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10-11120
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2010
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10-11120
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Last modified
8/16/2011 10:14:37 AM
Creation date
8/16/2011 10:14:36 AM
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Building Department
Company Name
SILVER OAKS
Building Department - Doc Type
Permit
Permit #
10-11120
Building Department - Name
DENSLOW,RICHARD
Address
6300 BRENTWOOD DR
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ACORD m C RT FI A I Lit( , y DATE /10 o/re) <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. <br /> THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE <br /> POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), <br /> AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, <br /> subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate <br /> does not confer rights to the certificate holder in lieu of such endorsement(s). <br /> PRODUCER COMPANIES AFFORDING COVERAGE <br /> 150 SAWGRASS URANCE DRIVE AGENCY, INC. COMPANY AMTRUST OF NORTH AMERICA/ROCH <br /> ROCHESTER, NY 14620 COMPANY <br /> B <br /> INSURED <br /> EGG COMMERCIAL. SYSTEMS INC COMPANY <br /> 7906 LEO KID AVE <br /> PORT RICHEY, FL 34668- COMPANY <br /> D <br /> COVERAGES CERTIFICATE NMI ; - ' ' REVIEKINRWIWR <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS <br /> LTR DATE (MM /DD/YY) DATE (MM/DD//Y) <br /> GENERAL LIABILITY <br /> _ J COMMERCIAL GENERAL LIABILITY <br /> GENERAL AGGREGATE $ <br /> PRODUCTS - COMP /OP AGG $ <br /> _ �LAI MS MADE L OCCUR <br /> OWNER'S & CONTRACTOR'S PROT <br /> PERSONAL & ADV INJURY $ <br /> EACH OCCURRENCE $ <br /> FIRE DAMAGE (Any one fire) $ <br /> MED EXP (Any one person) $ <br /> AUTOMOBILE LIABILITY <br /> — �' ANY AUTO COMBINED SINGLE LIMIT $ <br /> ALL OWNED AUTOS <br /> I SCHEDULED AUTOS BODILY INJURY $ <br /> HIRED AUTOS (Per person) <br /> NON -OWNED AUTOS BODILY INJURY $ <br /> - (Per accident) <br /> PROPERTY DAMAGE $ <br /> GARAGE LIABILITY <br /> — I ANY AUTO AUTO ONLY - EA ACCIDENT $ <br /> OTHER THAN AUTO ONLY. <br /> EACH ACCIDENT $ <br /> AGGREGATE $ <br /> EXCESS LIABILITY <br /> UMBRELLA FORM EACH OCCURRENCE $ <br /> OTHER THAN UMBRELLA FORM <br /> AGGREGATE $ <br /> WORKER'S COMPENSATION AND X we STATU oTH <br /> A EMPLOYERS' LIABILITY TORY I IMITS FR <br /> THE PROPRIETOR/ ` v 1 INCL AWC1005487 06/30/10 06/30/11 EL EACH ACCIDENT $ 100,000.00 <br /> PARTNERS /EXECUTIVE `1L7 EL DISEASE - POLICY LIMIT $ 500,000.00 <br /> OFFICERS ARE. EXCL <br /> EL DISEASE - EA EMPLOYEE $ 100,000.00 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS/ LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) <br /> CERTIFICATE HOLDER CAHcEL , <br /> CITY OF ZEPHYRHILLS BUILDING DEPT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> 5335 8TH STREET DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY <br /> ZEPHYRHILLS, FL 33542 PROVISIONS, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR <br /> LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. <br /> AUTHORIZED REPRESENTATIVE <br /> ACORD 25-S (2009109) <br /> w ICORD'cORPORAMIpN' 18$8 <br />
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