11-12155 - Laserfiche WebLink

Browse Search

ACORD, CERTIFICATE OF LIABILITY INSURANCE DATE(MhYDD1YW1� 07/14/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORAAATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIfICATE DOES NOT AFFIRMATNELY OR NEGATNELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETNlEEN THE ISSUING �NSURER(S), AUTHORIZED REPRESENTATNE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT If the cerdflcate hdder is an ADDITIONAL INSURED, the poNcy(les) must be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certiflcate holder in Ileu of such endorsement(s). PROOUCER C NTACT NAME: Insurance Office of America, Inc. �"�°N;_ 407 788.3000 �ac.No�:407.788.7933 P.O. Box 162207 e.� aooaess: �U��R - -- ---- ----- - — --- A tamonte Springs, FL 32716-2207 CUSTOMERID�: INSURER{S) AFFORDMJG COVERAGE NAIC / INSURED INSURERA ONmers Insurance 32700 ]ack Schimelfining INSURERB P.O. Box 7299 INSURERC Wesley Chapel, FL 33545-0104 INSURERD � INSURER E INSURER F - - -- -- - - - - - - - COVERAGES CERTIFICATE NUMBER: 2011/2012 REYISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. TNE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AlL THE TERMS. EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES. LIMITS SHOVIAV MAY HAVE BEEN REDUCED BY PAID CLAIMS. ��7}Z TYPE OP INSURANCE � INSR YWD POLICY NUMBER � � LIMITS GENERAlL1ABiLIN 7253758 09/23/2011 09123/2012 =, ,�_�_ �FF_r __ � t 1,000,00 -,..t.•:.:_F r,:F a-F-� � 50, 00 X , .u� �i n�:F..i :ii-, i��_.�_:�,„ �_L-.I �_-P . X, _ _ _ JF _ _—�—_ _ _._ — �,tEC E'F �:rr -, r-rr - ;� � , Q rj �Q A I =cF_�_F=L�-_�•I'i.tFi '� 1�0��0 j .: �-�:i �.�_� .. 7. i Z� �� 0 �F L 1�=='E'= _ -� 71 `F='L E , >EF - - - _ _ -�F�__�i i_T_ _ '�'F ' _ _- 'T 2�00�� X f �LI� - `p- � � � � '� AUTOMOBILE LIABIIrtY � � l�C = r: •L= _r u i f� �i� ' t i � i� �� ' 1�`. JI I tl � .� L !.�!= i-u ��r:� �� { , - t - E_��1�C � r � _�L L 1_i i' - 4 dcr� '{ ='F� ='Ff- f d,:- .: rti_C-i _ F-�,.._i.n t p �� .-� ; r� i --- — — –� – – UMBRELLALIAB , � I _-�_�1 ��_�_1FF_t __ �j EXCESSLIAB -�: .,�- i:. � ---- . __, ? L - IE_E i � f k�- "!I � 1 '( - t WORKERS COMPENSATION __ T T i _ h '. , AND EMPlOYERS' LIABILITY Y! N T�F , I'.1! -F -f � =F�_=�FIET� �F F1FT !F=�= ==�_T� �E - - -�_i 1�_�_ L=t T { �F= -EF r•�=1 tE=F E -L CE=� � N!A =- _ - (Mandatory m NH) - -. 7�_�_-it? _ri:�� -- I E � f � j--- --- — ��E�_FIFT - q rF - „'E_ ' ' -� r. t,�� . _ - - _� �Ec :E - - _�� _R il' 'F DESCRIPTION OF OPERATIONS! LOCATIONS I4EHICLES (Alteeh ACORD 101. Additional Remarks Schedub, ff mwe spue is requind) CERTIFICATE HOIDER CANCELLATION FAX• 813.780.0021 SHOULD ANY OF TFE ABOYE DESCRIBED POLIC�S BE CANCELLED BEFORE THE EXPNiATION DATE THERE�, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH TFIE PW.ICY PROVISiONS. Cl t y of Zephyrhi 11 s Bui 1 di ng Dept AUTHORIZED REPRESENTATNE � � 5335 8th Street �'. � '. - Ze hyrhills , Fl 33542 Mark Manfre RICIA OO 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD