DAMAGE IO RENIEU COMMERCIAL GENERAL i _ J CLAIMS -MADE r i OCCUR MED EXP (Ary one person) $ - I -- PERSONAL & ADV INJURY $ , 1 GENERAL AGGREGATE $ I GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ POLICY PRO LOC $ I �7 JEGT 7 ' 1 AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ ' (Ea accident) � I ANY AUTO BODILY INJURY (Per person) $ I I ALL OWNED AUTOS ' BODILY INJURY (Per accident) $ ISCHEDULED AUTOS PROPERTY DAMAGE $ 1 I HIRED AUTOS (Per accident) 1 1 NON -OWNED AUTOS $ , ''UMBRELLA LIAB OCCUR EACH OCCURRENCE $ — �EXCESS LIAB _ CLAIMS -MADE AGGREGATE $ I _ _ 1 DEDUCTIBLE $ RETENTION $ $ : WORKERS COMPENSATION X WCSTATU- OTH- ' AND EMPLOYERS' LIABILITY TORY L IMITS ER p ,, ' WCP760866000 2/27/102/27/ 100,000 ', ANY PROP R.E TORlPARTNE RlEXECUTNE YIN E.L. EACH ACCIDENT $ I OFFICERMEMBER EXCLUDEDn N/A 100,000 1 (Mandatory In NM) I E.L. DISEASE • EA EMPLOYE: $ I If yes, describe under Xe 00 -eel DESCRIPTION OF OPERATIONS below I E.L. DISEASE - POLICY LIMIT $ I DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ` I � 1 CERTIFICATE HOLDER CANCELLATION City of Zephyrhills ■ ' Building Dept. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 5335 8th St. ACCORDANCE WITH THE POLICY PROVISIONS. Zephyrhills, FL 33542 -...- AUTHORIZED 1r NTATIVE j / 1 Fax#813-448-0015 / // 1 r 1988- 2001RD CORPORATION. All rights reserved. ACORD 25(2009/09) The ACORD name and logo are registered marks of ACORD I I