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10-10389
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2010
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10-10389
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Last modified
3/22/2011 1:48:21 PM
Creation date
3/22/2011 1:45:37 PM
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Building Department
Company Name
ZEPHYR PLACE LLC
Building Department - Doc Type
Permit
Permit #
10-10389
Building Department - Name
ZEPHYR PLACE LLC
Address
6834 GALL BLVD STE 105
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Apr. 21. 2010 3:50PM BLUELINE MECHANICAL No. 7427 P. 7 <br /> CERTIFICATE OF LIABILITY INSURANCE OP ID DI " DA1t ( ) <br /> BLUEPL -2 04/19/10 <br /> I RMO= THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Bouchard - Clearwater ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> 101 Starcrest Drive HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR <br /> P 0 Box 6090 ALTER THE COVERAGE AFFORDED DY THE POUCIES BELOW. <br /> Clearwater FL 33758 -6090 <br /> Phone:727- 447 -6481 Sax:727 -449 -1267 INSURERS AFFORDING COVERAGE NAM 0 <br /> INSURED INSURER A: FOCI Insurance Co 10178 <br /> INSURER B: rocs co sercIAl Insurance co 33472 <br /> A <br /> n e la Pauaxo LLC INSURER C: soldeonoia I MPleq.sa za ce 10701 <br /> Mrs r6 . Angela <br /> 4611 107th Circle INSURERD <br /> Clearwater 21 33762 , <br /> I INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO TIE INSURED TAMED ABOVE FOR THE POLICY PERIOD INDICATED, ?CVM1 STANDING <br /> ANY REOUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR °TIER DOCUMENT WITH RESPECT TO WH10 4 THIS CERTIFICATE MAY EE ISSUED OR <br /> MAY PERTAIN, 11-E INSURANCE APPORDED BY THE POLICES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAMS. <br /> LTR 44 9 TYPE OFINSURANCE POLICY NUMBER DA (MAIDD/YYTYI DATE 1 I I .' 4 • "`" WITS <br /> GENERAL LIABILITY EACH OCCURRENCE s 1, 00 0 , 000 <br /> A COMMERCIAL GENERAL LwaILITY CPP00012908 05/19/09 05/19/10 PI` t MlsEs(" E "'occu.ncAL s 300,000 <br /> 1 CLAIMS MADE © OCCUR MED EXP (Any one person) 65,000 <br /> CONTRACTUAL LIAR yo pax Sue reeks WRAY PERSONAL 6 ADV INJURY S 1, 000 , 000 <br /> — <br /> ©Xc GENERAL AGGREGATE 02,000,000 <br /> OEM_ AGGREGATE LIMIT APPLIES PER: PRODUCES - COtiPfoR A ✓GG t 2,000,000 <br /> POLICY la l JECT f] (sic <br /> • <br /> AUTOMOBILE LWBLRY COMBMED SMIGLE LIMIT <br /> B ©ANYAUro CA00014577 05/19/09 05/19/10 (Eeeca°e110 x1, 000,000 <br /> ■ ALL OWNED AUTOS 30 NAY CAIC 11911131 MOW BODILY INJURY <br /> SCHEDULED Auros (kr person) _ <br /> III <br /> HIRED AUTOS <br /> BODILY INJURY 6 <br /> NON.O•AMED AUTOS (Per occident) <br /> III PROPERTY DAMAGE 6 _ <br /> (Per occident) <br /> DARAOE UABILm <br /> AUTO ONLY - EA ACCIDENT $ <br /> ■ ANY AUTO Eh ACC S <br /> OTHER THAN <br /> AUTO ONLY: AOG 6 <br /> EXCESS / UMBRELLA LIABILITY EACH OCCURRENCE 62,000,000 <br /> A © occuR 0 CLAIMS LIMB00007677 05/19/09 05/19/10 AGGREGATE 6 2,000,000 <br /> _ <br /> 10 DAY _ $ CANC NOTICE_ <br /> ■ DEDUCTIBLE FOR 1 NON -PAY <br /> X RErErmoN 610,000 s <br /> w. -. - COMPENSATE:* VVL 5IAIU UII+ <br /> AND EMPLOYERS' LIAYLITY ` x TORY LIMITS 1 F32 <br /> Y/N <br /> C ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L. EACH x 500 , 019606105 07/21/09 07/21/10 000 <br /> OFFICER MEMBER EXCLUDED? <br /> (ManatoryIRWI IF Sax CAM I T= NORM E.L. DISEASE - EA EMPLOYEE S 500.000 <br /> If yes. °eecnbe under <br /> SPECIAL PROVISIONS below E,L. DISEASE- POLICY LIMIT 6 500 , 000 <br /> OTTER <br /> DESORPTION OF OPERATIONS / LOCATIONS) VEHICLES / EXCLUSIONS ADDED eY EN CORSOM./dt / SPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF The ABOVE DESCRIBED POLICES Be CANCELLED BEFORETNE EXPIRATION <br /> CITYZEP DATE THIEREOP, THE ISSUING INSURER BILL ENDEAVOR TO MAL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO TIE LEFT, BUT FALUNE TO DO SO SHALL <br /> CITY or ZEPKYRXILLS IMPOSE NO OBLIGAT1ON OR LIABILITY OF ANY MIND UPON THE INSURER, ITS AGENTS OR <br /> BUILDING DEPARTMENT <br /> 5335 8Th STREET REPRESENTATIVES. <br /> ZEPHYRh2LLS IrL 33592 Ammonium ATIVE <br /> t <br /> ACORD 25 (2009/07) . A 1988 -2009 ACORD CORPORATION. AN ABMs reserved. <br /> The ACORD flame and logo are registered marks of ACORD <br />
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