11-11495 - Laserfiche WebLink

Browse Search

03/02/2011 WED 11:52 FAX 813 637 8484 IOA_TAMPA �001/001 ~`""'�`.'�"' CERTIFICATE OF LIABILITY INSURANCE DATE(MMAD/YYYY) 03/02/2011 THIS CERTIFlCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFlCATE DOES NOT AFFlRMATiVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL'OW. THI$ CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFlCATE HOLDER. IMPORTANT: if the certlficate holder Is an ADDI170NAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and condkions of the policy, certain policies may require an endorsement A statemer�t on this certlflcate does not confer Hghts to the certiflcate holder in Ileu of such endorsement(s). PRODUCER NAME: Insurance Office of America, Inc. a � E , : (813)637-8877 A , � 4915 W. Cypress Street A DRESS. Tampa, FL 33607 cus : INSURER(3) AFFOHDING COVERAGE NAIC M INSURED INSURER A Auto-Owners 10190 American Electrical Services of Tampa Bay, Inc �NSUIiERB 6408 W. Li nebaugh Avenue �nsur�e c Suite 102 INSUHERD Tampa, FL 33625 INSURERE INSURER F . COVERAGES CERTIFICATE NUMBER: 11-12 Master Cert REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTUVITHSTANDING ANY REQUIREMENT, TERM OR CONDRION OF ANY CONTRACT OR OTHER DOCUMENT WffH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDffIONS OF SUCH POLICIES. LIMRS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANL� A �� g � R POLICY NUMBER POLI Y EFF POLICY EXP �� LTR INSR NND MNDlYYY M D1YYY GEPERALLIABILITY BGL1101314462 0�1/2011 �2/��/Z��2 EACHOCCURqENCE $ 1 �00 �� X COMMERCIAL GENERAI LIABILITY PREMISES Ea occurrence $ IOO � OO CLAIMS-MADE � OCCUR MED EXP (Arry one peraon) $ S� OO A PERSONAL & ADV INJURY $ 1 OOO OO GENERAL AGGREGATE $ Z� OOO � OO GEN'L AGGREGATE LiM1T APPLIES PER: PRODUCTS - COMP/OP AGG $ 2� OOO � OO X POLICY jE�,^�7 LOC $ AUTOMOBILE LIABiLITY BAL1101314462 OZ/��/20� 1 0��/20�2 C�BINED SINGLE LIMIT $ �ea e��a�,q 1 000 0 X ANY AUTO BpDILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accitlent) y A SCHEDULED AUTOS PROPERTY DAMAGE X HIREDAUTOS (P�e�� $ X NON-OWNED AUTOS $ a UMBRELLA LIAB )( ��R BUL1101314462 OZ/O�/ZO� � OZ/O�/ZO� �L EACH OCCURRENCE $ Z� OOO � OO EXCE33 LIAB �q�MS-MADE AGGREGATE $ Z OOO OO B DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION W TATU- TH- APD EMPLOYERS' LIABILITY Y/ N ANY PROPRIETOR/PARTNER/EXECUTIVE� E.L. EACH ACCIDENT $ OFFICERlME6,6ER EXCLUDED? Nt A (Mandelory in N1) E.L DISEASE - EA EMPLOYE $ Itye s, deacribe untler DESCRIPTION OF OPERATIONS below E.l. OISEASE - POLICY LIMIT $ A nland Marine BIM1101314462 02�01/2011 02/Ot/2012 Leased/Rented Equipment Limit: 530,000 DESCRIPTION OF OPERATIONS � LOCATIONS / VEHICLES (Amch ACORD 101, Additlonal Remarks Schedule, it more epace k required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCF�BED POLICIES BE CANCELLED BEFORE THE EXPIRATON DATE THEREOF, NOTICE WILL BE DEIJVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. Ci ty of Zephyrhi 11 s A�OPo2ED REPFESENTATIVE �� 5335 8th Street Ze hyrhills, FL 33542 Ro er Perkerson ]ONESK � 1986-2009 AGORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name end logo ere registered merks of ACORD