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11-11869
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2011
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11-11869
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Last modified
2/9/2012 1:12:30 PM
Creation date
2/9/2012 1:12:25 PM
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Building Department
Company Name
ZEPHYR COMMONS
Building Department - Doc Type
Permit
Permit #
11-11869
Building Department - Name
ZEPHYR COMMONS LLC
Address
7952 7954 GALL BLVD
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AC�RDµ CERTIFiCATE 4F LIABILITY 1NSURANCE DATE{MM1DDfYYYY} <br /> 05/11/2011 <br /> THIS CEF2TIFlCATE IS ISSUED AS A MA7TER O� INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> GERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY T1iE POLICIES <br /> BELOW. THIS CERTIFfCATE OF INSURANCE OOES NOT CONSTITi1TE A CONTRAC7 BETWEEN THf ISSUING INSURER(S), AUTNORfZEd <br /> REPRESENTATIVE OR PRODUCE1t, AND 7HE CER71FfCATE FfOLDER. <br /> tMPORTANT: If the cartiflcate holder is an ADDITIONAL 1NSURED, the policy(iss} must be endorsed. If SUBROGATION IS WAIVED, subJect to <br /> the te�ms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br /> certif{cate holder in lieu of such endorsement(s}. <br /> PROOUCER " Mark Shobe <br /> NAIYEE: <br /> Tnsurance Office of America, Inc. tac,Na�exg,.( �^� Na � (813)637-8484 <br /> 4915 W. Cypress Street E-MAIL <br /> --. .._..._.,. .... .,..__. .. ... <br /> ADDRES$: <br /> --------------____. _ _. ....._..._..�__ <br /> Tampa, FL 33607 PRODUCER <br /> ..�.�ts�f� .._.... ._.._. .- - ----- <br /> INSURER(S� AFFORDING COVERAGE __ _ Nq�C �I 4 <br /> _�........... <br /> ----- - - -__-___._. ... ._-- .. __ ._. --._. .,------ ------- <br /> INSURED INSURERA: F'II'St Mercury Ins �O ��( )S] <br /> ---------------------------------- - ... _..---- ------ _. <br /> Critical System Soiutions, LLC �NSUaERS: Auto-Owners Ins Co. 18988 <br /> --._.......__._..____...�..__..._.._...__ ._._...._..._._.__._.____�______... ._------�- - ------------ ----------.............._.._ <br /> 2830 Scherer Drive �NSUeeRC: Com�rce & Indust Ins C 1941 <br /> Suite 300 - -- -----,--_.._...---.._.._.._-- — <br /> �HSUReR o: Bri dgef i el d Emp oy ers Ins Co 1070I <br /> -- �___....__�___.._ .... ....... .................---..-� -------- - --...._.._. ----- - - - -----_....__.. ._ <br /> St.Petersburg, FL 33716 IHSURERE: <br /> INSURERF: - - ------ - .°-. .--------- <br /> COVERAGES CERTIFICATE NUMBER: 2010.20I1 Master REVISION NUMBER: <br /> THtS IS TO CEF2TIFY Th1AT THE POLICIES OF lNSURAEVCE LISTEQ BELOW HAVE BEEN ISSUEO Tb THE INStJRED NAMED ABOVE FOR TME POLICY PERI00 <br /> I�lDICATED. NOTWITNSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CON7RACT OR OTWER OOCUMENT WITH RESPECT TO WFIICH TH�S <br /> CERTIFICATE MAY BE tSSUED OF2 MAY PERTAtN, THE INSURANCE AFFOROED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT FO ALL THE TERMS, <br /> EXCLl3SIO ANO C ONDITlONS OF SUCH POLfCIES. LIMITS SHOWN MAY HAVE BEEIV REDUCED BY PAfD CLAIM <br /> INSR . ___...__-.- ,-•----..__ .__.._....._..._..._.._..