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10-10641
Zephyrhills
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2010
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10-10641
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Last modified
2/3/2011 10:25:39 AM
Creation date
2/3/2011 10:25:36 AM
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Building Department
Company Name
SUMEMRHILL
Building Department - Doc Type
Permit
Permit #
10-10641
Building Department - Name
VONA,ROBERT & GARDNER, CHRISTIN
Address
5151 SUMMERHILL DR
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Gevity 7/15/2010 5:25 PM PAGE 2/002 Fax Server <br /> Certificate of Insurance <br /> This certificate Is Issued as a matter of Information only and confers no rights upon the Certificate Hdder. This certificate does not amend, extend, or alter the <br /> coverage afforded by the poldes described herein. <br /> Named Insured(s): <br /> TriNet HR Corporation <br /> and all its affiliates & subsidiaries• <br /> Stephens and Wood Aluminum Inc (Endorsed as alternate employer) Insurer Affording Coverage <br /> COMMERCE AND INDUSTRY INSURANCE COMPANY (A) <br /> 9000 Town Center Parkway <br /> Bradenton, FL 34202 <br /> Coverages: <br /> The polides of insurance listed below have been issued to the insured named above for the policy period indicated. Notwithstanding any requirement, term or <br /> condition of any contrad or other document with reaped to which the Certificate may be issued or may pertain, the Insurance afforded by the pdides described <br /> herein is subject to all the tens, exclusions and conditions of such pdides. Aggregate ilmits shown may have been reduced by paid daims. <br /> Type of Effective Expiration Limits <br /> Insurance Insurer Policy Number State Date Date ® WC Statutory Limits <br /> A 57057094 FL 07 -01 -2010 07 -01 -2011 <br /> Workers' Employers Liability <br /> Compensation <br /> Bodily Injury By Acddent <br /> 52,000,000 Each Acddent <br /> Bodily Injury By Disease <br /> $2,000,000 Policy Limit <br /> Bodily Injury By Disease <br /> 52,000,000 Each Person <br /> Others: Client Number 53101 <br /> Larry Stephens covered for workers' comp as a leased employee; <br /> Steven Green, Qualifier & License SCCC56671 <br /> The above referenced workers' compensation pdides provide statutory benefits only to the employees the Named insured(s) on such policies, not to the <br /> employees of any other employer. <br /> TrINet HR V, Inc TriNet HR Corporation <br /> Cancellation: Should any of the above described pdides be cancelled before the expiration date thereof, the Insurer affording coverage <br /> will endeavor to mall 30 days written notice to the certificate holder named herein, but failure to mall such notice shall impose no obligation or <br /> liability of any kind upon the insurer affording coverage, its agents or representatives. <br /> Certificate Holder: <br /> e Moo <br /> City of Zephyrhills Building Department titr/i Sotaem'a.`' <br /> AON Risk Services Northeast, Inc. <br /> 5335 8th St Authorized Representative of AON Risk Services <br /> Zephyrhills, FL 33542 (866)443-8489 07/15/2010 <br /> Phone Date issued <br />
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