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11-11515
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2011
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11-11515
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Last modified
10/31/2011 11:28:37 AM
Creation date
10/31/2011 11:28:33 AM
Metadata
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Building Department
Company Name
GRAND HORIZONS
Building Department - Doc Type
Permit
Permit #
11-11515
Building Department - Name
SHACKEWYE,CHARLES/ANNMARIE
Address
37212 NEUKOM AVE LOT 295
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�-� eb. 1`�. 2�� 11 1'� ; 43Ah1 NDVAK AGENCY No. j r �� �. �� � <br /> A��K,� GERTIFICA7E 0� LIABILITY INSURANCE DATE(MMlODtt'm! <br /> �,,. 02/10/2011 <br /> PROOUCEN i— THIS GERTIFICATE IS ISSUED AS A MA7TER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CER7IFICATE <br /> Novak Age�cy • HOLDER. THIS CERTIFICATE DOES NOT AMEND, Exl'ENO OR <br /> 11590 Semi�ole Bivd ALTER 7HE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Largo FL s377B <br /> ?'Z7-393-0840 INSURERS AfFORDING COVERAGE NAIC # <br /> �+suaeo �Rqrl!{ H MCKINNEY lCCC042879 CGC0485Q2 „�R A: MAR1cE< <r��Rhnnoap� <br /> Solar Shieid Industires inc iNSu� � <br /> 2321 NE 29th Ave INSU� : <br /> Ocala F� 34470 0: <br /> iNSURER E: <br /> COVEttAGE3 <br /> TH�POLICIESOFINSURANCHUSTEDBELOW HAVEBEENISSUEOTOTFEINSWiEDNAMEOABOVEFORTNEPQI.ICYPERIObIP <br /> ANY F�aI�IREM�NT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEM' WITH RESPECT TO WHICH TNIS CERTIFICATE MAY 6E tSSUEO OR <br /> MAYPERTAIN,TF� �NSURANC�AFFORDEDBYTHEPOIICIES DESCRIBEDHEREINISSUBJECTTOALLTMET�FiMS, EXCLUSIONS M�IDCOND�TIpNS OFSUCH <br /> POLICIES. AGGREGATE LIM17S SN4WN MAY HAVE SEEN REOUCEO BY PAID CLAIMS. <br /> INSl1 POLICY NUMSEN ��Y EFPECTIVE WNC� EI(PI T10N 1,NAITS <br /> c � y �� i „� T y M occu�q�x 1.000 000 <br /> A X COMbERGALOENEMLUA81�ItY MKM101845 0��9��� 03109/11 D REMED a 50 040 <br /> ClAlA13 MIlOE � OCCUR MEO E%P 8011 � ��� <br /> p �a,wv Y E ��ODO OOO <br /> � � 1000,040 <br /> PI'!, AGOREGAT£ IIMtT qPPLIES PER: PAOOUCT3 - COM P ACG ��OOO OOO <br /> PpUCY � LOC <br /> M/�OM1001LE L�AB�LfTY COMBINEA SINGLE LIMIT s <br /> ANY A1fT0 (Ee sociden!) <br /> /1ly OVYNED AlJT05 BppllY �NJURV s <br /> SCNEDULEO AUTDS {� ��� <br /> n�qEO AUTOS gprn�r u�uuqv = <br /> . t�V-oW NEO AUTOS (Per uadeMl <br /> PROPERTY OAMAOE _ <br /> tPar act�ent) <br /> GARAGE LJAB�LITY AUTO V- EA ACCIOENi <br /> ANY AU70 OSMER THAN � ACC <br /> A�(TOONLY: �G = <br /> E1iCE9S t UMBREI.LA LIA9ILITV ACH OGCURfIEHCE i <br /> OCCUR � CLA�S MAOE AGGRE TE _ <br /> DEOUCTIBI.E <br /> R�TENTION f <br /> 1NORKEI�COMPENSAT�ON WCSTATU- OTM- <br /> AND EM►LOYERS' LbIB11.ITY Y 1 N <br /> qNypftbpRlETpp�pAp7�EqlE%E(;u7N� E.L N CCIOENT <br /> oFwCewMEM6ER EXCWOEO7 U <br /> (Nland��ory 11f NN) E.L. DISEASE � 6 EM YE Y <br /> H , de8h� under <br /> Ng .l. OISEASE - POIIC� LIMIT <br /> Ot►1E1t <br /> oE9CR�PTroN OF OPERATION9 ! LoCAT1oNS f 1rBHICLE9 / EXCLU9101s AoDED eV ENDOp�EMENi t sPECU►� pqOY1610N5 <br /> FRANK H AACKINNEY /CCC042879 CGC046502 <br /> CERTIFICATE HOIDER CANCELLATION <br /> SMOUI.D ANYOf TNE ABbVE oESCPo9E0 PoLIC1E$ BE CANGEILED BEFOPE TME EX�4T10N <br /> CITY OF 2EPHYRHIL(.S BUILOING DEPARTM�NT DATE T11�REOF, THE ISSUMG INSURER M/1LL E�EAVpi TO MAII �_ DAYS WRTfTEN <br /> 5335 8TH ST NOi10E TO TME C�iTIFICATE NOlOER flAtAEO TO THE LEFT, 8UT FAILNiE TO DO SO SNALL <br /> ZEPHYRHII.LS, FR 33�4Z IMPOSE NO 06lHiAiION OR UA81lJTY OF ANY KINO t1rON TME IN3URER, ITS AGENTS OR <br /> A IV�6. <br /> AUTHORIgD REYRESENTATI + ' <br /> 352-237-5202 / 613-760-0021 .... .. <br /> ACORD 25 (200W01) � 19M-2 s ACOR� CO . . .' his reserved. <br /> The ACORD name and logo ar. ►sg�stered maNts of ACORD <br />
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