My WebLink
|
Help
|
About
|
Sign Out
Browse
Search
11-12006
Zephyrhills
>
Building Department
>
Permits
>
2011
>
11-12006
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/30/2012 11:42:10 AM
Creation date
3/30/2012 11:42:09 AM
Metadata
Fields
Template:
Building Department
Company Name
FLORIDA MEDICAL CLINIC
Building Department - Doc Type
Permit
Permit #
11-12006
Building Department - Name
FMC MARKET SQUARE INC
Address
38105 MARKET SQUARE DR
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
11
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
A� � CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYW) <br /> asn er2o� � <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES 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 /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this ceRificate does not confer rights to the <br /> certificate holder in lieu of such endorsement�s . <br /> PRODUCER CONTACT <br /> MARSH USA INC. NAME: <br /> 99 HIGH STREET PHON o t: F A/C No : <br /> BOSTON, MA 02110 ADDRIESS: <br /> Attn: stanleyblackanddecker.certrequest@marsh.com <br /> INSURER S AFFORDING COVERAGE NAIC # <br /> 72800 -SCSS-GAW-10-11 iNSURER q. Hartford Fire Insurance Co 19682 <br /> INSURED INSURER B, N/A N/A <br /> STANLEY CONVERGENT SECURITY Twin Ci Fire Insurance Co 29459 <br /> SOLUTIONS INSURERC. � <br /> (FORMERLY HSM ELECTRONIC PROTECTION INSURER D. NIA N/A <br /> SERVICES, INC.) <br /> 55 SHUMAN BLVD., SUITE 900 iNSUrtert e. Harttord Accident 8 Indemnity Co. 22357 <br /> NAPERVILLE,IL 60563 INSURERF. <br /> COVERAGES CERTIFICATE NUMBER: NYC-005995927-t0 REVISION NUMBER:2 <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 /> �L7R TYPE OF INSURANCE ADDL UBR pOLICY NUMBER MMIDD MMIDD/YYYY LIMITS <br /> A GENERAL LIABIL�TY 02 CSE J77005 O7/O1/?O�O O7/O1/ZO'I'I EqCH OCCURRENCE $ ?,OOO,OOO <br /> X COMMERCIAL GENERAL LIABILITY A N 2,000,000 <br /> PREMISES Ea occurtence S <br /> CLAIMS-MADE � OCCUR MED EXP (Any one person) $ 10,000 <br /> PERSONAL 8 ADV INJURY $ 2,000,000 <br /> GENERALAGGREGATE $ 2,000,000 <br /> GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPlOPAGG $ <br /> X POLICY PR � LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY Peraccident $ <br /> AUTOS AUTOS � 1 <br /> NONAWNED PROPERTY DAMAGE <br /> HIRED AUTOS AUTOS Per acddent $ <br /> $ <br /> UMBRELLA LIAB OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DED RETENTION $ $ <br /> C WORKERS COMPENSATION 02WBRP47700 (ND WIJ O7/O'I/?O'IO O7IOIIZO'I'I X VoC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY � <br /> A ANY PROPRIETOR/PARTNER/EXECUTIVE Y/ N 02 XWE J77002 (NY OH � 07/O'IIZO'IO O7/O'IIZO�'I 1,000,000 <br /> OFFICER/MEMBEREXCLUDED� � N!A E.L.EACHACCIDENT $ <br /> E �Mandatory in NH) 02 WN J77000 (CA) 07/011201 O 07/O112011 E.L DISEASE - EA EMPLOYE $ 1,000,000 <br /> If y es, describe under CONTINUED ON ATTACHED 1,000,000 <br /> DESCRIPTION OF OPERATIONS below E.L DISEASE - POLICY LIMIT $ <br /> A PRODUCTS LIABILITY/ 02 JSE J77014 (PRIMARY) 07/Ot/2010 07/01/2011 EACH OCCURRENCE 500,000 <br /> COMPLETED OPERATIONS <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD t07, Additional Remarks Schedule, if more space is required) <br /> VIDENCE OF COVERAGE <br /> CERTIFICATE HOLDER CANCELLATION <br /> CITY OF ZEPHYRHILLS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> BUILDING DEPARTMENT THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 5335 8TH STREEET ACCORDANCE WITH THE POLICY PROVISIONS. <br /> ZEPHYRHILLS, FL 33542 <br /> AUTHORIZED REPRESENTATIVE <br /> of Marsh USA Inc. <br /> Hilary Zeller �--�� ��-� <br /> O 1988-2010 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />
The URL can be used to link to this page
Your browser does not support the video tag.