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11-11930
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2011
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11-11930
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Last modified
3/30/2012 9:24:36 AM
Creation date
3/30/2012 9:24:33 AM
Metadata
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Building Department
Company Name
ABC PIZZA OF ZEPHYRHILLS INC
Building Department - Doc Type
Permit
Permit #
11-11930
Building Department - Name
ABC PIZZA OF ZEPHYRHILLS INC
Address
5963 GALL BLVD
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�°� CERTIFICATE OF LIABILITY INSURANCE 6 j27i2a� <br /> TN13 CERTfFICATE IS 159UED AS A MATTER OF INFGRMATION ONLY AND CpkF�RS NO RIGHTS UPON TNE CERTIFICATE (idLOER. TFNS <br /> CERi1FICAT� OpES NOT AFFIRMATNELY OR N�C+IITIVELY AMEND, �XTEND 012 ALTER THE COYERAG� AFFORDED BY THE POUCIES <br /> BE�OW. THl8 CERTIFICA7E OF INSURANCE DOES NOT CON3TIME A CONTRAC7 B�1'VYEEN THE ISSUING IN8URER(S), AUTHORIZED <br /> REPR�SQVTATNE OR PRODUC�R, AND THE CERTIFICA7'� MCLDER. <br /> IN�ORTANT: If the ce cabe holtlar 1s an ADDI1'IpNAL RED, ths policy(les) must be endorled, If SUBROGATIQN f$ WAIV�O. SubjeCt to <br /> Nte terms and condltlonc of !he ppliCy. certsin poReles may rpquire 8n e�do�semenL A sfalement on thi9 certificabe does not eoMor nghfs to the <br /> �art�GG�be holdor in Ilsu of sueh endQrgeime s. <br /> PROGYCER NA � T 111 HaID�i'Ox'� <br /> Hamero�� Ineurarice Ageacy .. PKbN� (813) 870-628� .. .. �.F"� <br /> tN.�'n.NO, E7etj:. I (A1C� No�: f 613 ) 075-3x�0 <br /> PO Hox 270127 ��eai@tam�bey.��e.com . <br /> PRODUCER paoo03ox ..- - - --- - ... <br /> . ..----- C.U.S.LOMERID.f.. .�. ._..___....._.... ._ . ...._ . <br /> Tampa _._.....__ FI� _ 33668 _ ... . IN9UREq{S) AFFOrmI�ICiCWEAAOE _ . .. .. MAIC <br /> IN9URE0 _� F . � <br /> ,INSURERA:�eXa.CBlJ 3��@9 ... .. ...... . . .. 9'704, <br /> INSIIRER B : <br /> TE�O�A,S G LI3NOCEC SI,EC'��I� CO � .,._......___.. ... .__._._.._... ..... .. .....� _.. <br /> INSURE�I C ; <br /> 22917 BTERLIIQG L�,t�FOR LOOP ..._._.._ ... _.._......_.. _ . ..._.. ._._ <br /> INBUREp D : <br /> INBttREft E : � - _ _ . _.1. . -. <br /> �UTZ FL 33549 � u F: . . , <br /> COVERAG�S CERTiFICA7'� NUMBER:cs.iosa000991 REVISION NUMBER; <br /> YNIS 15 TO CERTIFY THA7 71iE POIICIES OF INSURANCE LISTED B6LOW HAVE BEEN ISSUED TO THE INSURED NAMED AepV� FOR THE POLICY PERIOD <br /> 1N�IGATEO� NOTWlTHSTMDING ANY REQUIREMENt, T�RM GR COMDITION OF ANY CONTRACT OR 01'HER DQCUMENT 1MTH RESPECT Tp WHICH THIS <br /> ceRn�ICATE MAY BE issuEO pR MAY pERTAIN THE INSURANC6 AFFORDED BY THE PdCICIES DESCRIBEO HEREIN IS $UBJECT TQ qLf. TNE TERMS <br /> EXCLU310NS AND CONDITIONS OF SUCW POIICtES, LIMITS 3HOWN MAY HAVE BEEN REDUCED BY PAID CI�AIMS. <br /> __ ...._ _.