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09/20/2010 22:37 3525230434 BAUER ASSOCIATES PAGE 01 <br /> AC :WO DATE (MM/DD/YY) <br /> CERTIFICATE OF LIABILITY INSURANCE ! 09/21/10 <br /> PRODUCER Bauer & Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 12210 US Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE • <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY7HE POLICIES BELOW. <br /> Phone (352)567 -3702 Fax 352 523 -0434 1,. <br /> - � ) INSURERS AFFORDING COVERAGE NAIC # <br /> I -.,_ <br /> INSURED COLBY JAYNES PLUMBING INC. INSURER n: OWNERS INS. CO. <br /> • <br /> INSURER e: AUTO OWNERS INS. CO. i <br /> 39041 CLINTON AVE - _. <br /> DADE CITY, FL 33525 INSURER C: ._• i <br /> • • • INSURER D: <br /> i INSURER E: • <br /> VERA S I INSURER F: <br /> THE POLICIES OF INSURANCE LISTED 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 UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> ./NSF! NSRD TYPE OF INSURANCE POLICY NUMBER � / DA wo om r ) N I LIMITS <br /> • GENERAL LIABILITY � EACH OCCURRENCE i 300,000. <br /> 41 COMMERCIAL GENERAL LIABILITY 20556297 -09 <br /> 01/08/10 I DA 4GE TOREIQTEO — 50,000' <br /> I 01/08/11 I P REMISE�Eaoxurence) <br /> _...;L... CLAIMS MADE R, OCCUR MED EXP (Any one person) 5,000 <br /> • • <br /> • <br /> A — — I PERSONAL & ADV INJURY 300,000; <br /> ! ± _ I .GENERAL AGGREGATE 300, <br /> i GEN'LAGGREGATE LIMrrAPPLIES PER: i PR ODUCTS- COMP /OPAGG 300,000: <br /> N POLICY ✓ PROJECT F ; LOC <br /> AUTOMOBILE LIABILITY :COMBINED SINGLE LIMIT i u 300,000; <br /> ANY AUTO Z 9604948901 01/11/10 01/11/11 (Ea accident) <br /> 7 ALL OWNED AUTOS <br /> • B 7 L... SCHEDULED AUTOS ! BODILY INJURY i • <br /> • <br /> HIRED AUTOS ! BODILY NJ <br /> F. NON OWNED AUTOS I (Per accident) • • <br /> —' I PROPERTY DAMAGE <br /> 1 <br /> (Per accident) <br /> .L _ <br /> GARAGE LIABILITY ' ' AUTO ONLY - EA ACCIDENT <br /> � ANY AUTO . _ — <br /> • ! I i OTHER THAN EA ACC <br /> _ I I I AUTO ONLY: AGG _ <br /> • EXCESS/UMBRELLA LIABILITY I <br /> NCH OCCURRENCE <br /> OCCUR ! I CLAIMS MADE i • i AGGREGATE <br /> • <br /> • <br /> DEDUCTIBLE i —. . . -'- . .. . <br /> ' RETENTION $ <br /> WORKERS COMPENSATION AND <br /> I EMPLOYERS' LIABILITY .... OORR Y LIMIT S .20644045 01/08/10 01/08/11 . L J OTH_' • <br /> _ LIMITS ER <br /> 6 ! ANY PROPRIETOR / PARTNER / EXECUTIVE • E.L. EACH ACCIDENT 100,000 <br /> OFFICER / MEMBER EXCLUDED? <br /> If yes, describe under • E.L. DISEASE - EA EMPL 100 i <br /> SPECIAL PROVISIONS below -1 • E.L. DISEASE - POLICY LIMIT 500,000; <br /> OTHER <br /> I <br /> • • <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> :PLUMBING CONTRACTOR <br /> • <br /> CERTIFICATE HOLDER CANCELLATION <br /> ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> CITY OF ZEPHYRHILLS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br /> BUILDING DEPT. THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> • <br /> 5335 8TH STREET • OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> RUTH /ZED REPRESS ATIVE <br /> ZEPHYRHILLS , FL 33542 � / / <br /> _ 1 FAX ©813 -780 -0021 <br /> ACORD 25 (2001/08) CIF � -• <br /> ACORD CORPORATION 199 88 <br />