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Huu-1y—��11 13�14 HOCKf�1AN INSURANCE AGENCY 213 281 1086 P.01i01
<br /> �,
<br /> ACORL�� DATE(MINlDD/YYY'I) �,
<br /> �,, CERTIFICATE OF LIABIL.ITY lNSURANCE oar�s»�
<br /> THIS CERTIFICATE !3 ISSUED AS A MA'TTER OF INFORMAT]ON ONLY AND CONFERS NO RIGHTS UPON THE CERTiFICATE HOLDER. THI$ ;�,,,,
<br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER TH� COVERAGE AFFORDED BY THE POLIGIE8 �'.;
<br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CON7RACT SE?WEEN THE 15SUING INSURER(5), AUTHORIZEO ,,
<br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br /> IMPORTAt�T: If the c6rt�flcate holder fg an ADDITIONAL INSURED the policy(ies) must be endorsed_ If SUBROGATION IS WAIVED, subject to .�-,.
<br /> the terms and conditions of the po(lcy, certain pollcles may require an endorsement. A 5qtement on this Gertlftcate does not confer rights to the .,
<br /> certificate holder In lie� of such endorsement s.
<br /> DRODUCER GOMTACT
<br /> 813-636�OD0 w,ME Gafl Walunas
<br /> Hockman Insuranca Agency, Inc. 813-261-1086 PHON ~ A 813-281-1086 '�' ��
<br /> 3d38 Cotwefl Avenue No,_EM��. ,,, arc No :
<br /> Tampa, FL 33614 E-MA
<br /> Hockman Inaurance Agency, Ina aoortESS: __„_ ,,_ M ,__
<br /> INSURE AFFORDING COVE _., NAIC il
<br /> . w wsuReRa:fdorthPointelnsurance __ _�_
<br /> fNBURED Randal� Mulllns Construction IN9 eJRERe �
<br /> Inc., 8 Randell Mullins - ---' ' " ""
<br /> 9351 Del ray Dr INSURER C: � _, ,_ ._
<br /> New Port Richey, FL 34654-5655 INSURERD; __ � �
<br /> INSURER E ' _ v �
<br /> INSURER F : � � � 1 '
<br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: '
<br /> THIS 15 TO CERTIFY THNT THE POUGES OF IN9URANCE LISTED BELOW HAVE OEEN ISSUED TO THE INSURED NAMED AsOVE FOR THE POLICY PERIOp ,° '
<br /> INO�CATED NOTWI7NSTANDING ANY REqUIREMENT, TERM OR CONDlT10N OF ANY �ONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 7Ff16 °~
<br /> CERTIFICATE MAY 9E ISSUED OR MAY PERTAIN, TNE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
<br /> EXCLUSIONS AND CONDITIONS OF SUCH POLIC�ES, LIMITS SNOWN MAY HAVE BE�N REDUCED SY PAID CLAIMS,
<br /> IN3R �ypE OF IN6URANCE sV POLICY NUMBER MMl�DlYYr MMlDD/YYYY LIM178
<br /> OEN�RAL LIACIUTY
<br /> EACN OCCURRENCE 5 � ���"
<br /> /4 X� COMMERCIAL OENE�L LIA61LIlY � AU06242019 R126'124 �6��L4/� � U6/24/12 pREMI3E3 E9 OC ca $ i� �
<br /> CLAIMS-MADE � OCCUR nnEp EXA (� one erson) � si'Q ,
<br /> I i � � � PERSO S ADV �NJUR1' � �e0� f ��
<br /> �.,.. _.
<br /> �� � GENERALAGGREGATE_ E 2 ,��N� ,
<br /> GEN'L AOOREGATE �IM�7 �PPL�ES PER: PRODUCTS - GOMP/OP AOG 5 2 ���i
<br /> r— i - , .-. ,.-,-
<br /> PRO
<br /> i POUCY ^ I �OC $
<br /> AUTOMOBILE LIABILITY ' M NEO SINGL.E LIMIT
<br /> (Ea acciaenq
<br /> ANY AUTO BOD�LY INJURY (Per pereon) 5
<br /> A�L OWNE❑ � SCHEDULEO BDDILY INJURY (POr �Ccidenf) S --�� �
<br /> j� AU708 AUTOS
<br /> NON-0WNEO I Pft P D�A � A E $
<br /> H�RE� AUTUS i^ AUTOS {PQr occidenU
<br /> i -- E ,
<br /> UM9RELW LIAB ; OCCUR EACH OCCURFENCE S
<br /> ~�, EkCES61.w8 G�AIMS-MADE � AGGREGATE I,� � �'
<br /> I OEO RE7ENTION $ I — �— g —
<br /> -
<br /> WORKER$ COMPENSATION i WC S7ATU- OTN� '
<br /> AND EMPLOYERB' LIABIUTY 'I _. f3.,, ,,.._
<br /> I ANY PROPRIETOR/PARTNERIEXECUTIVE Y � µ E.�. £ACH ACCI�ENT S "
<br /> j OFFICER/MEMBBR ExCLUDED7 a� N I A i � s
<br /> (Meneetory {n NH) � E L. D�SEASE - EA EMPLOYEE 3 '�
<br /> II yoo deacriDe unaer r---- .
<br /> DESCRIPTI N OF OPEFiATIONS D910w E.L. DISEASE - POUCY L{MIT I S �� .
<br /> i
<br /> i l i
<br /> i � ,
<br /> D@3CRIDTION OF OPERATIONS ! LOCATIONS / VEH�GIES (AK�ch ACORD 707, AdCltlona� Ram�rxn ScneUUle, I� mcro spaco Is req�IroA) �
<br /> CERTIFtCATE_HOL..:.�_ _ �, � � T � CANCEI.LATION
<br /> — 1
<br /> SHOULD ANY OF THF A80V£ DE3CRIBED POUCIES 8E CANCELLED B�FOEI'E;' s , ;
<br /> CIL of Ze h rhills THE EXPIRATION DATE TMEREOF, NOTIGE WIL� BE DELIVEREO 'IN=. ";
<br /> Y P Y ACCORDANCE WITFi TH� POLICY PftOV1SfON$.
<br /> 5335 8` Street
<br /> Zephyrhills FI 33542 AUTHOR�ED REPRESENTATIVE
<br /> / L.�.-. �
<br /> � 1968-2U10 ACORD CORPORATION. All rights resarvod'. ,
<br /> ' ---- __ ,...._....._. -r�_ w.-..�c� ......... ......1 1,..... .�... �o...ote�e.1 rt�nr4a nf A(�C1R1'1
<br /> TOTRL P.01
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