__ .. . ...._ . ...._._._., .. . <br /> �L� TYPEOFINBURANC� P061CrNUNBER M�p ��PSLJCY�KR .�..._ .. _. LIMITS _ -. .. . <br /> g ������ E!1CM OCCURRENCE 5 1 w 000, OD4 <br /> X COMMERCIAI, QEN@RAL LIABILRY � - ". .'- `. . <br /> p+ w. . j C��S-MADE n OCCUp 1C13XJ70480 / /9/2012 PRlMlSES.lE0.om+nancel �_,.,....� 2�� <br /> a�o��«,e��,.. .� io,00a <br /> . . .... <br /> ...--� -°--_ --. ,--_ � PERSOWLL 8 ADV INJURY S 1� OOO , OOO <br /> -- � GENF.RAL AGGREGAtE S 2, 000, 000 <br /> c�nr� AGOREOntE uMrc pa�.iES aER; � PROOUCTS - COMP� aGG a 2, 000 , 000 <br /> 7C � POLICY PItG �� ' . __ _, ._.. <br /> nuraxoeic¢ ua�urv cO��NEO StNG�E un�rr <br /> aNr �uro (� a�Ml = <br /> I1E,L OWhIfO AUT03 BODn.Y INJURY (Px Dereon) s ._. ... <br /> BCHEDUtED AU7'OS � BODILY INJURY (Pe► �ed0q� g �� <br /> PRpP�RTYONNAGE _ . <br /> MIRED AlITO& (PK eoCltleM) <br /> ...._...... ._ . . ,..... ._. . .__. <br /> _ N .ouVNEO At/T'08 ` <br /> .. .. .; ......_.... <br /> � uMar���.a urs <br /> _.. OCCUR I F.ACM OCCURR�NCE � i <br /> � FJtC�33 W4B CLNMS�hMDE ._ _..._ .... _ <br /> oEOUC7191.E AGaREGATE , S _ _..-- <br /> i <br /> R ON S • ........_.. <br /> M�OIiKERB COMPEW�A710N YYC 9TATU. ' � TH. <br /> � �� � � TORY LIMI'f3.1 i ER <br /> ANY PROPRIETOWPARINERI�XEpJTfVE YIq ._. _ .. . <br /> OFFICER�IAEM�ER E%CLU08D9 a N I A E.L EACH ACCID�Nr s <br /> fNaneNe+Y 1n NH) • .. �� . . .. <br /> N�e dNixlbB IMtler E.L DISEAS6 •�A EMPLOYE i ...__. .. <br /> OEeCRIP710N OF OPERATIONS belew ,•-..__ .. .. . . .. <br /> E.L.DIS8A8E-POLICY�IM�T � <br /> O�RIP1r10N OF OPERA'ItONSI LOCA7�ON9! VEMICLEB (�Shch ACORD 101. Ad�tlenY R•marks 9eMAule, M mon sp�q b <br /> 10 Days writtpn liOC i'os �fpn-pay��ti, <br /> G�63�ock Tho�e G <br /> LiCeaeaM �C000299b <br /> �a�F�cA� Ho�o�R CANCEI.LATION <br /> ;813)780-002i <br /> SMpULD ANY OF TF1E ABOVE OESCRIBED Pp�ICIEB SE GqNCELLED B�FdRE <br /> THE EXP�RATION DATE THEREOF, NO?ICE NIILI, BE DELNEitED IN <br /> City Of Z6phy�C�hi119 ACCORDANCE WITH TNE POLICY PROV1310NS. <br /> k3uf.lding Aepartment <br /> 5338 @th 3t, �utrioRrzeon��eseHTanv{ <br /> Z�phy��sills, FZ, 335�2^-4312 <br /> 141 Ham�ro�f/bE�7TT� � � <br /> ►CORp 25 (2008l09) � 9988.�009 ACORD CORPORATION, All right� �=erved� <br /> VSp25 �oosos� The ACOIta nante and logo are registerad marks pf ACORO <br />
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