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11-11894
Zephyrhills
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2011
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11-11894
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Last modified
2/9/2012 1:28:42 PM
Creation date
2/9/2012 1:28:40 PM
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Building Department
Building Department - Doc Type
Permit
Permit #
11-11894
Building Department - Name
GARCIA,BILLE & NOTHSTEIN,RICK
Address
5128 17TH ST
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F��� <br /> �'��' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YVYY) <br /> 5/19/2011 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOIDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW THIS CERTIFICATE OF INSURANCE pOE$ NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy�ies) must be endorsed. If SUBROGATION IS WAIVED, subject to <br /> [he terms and conditions of the policy, certain policies may require an endorsement. Astatement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement(s). <br /> PRODUCER <br /> NAME <br /> BUHL INSURANCE A�c,"No, exc 813 876-0057 (A/C, No) (813) 877-8540 <br /> PO Box 152698 ADORESS ktramer@buhlinsure . com <br /> Tampa, FL 33684 INSURER�S) AFFORDING COVERAGE NAICII <br /> INSURER A OHIO CASUALTY 24074 <br /> INSURED EASY A/C & WATER CONDITIONING INSURER B �ST AMERICAN INS . CO. <br /> 3G AIR CONDITIONINGAND HEATING INC. DBA INSURER C <br /> 9402 E. HWY . 92 SUITE 102 INSURER o <br /> TAMPA F 33610 INSURER E <br /> 813-633-0440 INSURER F <br /> COVERAGES CERTIFICATENUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> INSR TYPE OF INSURANCE <br /> �TR INSR YWD POLICY NUMBER (MM/DD/YYW) (MM/DD/YYYY) LIMITS <br /> GENERAL LIABILITY <br /> EACH OCCURRENCE S 1 OOO OOO <br /> X COMMERCIAL GENERAL LIABIUTY PREMISES (Ea occurrence) $ ZOO OOO <br /> I CLAIMS-MADE CI OCCUR MED EXP (Anyoneperson) $ 1 O <br /> A X BK� 53363387 05/21/11 05/21/12 pERSONAL BADV INJURV $ 1� 000 � 000 <br /> GENERAL AGGREGATE $ 2� OOO � OOO <br /> GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $ 2 OOO OOO <br /> POLICY }[ PRO- LOC $ <br /> JECT <br /> AUTOMOBILE LIABILITY SOO OOO <br /> Ea accident $ i <br /> X I ANYAUTO 05/21/11 05/21/12 BODILY INJURY (Per person) $ <br /> I AUTOSNED _I AUTOSUIED Bpl� 53363387 BODILYINJURY (Peraccitlent) $ <br /> B NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS (Per accident) <br /> X HIRED A[/TO PF[YS <br /> $ <br /> UMBRELLA LIAB pCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ g <br /> WORKERS COMPENSATION VJC STATU- OTH- <br /> AND EMPLOVERS' LIABILITY �,� TORY LIMITS ER <br /> ANV PROPRIETOR/PARTNERlEXECUTNE <br /> OFFICER/MEMBER EXCLUDED� ❑ N�A E L EACH ACCIDENT � <br /> (Mandatory inNH) EL DISEASE- EAEMPLOYEE $ <br /> Ifyes,descnbe untler <br /> DESCRIPTION OF OPERATIONS below E L DISEASE- POLICY LIMIT $ <br /> A SURETY BOND 3882057 o2/oa/io o2/os/i2 $5,000 <br /> DESCRIPTION OFOPERATIONS/LOCATIONS/VEHICLES (AttachACORD 101 AddiUOnalRemarksSchedule,dmorespaceisreqwred) <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> 5335 8TH STREET THE EXPIRATION DATE THEREOF, NOTICE WIIL BE DELIVERED IN <br /> ZEPHYRHILLS , FL 33540 ACCORDANCE WITH THE POLICY PROVISIONS <br /> AUTHORIZED REPRESENTATIVE <br /> ' ' '� � . ` , . , i:Y <br /> OO 1988-2010 ACORD CORPORATION All rights reserved. <br /> ACORD25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />
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