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11-11729
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11-11729
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Last modified
2/8/2012 11:23:16 AM
Creation date
2/8/2012 11:23:14 AM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11729
Building Department - Name
CHILI'S BAR & GRILL
Address
7643 GALL BLVD
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from: Oi1211201� a0:a9 #464 P.D01/001 <br /> Aco � CERTIFICATE OF LIABILITY INSURANCE DATE(MN/DDIYYYY) <br /> 1 <br /> PRODUCER Alliance Insuranoe Salutions LLC TFtIS CERTIFICATE IS tSSUED AS A lMATTER OF INFORNlATiON <br /> P� BOX 1777 ONLY AND COMFERS NO RIGHTS UPOPI THE CERTIFICATE <br /> St Petersbur , FL 33731 HOLQER. TMIS CERTIFtCATE DOES NOT AMEND, EXTEND OR <br /> 9 ALTER THE COVEfiAGE AFFORDED BY THE POLICIES BELOW. <br /> 727�97-1247 <br /> www.ins4biz.com 727�g7-1280 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED progressive Employer Management Company, Inc. wsu�Ra suN ins+, c � 3a7 <br /> Progressive Employer Management Company II, inc. ,,,��,� <br /> 6407 Parkland Dr ,NSU�R c: <br /> Sarasota FL 34243 <br /> INSURER D: <br /> 1NSURER E: <br /> COVEf2AGES <br /> THE POIICIES OF INSURANCE LISTED BELCHM HAYE BEEN ISSUED TO T HE INSUREO NRMED ABOVE FOR THE POLICY PERI00 �NDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TEf�t OR CONOITION OF ANY CANTRACT OR OTHER OOCUf�M WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE tNSURANCE AFFOROED BYTHE POLlCIES DESCRlBEO HEREIN iS SUBJECT T0,4L1. THE TERINS, EXCIUSIONS ANO CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LpNITS SHOWN MAY HAVE BEEN REDUCED BY PAIO CLAMS. <br /> INSK DD POtiCY EFFECTIVE POLICY EXPIRATpN <br /> T N TY POLICY NUNBER LINUTS <br /> GENERAL�U&UTY EACN aCCURRENCE � <br /> COMMERCIAL GENERAL UABiLJTY DAMA TO NT D <br /> PREMISES a oavaence 3 <br /> CLAIMS MADE � OCCUR MED EXP me persan S <br /> PERSONAL&AQVtNJURY S <br /> c�ENERflI aGGREGATE S <br /> GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS - COMPfOP AGG S <br /> POl1CY P � �OC <br /> AUTOMOBILE 1N61LITY COMBUVEUSAIC�E LIM1T $ <br /> ANY AUTO (Ea accdem) <br /> ALL OWNED AUTOS <br /> BOOILY WJURY $ <br /> SCHEDULED AU70S (� DB5m1 <br /> HIRED AUTOS <br /> BODILY INJURY $ <br /> NON-OWNED AUTQS (Per acdtleng <br /> PROPERTY OAMAGE 3 <br /> (Per act3danq <br /> GARAGE1.iAH1LtTY ALtiODNLY-£AACCIOENT S <br /> ANYAIlCO EAACC S <br /> OTHERTHAN <br /> AUTO ONLY• AGG $ <br /> EXCESSI UMBREILA LINBWTY fACH OCCURRENCE $ <br /> OCCUR � CLALMS MApE qC,�Gp� S <br /> a <br /> DE�UGTIBLE <br /> 5 <br /> RE7ENTION S $ <br /> A WORKERSGOMPENSATION WCPE0000�5401 11/1/2010 11Hl2011 ✓ wCSTATU• OTH- <br /> ANDEMCLOYER$•11ABWTY �� � <br /> ANV PROPRIETORIPAKTNER1EJfECUTVE ❑ E.L £ACH ACCIOEM' S 1 OOO O00 <br /> OPFlCEHIMpABQtEX(1UDED? <br /> { �� ° � O7 �^ � E.L OISEASE - EA EMP�OYE 3 � Q <br /> Ifye s, dewibe uMa E.L OISEASE - POLICY ULtIT 5 1,000,000 <br /> SPECULL PROMSIDNS bdaw <br /> O7HER <br /> QESCRIPTION OF OPHtRT10NS! LOCATIONS 1 YEHICIE$ / EXCLUSIONS ADDED BY ENDORSEMEIQT I SPECIAL PROVtS10N$ <br /> Coverage Provided for all teased empioyees but not subcontractors of- Sunshine Pressure Cleaning, In <br /> Cliern EffeCtive: 11t1/ZU10 <br /> fax 888-267-6475 and to 663-701-2329 <br /> CERTIFICATE HOLDER CANCELLATION <br /> 8317 -- ---- --_ - - - SHOU1,p/WypFTNEpgpyEDESCR�EDPOUCIESBECANCELLED6EFORETHEEIU'IRATION <br /> DA75 T1ffREOF, 71iE 55tll16 115URER WlIL ENDEAYOR TO!'UIL , 3O � DAYS YVRifTEN <br /> NOTICE TO THE CERTiFICATE HOIDER NNNEp TOTfE LEiT, BUT F/1lURE TO Dp SO SHALL <br /> MAPOSE NO OBLIGATION OR UABIlRY OF ANy !WD UPON TNE WSURER, ITS AGENTS OR <br /> REPRESfNTAT1VES. ' 1Q Days tar NomPaymmt d Premium. <br /> AUTMORIZEp REPRESENTATIVE -'///��'� <br /> Glen J Distefarro ,� ���� <br /> ACORD 25 (2009I01) m 1968 2409 ACORD CORPORATiON. AII rights reserved. <br /> C2£T ilC. 9�cid9� CLI@3T CCCE PEMCC :en 9aart 1j2C/2�11 6:C9 :o W. Page 1 ot 1 <br />
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