Laserfiche WebLink
A�,,,._° �' CERTIFICATE OF LIABILITY INSURANCE DA 04/05/11 m � <br /> PRODUCER Bauer & Associates THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> 12210 Us Highway 301 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> Dade City, FL 33525 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. <br /> Phone (352)567-3702 Fax (352)523-0434 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED JOHN SMITH DBA/ iNSURERA. AUTO OWNERS INSURANCE <br /> INSURER B: <br /> JOHN L. SMITH CONSTRUCTION <br /> INSURER C: <br /> 4240 COATS ROAD INSURER D <br /> ZEPHYRHILLS, FL 33541 INSURER E. <br /> COVERAGES INSURER F <br /> THE POLICIES OF INSURANCE LISTEO HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADD'L TypE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION <br /> LTR INSRD DATE (MM/DD/YY) DATE (MM/DDlYY) _ LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE 300,000 <br /> d COMMERCIAL GENERAL LIABILITY 20632794 05/01/10 05/01/12 PR M SES Ea occureDnce) 50,000 <br /> CIAIMS MADE d OCCUR MED EXP (Any one person) S,QQQ <br /> A PERSONAL & ADV INJURY 300,000 <br /> GENERALAGGREGATE 600,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PROOUCTS - COMP/OP AGG 600,000 <br /> d POLICY PROJECT LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea accident) <br /> ALL OWNED AUTOS BODILY INJURY <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY <br /> NON OWNED AUTOS (Per accident) <br /> PROPERTY DAMAGE <br /> (Per accident) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT <br /> ANY AUTO OTHER THAN EA ACC <br /> AUTO ONLY AGG <br /> EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE <br /> OCCUR CLAIMS MADE AGGREGATE <br /> DEDUCTIB�E <br /> RETENTION $ <br /> WORKERS COMPENSATION AND WC STATU- OTH- <br /> EMPLOYERS' LIABILITY TORY LIMITS ER <br /> ANY PROPRIETOR ! PARTNER / EXECUTIVE E.L. EACH ACCIDENT <br /> OFFICER / MEMBER EXCLUDED? <br /> If yes, describe under <br /> E.L DISEASE - EA EMPLOYEE <br /> SPECIAL PROVISIONS below E.L DISEASE - POLICY LIMIT <br /> OTHER <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT! SPECIAL PROVISIONS <br /> BUILDING CONTRACTOR <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE <br /> EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> CITY OF ZEPHYRHILLS 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO <br /> BUILDING DEPT THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY <br /> 5335 8TH STREET OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. <br /> ZEPHYRHILLS , FL 33542 AUTHORIZED REPRESENTATIVE 5,( ` <br /> FAX@8'13-780-0021 ��, d � � �'��/ <br /> ACORD 25 (2001/08) QF �O ACORD CORPORATION 1988 <br />