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10-10678
Zephyrhills
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2010
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10-10678
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Last modified
3/22/2011 3:21:11 PM
Creation date
3/22/2011 3:19:32 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-10678
Building Department - Name
WILKINSON,CHRISTINE
Address
5436 TANGERINE DR
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Jul 86 2818 12:56:46 Via Fax -> 7272646821 The Hartford Fax Page 084 Of 804 <br /> ACORD CERTIFICATE OF LIABILITY INSURANCE DA 71 <br /> 07 - 06 - 2010 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> NORTHEAST AGENCIES INC /PHS ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER, THIS CERTIFICATE DOES NOT 210519 P: (866) 467 -8730 F: (800) 308 -5459 ALTER THE COVERAGE AFFORDED BY THE POLI BELOW, <br /> 301 WOODS PARK DRIVE <br /> CLINTON NY 13323 INSURERS AFFORDING COVERAGE <br /> INSURED INSURER A: Hartford Casualty Ins Co <br /> MICHAEL E. SMITH & ALL SERVICE INSURER B: <br /> PLUMBING OF PA$CO, INC INSURER CI <br /> PO BOX 1784 INSURER D: <br /> NEW PORT RICHEY FL 34656 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 /> POUCIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> TYPE OP INSURANCE POLICY MP41& AM 1IB/YY1 Ri PTY) LIMITS <br /> UAINUTY EACH OCCURRENCE $1,000,000 <br /> A COMMERCIAL GENERAL LIABILITY 01 SBM KS 8 8 6 6 10/10/09 10/10/10 FIRE DAMAGE (Any one Mil 03 0 0, 0 0 0 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) .10 , 0 0 0 <br /> X General L i ab PERSONAL & ADV INJURY 0 1,000,000 <br /> — <br /> GENERAL AGGREGATE 02,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP /OP AGO *2 , 0 0 0 , 0 0 0 <br /> POLICY X FRO LOC <br /> JECT <br /> AMMONIA, VANITY COMBINED SINGLE LIMIT <br /> ANY AUTO (El eNCIdeNS) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY • <br /> NON -OWNED AUTOS (Per /OCIdant) <br /> PROPERTY DAMAGE 0 <br /> (Pa accident) <br /> OAl1A0ELd111VTY AUTO ONLY • EA ACCIDENT 0 <br /> ANY AUTO EA ACC • <br /> OTHER THAN <br /> AUTO ONLY: <br /> AGO 0 <br /> EXCISSLLlfB ?Y EACH OCCURRENCE 0 <br /> OCCUR j CLAIMS MADE AOOREGATE 0 <br /> • <br /> DEDUCTIBLE • <br /> RETENTION 0 e <br /> WORKERS COMPYASA WC STATU- 07N- <br /> IMPLOYER8'114IL1TY TORY IACTS FR <br /> E.L. EACH ACCIDENT e <br /> E.L. DISEASE • EA EMPLOYEE 0 <br /> OTHER <br /> E.L. DISEASE - POLICY LIMIT 0 <br /> DEWRIPTION OF OPERA77QNWLOC47TWt54 MCLEL'EXGLLMlO,YB ADM EYEADORIEMEM /aPf0141, PROVNION8 <br /> Those usual to the Insured's Operations. <br /> CERTIFICATE HOLDER X ADDITIONAL E1CMO; INSURER LETTER: A CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> 30 DAYS WRITTEN NOTICE 110 DAYS FOR NON - PAYMENT) TO THE CERTIFICATE <br /> City of Zephyrhi lls HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO <br /> 5335 8th St . OBLIGATION OR LIABIUTY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> REPRESENTATIVES. <br /> 7er�1- ,.svY� i 1 l a L'T. <br />
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