|
� 02/07/2011 12:09 FAX 81a8793505 ADRIt1N_.FERNANDEZ INS I�j001
<br /> `. .���r, / ��r � .. .......:.... .. . ` . . Si� Y: •; .7k:�:;.'. ::i: C :r4�Y s�ad:e . ,�
<br /> � I"f V � ' •,���} 'r' {H a : 'ri�; y . y . '��..''�' < o- es`:<>'a" ��� {" �frn
<br /> .� . �a�,..;; . �� ....: c � �� t a� �
<br /> PfiODYCEA �„ ..., .. ..,... i;'r�. . >.9i:.�:...'Y�fi2 +�a< .�.. + !:::� ° •:.`:.s:+":.. e ° ' F Q!. 07f 11
<br /> THIS CERTIFICATE 1S (SSUED A� A MATTER OF INFORMATION
<br /> Adrian �'ernandez Ins ., Inc . ONLY AND CONFEFIS NO RIGHTS UPON THE CERTIFICATE
<br /> 6115 N. Armeni a A'cTe . A LTER THE COVE QE ORDE BY T E OLCI�S BEL WR
<br /> GOMPANIFS AFFORDING COVEFIAGE
<br /> Tampa FL 33604- � •�
<br /> (813) 872-8481 �
<br /> , (813) 879 A CFNTURY SUR�TY
<br /> utsuaeo ' --�
<br /> COMPANY
<br /> Wayne C. Stzohaker and �BRIDGEFiELD I
<br /> Security Concepts of Tampa, Inc �p "-
<br /> Post Offic� Box 906 c
<br /> Brandon FL 3 3 5 0 9- �,,, ' '
<br /> (813) 684-6877 D
<br /> ... . * ' �" a>£kr °e'° �* ' o. a... .m' seb .,� aa a<wo :, a
<br /> .. .. .'.': .,{} � .�,G s s � ,�} � e ao
<br /> ,�`5i.'�F•�'S4SY�.O�C..f+.>4���i���'�'<�'�� + } 6 . 0 {����:���i�.ii� . •7 9{}O4 i • . . • . ri
<br /> THIS IS TO CER7IFY THAT THE POLICIES OF INSURANCE USTED BELOW HAVE 9EEN ISSUED TO THE INSURED NAMED A80VE FOR THE POLICY PERIOD
<br /> INDICATED, NONVITHSTANDING ANY REQUIREMENT, TEFiM Of100NDITION OF ANY CONTRACT OR O7NER DOCUAAENT WRFi RESPECT TO WHICH 7NI3
<br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TFIE IN8URANCE AFFORDED BY TH� POLICIE3 DESCRIBED HEREIN 1S SUBJECT TO ALL 7HE TERMS,
<br /> D(CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS 5Y10WN MAY NAVE BEEN REDUCED BY PAID CLAIMS.
<br /> �.� TYPE OF INSURANCE POI.ICY NUMBEN POUCY EFFECTNE POLICY p�IRI�TICN ,, LlNITS
<br /> a►TE (NIM/DC/1M OATE (YM/on,rvr)
<br /> A OENEM� 4n01LTY GENERALA(iRPfiGA7E S1 , O O O, O O O
<br /> X COMMEHCIAL GENEFAL LUBIl17Y C C P 6 5 0 2 0 4 0 5/ 13 / 10 0 5/ 13 / 11 PAOpUC7g . CpMppp ppp a 1 0 0 0 0 0 �
<br /> cuuMS tiaoe � occuR �,� e,�ev iN,nu�r s]. 0 0 0, 0 0 0
<br /> ow�vER'S a coN�aa,cTOR'S PROT Eacw Oca� s 1, O O O, O O O
<br /> flr� orun�oE (any one nre) s 5 0 0 0 0
<br /> M� � wnr «�o ao��� s �5 , 0 0 0
<br /> AUTOMOBIIE LIABILIYY
<br /> ANY AU70 / / / / COMBINED SNV6LE LJMIT S
<br /> au. owweo a,uros • � . •
<br /> BODILY HVJURY i
<br /> SCMEDUI.ED AUTOS (pp� p � n � S
<br /> HIRED AUTOS '
<br /> NoN-oWNEOAUTQ4 bO01LYINJUqY E
<br /> (ver acciaenq
<br /> � PqoPEA7Y DAM,44E s
<br /> WiAOE uABILITY AUTO ONLY - E4 ACC�OENT S
<br /> �►ur nuTO I I I I on+eR �R+iw �uTO aaLY: '
<br /> �• - FACw,�cioE►�T s
<br /> �f3�RE0a7E s
<br /> DcCE55 uA61UTY EACN OCCURRENCE i
<br /> �MeReun r-oAM / / / / AccaECn� � -. ._ S . � .
<br /> o7►+Ea,ww uMeaew►FOr�,+� -
<br /> :
<br /> 8 woa�ns coM�ens�►noa �� X - R : • . . • . .
<br /> EYALOYlRS w�eiurr B 3 0- 3 2 9 71 12 / 2 0/ 10 12 / 2 0/ 11 EL F�4CH AOCIDENT t5 0 0, 0 0 0
<br /> PaAr a°PA �si� curne '" E� as� - aoucv u�ur ���s 5 0 0 0 0 0
<br /> ORfICERS ARE X Fxc� EL 019EASE - EA EMPLAYEE a 5 0 0, 0 0 0
<br /> on�ea
<br /> oescnianoH oF o�enn�NSn rrF�ea
<br /> � ' r " ��;�� • aa , •; �
<br /> � .,........, . <> ...�� .,
<br /> , ¢ +�,.,
<br /> .. .........� • ..an £'�.:...:;5?t.l+� :•:•^.4'A,� •e..:a<• ..,..:��:�kt' s.esees , � �e�ia �
<br /> . . . � .... �.. ?t. . . � � . h« '$� ........
<br /> fsHOULD ANY OF THE A60YE DESC1116Ep roLlC16S BE GANCFLLEO BEFOpE THE
<br /> E%PIRATfOX DATE TIIEREOF, THE ISSYINQ COMpqNY WILL GND�RVOp Tp I�Ip,TL
<br /> Cl�Y Of Zephyrhil ls ,�� pAYS Wpf1TEN NOTICE TO i'NE CEFRIFICAI'L� NO�,pF,p NpM1E0 TO TFiE LEF7,
<br /> Bui lding Department BUT FAIWRE TO YAIL SUCM N077CE SHAIL INP06E NO 06LWATON OR WIBILT\
<br /> 5��5 8th Stxeet OF ANY qN0 YPON COYP/WY, ITg � ��p�����g
<br /> Z ephyrhi 11 S FL 3 3 5 4 Q aurNOar�c Revnestnr�nv
<br /> •_�.v .�. , .. . ......... „�
<br /> • ,�.> . �
<br /> ' " ������� M �`� .'� `'������
<br /> . • £'�£'.�o. .�.�CS.;.. ' . ��.r , • >: �.� ..... ` .....,,.,.
<br /> r• z
<br />
|