----ADQL$UBR ------------------- - POLICYEFF POLICYEXP ----- -----------°--- .__�_� -- <br /> �� TYPE OF tN3URANCE INSR VYND POLICV NUMBER AtM1DD MMIDDIYYYY LIMITS <br /> CaENERAL UABILITY Fr�M�oaxiz 08115l2010 08/95/2011 EACH OCCURRENCE $ 1� � � QQQ <br /> .._.. <br /> DAMA R NTED-----------._._......._.._.--- <br /> X COMMERCSAI GENERAL I.IA91LfTY pR������� _$ __ SO � OOO <br /> - - --- <br /> CLAtMS-MADE X OCCUR MED EXP (Arty one person) $ S OOO <br /> ........,._---- __...> > <br /> ._ ...._ �._. _.___--.,— <br /> A X LTD ContraC L1 3I7 ^ PER30NAL8ADVINJURY _$ 1,0 00,000 <br /> —.____.---- ----- <br /> .._.__ .,......._._-------...._.._.__...._..---.�___ G ENERAL AGGREGATE $ Z� OOO � OQO <br /> • .......... ....._� <br /> GEN'L AGGREGAT� LIMIT APPLIES PER: PRODUCTS - COMPlOP AGG $ _ 2� U(}O � OQO <br /> PRO ----._..__.._......_......._.._._._--------- <br /> POLICY X ,JECT LOC 3 <br /> AUTOfAOBILE UABILITY 477320560 081'15/2010 08/1512091 COMBINEfl SINGLE i.IM1T <br /> ---- s <br /> X ANY AUTO (Ea accidenty 1 Q�� QQ� <br /> ..r._._._�._.__....._......--°-°_-- ------------'.._..___._.t-•---�- <br /> ---- BODILY INJURY (Per person} $ <br /> AILOWNEDAUTOS - -------._......_._. .--------------- � <br /> -- - 80DILY INJURY (Per accident� $ � <br /> B SCHEpULEDAUTOS -----------------------___.-°---------+ <br /> X HIRED AUTOS {�Per accide t DAMAGE $ <br /> X NON-OWNED AUTOS � $ <br /> __'_... --------. ..- ---_...------- -,._......_..._._�..__._..�.� <br /> $ <br /> UMBREL.LA UAB X OCCUR BE05245740 08l15/2010 08l1512011 Eq OCC $ 4��� � � 0 <br /> __° __ — ------ -----------.... .............. <br /> EXCE33 LIAB CLAIMS-MADE AGGREGATE s a aoa o0 <br /> C _----...�_.�_._.�..___._....--- — � � <br /> p�oucrie�� .__ UMBRELLA FOR s --------------..� <br /> -- ....._._. ._-------- <br /> X RE7ENTION $ Q y <br /> WORKERB COMPENSATION d83034728 08/15l2010 08l1512011 X W STATU- OTH- <br /> AND EMPLOYERS' LIABILITY Y r N T RY I T __ �F2, ,,____ <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE E.l. EACH ACCIDENT $ �. � OOO � OOO <br /> D OFFICER/MEMBER EXCLUAED? � N! A <br /> (Mandat in NH --•-••--�--------- --------- ---..._�______._.__ <br /> aY 1 E.L. DISEASE - EA EMPLOYE $ 1� OOO � OOU <br /> Ifyes, describe under ------------..-....-_... --- -- -- - <br /> DESCRIPTION Of OpERA710NS below E.L. DISEASE - POLICY E.IMIT $ 1� OOO OO <br /> PESCRfPTtON OF pAERATION$ ! LOCA7tONS ! YEMICLES (AttdCh ACORD 101, AdtllUonal Remarks Schedule, If more apeoe is requlred) <br /> CERTIFICATE HOLDER CANCELL.ATION <br /> FAX: 813.780.002I <br /> SHOULD ANY OF THE ABOVE DESCRIB£D POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION QATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> ACCORDANCE WITH THE POLICY PROVISIONS. <br /> �l ty of Ze �1 1"�'1l � � S BUl � al Jl ��pt AUTHORIZED REPRESEIJTATIVE � `* � r �� � <br /> p Y 9 �� ��. ��. r-:.::- ., �.t.. ..�,:_. <br /> 5335 8th Street <br /> Ze hyrhi1ls, FL 33542 Mark Shobe ElAZA <br /> �O 1988-2009 ACORD CORPORATtON. Alf rights reserved. <br /> ACORD 25 (2009109} The ACORD name and logo are registered marks of ACORD <br />
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