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09-9290
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09-9290
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Last modified
3/21/2011 3:27:15 PM
Creation date
3/21/2011 2:08:58 PM
Metadata
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
09-9290
Building Department - Name
CITY OF ZEPHYRHILLS
Address
4241 SKY DIVE LN
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_____. i ACORD,., CERTIFICATE OF LIABILITY INSURANCE 6/23" / 2 0 ) <br /> iODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> COMMERCIAL INS SPECIALISTS INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> POE 17738 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Tampa, FL 33682 NAICI'! <br /> (813) 949 _INSURERS AFFORDING COVERAGE <br /> ISURED RYAN W. KOSTER & INSURER A SOUTHERN — OWNERS INS . CO <br /> KOSTER KONSTRUCTION, INC. INSURER B; AUTO — OWNERS INS. CO. <br /> 3248 LAKE SAXON DR. INSURER C: <br /> LAND 0' LAKES, FL 34639 INSURERD: <br /> 1 INSURER E: ' <br /> ;OVERAGES <br /> THE POLICIES OF INSURANCE USTED 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 /> PO Y EFFECTIVE POLICY 3:1• 'RATION LIMITS <br /> u' :.1Y9 POLICY NUMBER , - g . ID. • I DATE lei.. • •-W <br /> �� ' EACH OCCURRENCE S 1 000 000 <br /> GENERAL UAEOurr <br /> 111 COPAMERCIAL GENERAL LIABILITY ' I _ $ 50,000 <br /> s 5,000 <br /> A 084612 20704059 05 -22 -09 05 -22 -10 PERSONAL&ADV S 1,000,000 s 1,000,00 <br /> COMP/OP GENL AGGREGATE LIMIT APPLIES PER: <br /> Ell POLICY Ell PRO =II <br /> NE LOC GENERAL AGGREGATE PRODUCTS - • $ 1,0 00,000 <br /> AUTOMOBILE LIASILITY COMBINED SINGLE LIMIT S 300,000 <br /> (Es accident) <br /> is BODILY INJURY 1 <br /> • ' (Per person) <br /> ■ <br /> B © • BODILYINJURY 3 <br /> �!� (PeraaddeI.) <br /> ill 47 <br /> (Per aeeldent)DGE S <br /> AUTO ONLY -EA ACCIDENT $ <br /> GARAGE LIABIUTY ■ OTHER THAN EA ACC S <br /> AUTO ONLY AGG S <br /> EXCESS/UMBRELLA LIABILITY <br /> EACH OCCURRENCE S RETENTION S 1 AGGREGATE S <br /> S OCCUR El cuvonsmAoe <br /> $ <br /> El r . S <br /> rr ■ x TORVLIM[ ' ER <br /> WORKERSCOMPENSATIONAND E.L. EACH ACCIDENT S 100,000 <br /> EMPLOYERS' LIABILITY 081712 20711813 05 -22 - 09 05-22-10 <br /> ANY PROPRIETORIPARTNERIEtECUnVE E.I. DISEASE • EA EMPLOYES 1001 000 <br /> A OFF1cEPIMEMEER EtcLUOEI» <br /> ;VAL. PROM El, DISEASE • POUCY LIMIT S 500,000 <br /> SPECIAL PROVISI(OO NS below <br /> OTHER <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PROVISIONS <br /> RYAN W. KOSTER LIC #CBC1256720 <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> CITY OF ZEPHYRHILLS DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAa,O DAYS WRITTEN <br /> BUILDING DEPARTMENT NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 80 SHALL <br /> 5335 8TH ST • IMPOSE NO OBLIGATION OR UABILITY OF ANY KIND UPON THE INSURER. ITS AGENTS OR <br /> ZEPNYRBILLS, FL. 33540 REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> FAX 813 180 -0021 <br /> 1 IAA, A. is.....A.,„ <br /> el ACORD CORPORATION 1988 <br /> ACORD2S(2001108) <br /> 10 'd £999 6176 818 I '0N Xdd 1S1dIO3dS SNI 1VIONHWWOO WV 88:60 3fl,l 6002- £Z -Nflf <br />
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