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Apr 29 11 04'06p Eva Marshall 813-780-7470 p.1 <br /> � NOR7H �QINTE INSURANCE CO C�MERCIAL SUMMARY DEC <br /> i079950UTHSIDE f30ULEVARD.#200 �"�Of� <br /> JACKSONVILLE FL 3225fi . � <br /> N{JRTH . � <br /> POI NTE ______-- <br /> POLlCY NUMBE POLI(:Y PERIUO 12�tw.1l�SSSrida�dTi�ne <br /> i FRONE TO P�� ��med insuied. <br /> 2094123055 I 4l01 /11 4l01 /12 <br /> . <br /> .. � :_. _.. _. <br /> N�1ME�::iNSU . .. . kf�0�_AD�RE:�� � :. .... .. ` - : - - -; - -_ - - - - -- _ - - _ _ - -� <br /> . .. .. - --. . ... . . . ... . . <br /> ° - -. A(�`��'3-:11�t�N�.SS: :. <br /> ... -..: � __:- . . ... _:.�. <br /> _ . -.. . -..:. -- _ _. <br /> :. . .. _ ... .. ... .... :.. ::.. - <br /> 4�04 -.. . . <br /> A KIlBRIDE INSURANCE 1NC <br /> TKJ CONSTRUCTlON INC 4501 NEBRASKA AYE <br /> 376Q6 AAARCLIFF TERRACE TAMPA F1336pg <br /> ZEPHYRHIL.LS F� 33541 <br /> (813j 238-7467 <br /> Business Descript�on• ROOFENG � Fonn of Busi�; CORPORATION <br /> ���� <br /> tFi�s policy, PaY �� � pnemaim an S rms �s qr. w�e agree l►� b .muranae as n <br /> THiS POLICY CONSISTS OF THE FO;LLOWING COVERAGE PARTS FOR WHICH A Pi�iEMlU�A IS lNOICATEO. <br /> THIS PREMIUM MAY BE SUBJECT T� AD.JUS7MENT'S. <br /> COMMERCIAL GENERAL LfAB. CCIVERAGE PART �� <br /> � i,5os.00 <br /> FEDERAL 7ERRORISM ACT $ 15 _ 00 <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> $ <br /> FL INSURANCE PREMIUM SURCH4RGE $ 33.8� <br /> $ <br /> $ <br /> Emaigency bTanagement Preparedness and Assistanca Trust vnd Fee: <br /> Ci6zens RecoupmorG Fee: <br /> Fbrfda Hunicang Cat2sUaphe Fund q5ses5�nert• ; i9 �1 <br /> �oraa�nsuranceG�aranryASSOeiaGonAssessment; S ia ia <br /> CAizens' 2005 Emergency AsSe8SrnenL• <br /> TOTAL ADVANCE PREMIUM $ 1 549 _ 81 <br /> �n ��� ANNUAL <br /> Coinsurdnce ontract; the rate charged in this pol cy is based upon the coinsurance ciause attached to this <br /> poi�cy with the conserrt of the insured. <br /> Form(s) and Endoraement(s) made part of lhis polic,y st lime pf is��e: <br /> ' ACfiOUS{Q2/08) CG2i70(01/08) fL0UC�3(09/08) fL0017(11/98) IL0021(09108) <br /> IL0932(07!02) NPQ194(OSi70} NP037!1(05/05) NP0381(01/01) N�0382(10/Q8) <br /> �IP0385(01/0Y) NP2001(09/10) <br /> Countersigned g <br /> 04/19,�11 <br /> �� In Witnes..� YJhErEOf. the �Ompany hgs c2u5ed 7hi8 (7o'iLy W 7C+ exB�f9tl a�ld dR8928d. bU�lh15 PDIiCy SFIa'I fqf b2 Y8110 Uflk55 I ' <br /> ��unlersigired by a tluly aunorized repr�sentaUve of the oonpany, � <br /> CP°SUMDEC(7 t-p8) <br /> COAIfjBL Ff/ <br />