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10-11026
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2010
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10-11026
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Last modified
8/15/2011 3:02:44 PM
Creation date
8/15/2011 3:02:41 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
10-11026
Building Department - Name
ZEPHYR COMMONS LLC
Address
7800 GALL BLVD
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DATE(MM/DOmrr) <br /> ACORD., CERTIFICATE OF LIABILITY INSURANCE OPID FR <br /> USSIG -1 08/31/10 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Lykes Insurance, Inc . - FTM HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> P.O. Box 60043 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Fort Myers FL 33906 -6043 <br /> Phone: 239- 931 -5600 Fax: 239- 931 -5604 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: FCCI Insurance Company 10178 <br /> INSURER B: <br /> U.S. Sign & Mill Inc. INSURER C: <br /> 7981 Mainline Parkway INSURER D: <br /> Fort Myers FL 33912 <br /> INSURER E. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LSTED 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 HEREt'1 IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> WW1 WUU•L POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRC TYPE OF INSURANCE POUCY NUMBER DATE (MM/DDYY) DATE (MMlDDVY) LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE S1000000 <br /> A X COMMERCIAL GENERAL LIABILITY GL0005425 05/01/10 05/01/11 PREMISES (Ea ocalence) $ 100000 <br /> CLAIMS MADE X OCCUR MED EXP (Any one person) $ 5000 <br /> X Contractual Liab PERSONAL BADVINJURY S 1000000 <br /> GENERALAGGREGATE $ 2000000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER• PRODUCTS - COMP /OP AGG $ 2000 000 <br /> 7 POLICY X jE T LOC — <br /> AUTOMOBILE UABIUTY l COMBINED SINGLE LIMIT <br /> A X ANY AUTO CA0004430 05/01/10! 05/01/11 (Ea accident) <br /> $ 1000000 <br /> ALL OWNED AUTOS _ <br /> BODILY INJURY $ <br /> SCHEDULEDAUTOS (Per person) <br /> X HIRED AUTOS <br /> BODILY INJURY $ <br /> X NON -OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LWBIUTY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO <br /> OTHER THAN EA ACC $ _ <br /> AUTO ONLY AGG $ <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE _ $ 1000000 <br /> A X l OCCUR CLAIMS MADE UMB0002233 05/01/10 05/01/11 AGGREGATE $ 1000000 — <br /> DEDUCTIBLE <br /> X RETENTION $ 10,000 $ WORKERS COMPENSATION AND X TORY L I ER <br /> A <br /> EMPLOYERS' LIABILITY 001WC09A57779 04/01/10 04/01/11 E.L. EACH ACCIDENT $ 500000 <br /> ANY PROPRIETOR/PARTNER/EXECUT1VE <br /> OFFICER/MEMBER EXCLUDED? <br /> yes, decribe rxler <br /> E.L.DSEASE - EA EMPLOYEE $ 500000 <br /> K <br /> S PECI ALsPROVuSIONS below E.L. DISEASE- POLICY LIMIT $ 5500000 <br /> OTHER <br /> A Inland Marine CM0003052 05/01/10 05/01/11 Leased /Re 100,000 <br /> ( Leased /Rented Equi <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS <br /> No exemptions are listed on the workers compensation policy. <br /> CERTIFICATE HOLDER CANCELLATION <br /> C1TY533 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> City of Zephyrhi 11 s IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 5335 8th Street REPRESENTATIVES <br /> Zephyrhills FL 33542 A,i!'T2,i R SE An _ <br /> Jw➢ J <br /> ACORD 25 (2001 /08) G/ © ACORD CORPORATION 1988 <br />
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