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11-11631
Zephyrhills
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2011
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11-11631
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Last modified
12/15/2011 9:21:06 AM
Creation date
12/15/2011 9:21:05 AM
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Building Department
Company Name
CITY OF ZEPHYRHILLS
Building Department - Doc Type
Permit
Permit #
11-11631
Building Department - Name
ZEPHYRHILLS DEPOT MUSEUM
Address
39110 SOUTH AVE
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From:�,ee Reed Insurance 03/14/2011 14:27 #199 P.001l001 <br /> ACO d CERTIFICATE OF LIABILITY INSURANCE 3/14/201� <br /> THIS CERTifICATE IS ISSUED AS A AIATTER Of pIFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDER. 7H� <br /> CERTIFICATE DOES NOT AFFlRMATIVELY OR NEGATIVELY AYEND, EXTEl� OR ALTER THE COVERA(iE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERT�ICATE Of INSIfRANCE DOEB NOT CONSTITUTE A CONTRAtT BEtYYEEN THE ISSUING INSURER(S�, AUTHORIZED <br /> RppRESENTATNE OR PRODUCER, A!O THE CERTIFICATE NOLDER. <br /> IMPaRTANT: M 1M csrtiflcate IwNler k an ADORIONAL INSUItED, tAa polky(les) mutt be �ndoraad. N SUBROliAT10N IS WANED, wbJect a <br /> the brma and wndkio�s M Me polky. caAain pdides may roquha �n andorsement. A tbtem�M on tMis cMKicate doas not conlsr rigMs to tha <br /> certNksta holdet M INu ol wcb enAOnemartt�:). <br /> �OD�R w�w�: And Mitler <br /> LEE REED INSURANCE P 813 782-5502 " <br /> PO Box 908 "° E"c: � f ,NO. (813)788-1996 <br /> „���, andy�leereedins.com <br /> Zephyrhilis, F133539-0908 <br /> INNMER�s) AfPORDNIO COVERA6E NAICi <br /> „asur�a � Southern-0wners Insurance Company 10190 <br /> in�auR�o Post R Us, Inc. i�su�R e <br /> dba Acme Fence „�sur�R c <br /> 5630 6th St. ir�ur�re o <br /> Zephyrhills, FL 33542 iNSUaa: E <br /> W8UAER F . <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CER7IFY THAT THE PaLICIES OF IN3UR4NCE IISTED �LOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE Pp�ICY PERIQO <br /> INOICATED. NOIWRHSTAN�ING ANY REQUIREA�NT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WRH RESPECT TO WHICH THIS <br /> CERTIFICATE AMY BE ISSUEO OR MAY PERT/UN, THE iNSURANCE AFFORDED BY THE POLIGES DESCRI9Ep HEREIN IS SU8,IECT TO ALL TME TERMS, <br /> EXCLUSIONSAND CONUITIONS OF SUCH POLICIES. LIMITS SHPWN MAY HAVE BEEN REWCED BY PAID CLAIMS. <br /> � TYPE Of IN8URANCE � ynp pOLICY NUMBER Y MIOOVYYYy UMITB <br /> 6ENERAL UABIIRV EACM OCCURRENCE i Z�OOO�OOO <br /> X conneeRau c�wa. �waiun w�u�ses e. ox�xr«�ca a 50,000 <br /> CWMS�MADE � OCCLNt MEDEXPIAnyomDwbn) S S,OOO <br /> A 102312-20727448 1/29/11 1/29/12 PERSONALdADVIN.MJRV a�,�,� <br /> c�nu AGfiREGATE s 2,�0,000 <br /> 6FM AOGREGATE LIMR APPL�S PER: PRODUCTS - COMPIOp A(aCa t Z�OOO�OOO <br /> x POLICV �� IAC i <br /> AllTOMOBILE LIA6RITY � <br /> E..�a.�r a <br /> ANYAUTO 90D4.Y INJURY (Per paiwn) _ <br /> ALL OWNED SCFIEDULED <br /> AUTOS AU70S BODILYIWURV(perapadpq) i <br /> NON�OWNED p i <br /> WREOAVI'OS AUTOS Wrwdderq <br /> s <br /> weeaeu.� uns �� eneH occurtnvace s <br /> EXCEBS WB CIAMABIAAOE A03RE(iATE S <br /> DED RETEMION i = <br /> WpqKER3 COMPENSATION WCBTATLL OT4 <br /> qNP EMPLOYERS' I,IABILRY Y/N TOHY LIMIi'8 EA <br /> urr Pnorneraw�r�n��am�e E.L. EACN RCCIOENT f <br /> pf41�.EygEp ElWWOEDp N!A <br /> �r � �+) �.�. as�se - � �w.ov� s <br /> M 1roi. dr�xib� uder <br /> DE8CR�TION Of OPERATIONS bsbw El. D18EASE - POLICY UYR = <br /> DESCRIPTION OF OPERATIONS ! LOCAI'IONS ! VEhNCLE3 (Atladf ACORD 101, �Adtloml RanaXU 8drd�le. q mor� epsoe Is taqui�pl) <br /> GERTIFICATE HOLDER CANCELLATIOM <br /> City of Zephyrhills Building Department $HOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCEiLED BEFORE <br /> 5335 Sth Street THE EXPiRAT10N DATE THEREOF, NOTICE WILL BE DEUVERED IN <br /> Zephyrhiils, FL 33542 ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Fax:(813}780-0021 <br /> AIJTHOWZED REPRESENTATIVE <br /> � <br /> � 1988-2010 ACORO C PORATfON. AII rigMs reserved. <br /> ACOR025(2010/05) The ACORD name and logo are registered marks of ACORD <br />
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