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10-10783
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2010
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10-10783
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Last modified
2/7/2011 9:56:20 AM
Creation date
2/7/2011 9:56:16 AM
Metadata
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Building Department
Company Name
WALGREENS
Building Department - Doc Type
Permit
Permit #
10-10783
Building Department - Name
WALGREENS
Address
6429 GALL BLVD
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c� CERTIFICATE OF LIABILITY INSURANCE OP ID B8 DATE (MM /DD /YYYY) <br /> INTE -17 04/21/10 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Brown & Brown of Florida, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P. 0. Box 15519 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Tampa FL 33684 -5519 1 <br /> Phone: 813 - 226 -1300 Fax: 813- 226 -1313 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED International C & C INSURER A: ZENITH INSURANCE CO ' 13269 <br /> Corporation, International INSURER B: southern Owners Insurance Co. 10190 <br /> Linear Matrix Corporation <br /> Int 1 Sign and Design Corp INSURER G: AUTO OWNERS INSURANCE 18988 <br /> 10831 Canal Street INSURER D: <br /> Largo FL 33777 -1696 <br /> I INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <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 /> INSR ADD"L POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR INSRD TYPE OF INSURANCE DATE (MM /DD /YYYY) DATE (MM /DD /YYYY) <br /> GENERAL LIABILITY EACH OCCURRENCE $ 1, 000, 000 <br /> UAMAGh TO HENIEU <br /> B X COMMERCIAL GENERAL LIABILITY 20718180 -10 04/15/10 04/15/11 PREMISES(Eaoccurence) $ 50, 000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5, 000 <br /> X $1, 000 DED PD PERSONAL &ADV INJURY $ 1,000,000 <br /> ■ GENERAL AGGREGATE $ 2,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGG $ 2,000,000 <br /> X POLICY PEA LOC Emp Ben. 1,000,000 <br /> AUTOMOBILE LIABILITY <br /> C X ANY AUTO 9669517500 04/15/10 04/15/11 COMBINED SINGLE LIMIT $ 1, 000, 000 <br /> CO accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) $ <br /> I ' , HIRED AUTOS <br /> BODILY INJURY $ <br /> NON -OWNED AUTOS (Per accident) <br /> ■ PROPERTY DAMAGE $ <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO OTHER THAN EA ACC $ <br /> AUTO ONLY: AGG $ <br /> I i <br /> EXCESS / UMBRELLA LIABILITY ', EACH OCCURRENCE $ <br /> { <br /> OCCUR CLAIMS MADE AGGREGATE $ <br /> DEDUCTIBLE I i i $ <br /> RETENTION $ /� $ <br /> WORKERS COMPENSATION WC S1A1 U- 0I <br /> AND EMPLOYERS' LIABILITY Y / N J` X TORY LIMITS ER <br /> A ANY PROPRIETOR /PARTNER /EXECUTIVET - 7 Z830005723 09/15/09 09/15/10 ' E.L. EACH ACCIDENT $ 1000000 <br /> OFFICER /MEMBER EXCLUDED? <br /> (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 1000000 <br /> If yes, describe under <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT $ 1000000 <br /> OTHER <br /> B Installation 20718180 -10 04/15/10 04/15/11 Limit 20,000 <br /> Floater <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> ZEPHYRH DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 030 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> City of Zephyrhills REPRESENTATIVES. <br /> 5335 Eighth St AUT ZED REP ESENTATIVE <br /> Zephyrhills FL 33542 fi'iZ <br /> ACORD 25 (2009/01) ©19 8 -2009 ACORD CORPORATION. All rights reserved. <br /> The ACORD name and logo are registered marks of ACORD <br />
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