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11-12356
Zephyrhills
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2011
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11-12356
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Last modified
6/11/2012 12:45:21 PM
Creation date
6/11/2012 12:45:20 PM
Metadata
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Building Department
Company Name
DRIFTWOOD
Building Department - Doc Type
Permit
Permit #
11-12356
Building Department - Name
GRIFFIN,ELEANOR
Address
38365 IRONWOOD PL
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09/14/2011 13 50 FAx �002/003 <br /> '`�� °= �°� CERTIFICATE OF LIABILITY IN URANCE °"'�`� �"'°°""""� <br /> 09/74/11 <br /> THIS CERTIFlCATE IS IS9UED AS A MATTER OF INFORMATION ONLY AND C�NFER� O RIGHTS UPON TNE CERTIFlCATE NOLbER. THlB <br /> C�RTIFICA7E DOE3 NOT AFFIRMATIVELY OR NEGATIVELY AMENQ, EXTEND OR AE ER THE COVERAGE AFFORDED BY THE POLlCIES <br /> BELOw. TH13 CERTIFICATE O� �NSURANCE DqES NOT CONSTITUTE A CONTRACt E1W�EN THE ISSUING INSURER{S), AUTHORI2ED <br /> REPRESENTATIVE OR PR�DUCER, ANb THE CERTIFICATE HOLOER <br /> IMPORTANT: If the �ertlflcsta nqlder b an ADDIIIWlAL INSUaED, the polky{los) mustj ondoraotl. tf SUBROGA7ION IS WANED, subjoat to <br /> tho �orm9 and condltlons oi tho pollcy, Cerlaln polklos may wqulre an endorJanwnt A s, n! on thls csrtificAte doos not eonfor rights to tho <br /> certificato hol�le� io INu M such endorsan�nt�s). <br /> F vnd Insunnce CenNr !ne 813-764-3587 �!� du ner AA1 AU A!8 CPIW <br /> 414 N Aloxanew Straat B13-764-840Z <br /> PlantClty,FL�Jasa3 �� ,813-7 561 �,N,� <br /> Florida Insurance CeMor, Ine. ; Ju►a orldalnsuranceoenter <br /> ° �. C dD-2 � .' <br /> IMS REI�(S) AFFORDIN6 COVlRAOE NAIC s <br /> INSURED Craddock AlrConditianin9 d� � .,� u,�� : Add� In surance Cornpa 10324 <br /> Heating LLC iNSUn�r,, e: Bridg, eld Employers Ins Co 10701 <br /> POB 17 24 • - <br /> Oldsmar, FL 34877-1124 ���" c : . . ' <br /> waua�a o : � <br /> Nsu�e e : <br /> IN9URER F : <br /> COV�RAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED t THE fNSURED NAMEp ABONH FOR THE PQ�ICY PEFiIOD <br /> INDIGATED. NOTMTM5TANDING RNY RHDUIREMENT, TERM bR CONDI710N OF ANY CONT pR 0'YMER DOCUMENT WITN RESPECT TO WHICH TF11S <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY TM� POLICIE DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSION AND CONpITI OF SUCH PpLICIE3� LfMI SHOWN MqY MAVE 6EEN REDUCED B�/ AID CIAIMS. <br /> Tp ME OF IN9URANC! .. NUIISlR �' VAAITS . <br /> GENERqL LIABILITY ' G�►{ pCC�qRENCE t 500,00 <br /> A X CqMMERqAtGENERALLIABILITY 398721 1110l/70 71l01Mi PR Ms��sEN . _ �OO,pd <br /> I CLAIMS-MAOE X❑ OCCUa AAED E7tN . _ <br /> .S�+y o�w cenon) s 5,00 <br /> . � PERSONa� a �ov INJUftY s 600,00 <br /> GENERAIA(�3REOATE S 'I�OOO�OO <br /> GEN'LAGGREGAikuMiTqpp�IESPER PROOUCtS-�WpP,�,CG S 'I�OOQ�00 <br /> � F'OLICY X � LOC S <br /> A�ro�� �&uT�' COMBINED SINGLE LIMi7 s <br /> (Ea Yc�eM) <br /> A A�vAUro 60398721 ��rov�a; ��ro�r�� - �o��v��uuRr�a�,�«.�� a� zao,00 <br /> ALL ONMED AUTOS � BOOILY INJURY (Per a¢�tlu�1) i GO O OO <br /> X SCMEDULEDAUTOS '• � <br /> PROPERTY DAMA6E <br /> I IIitEG AU � OS (Pit BCdtlMlq S 1 DO,� <br /> NON-0WNEDAUTOS PIP s 10,00 <br /> _... � _._ <br /> VMBIIELIA UAB p��R EACH OCCURRENCE f <br /> E%CE56LIA8 Ca.air5-MAOE ACORECA7E . t °-- <br /> DEDUCTIBLE S <br /> RET ION � <br /> � C �� N � T � X TO UMf�T& ER <br /> ANO EMPLpYER6' �IAbILIrY .__... _ <br /> B ANY PROPRIET01ilPARTNER/EXECUTNE Y � N 830-291 S6 �91 � Q//26J72 E.L Fi�CH ACCIDENT S 'FOD�OQ <br /> ORFICEWMEMBER EXCLUDED9 � N 1 A <br /> �M�nAMSry In N}1� ' E.L DISGAS[ - EA EMPLOYE S '���i� <br /> K io�ia o � F..l. d8EA8E - POII(,Y I.IMR � 600.00 <br /> A lnstallatlon Float 0396M1 11l01M0; 11l01H1 LIn1R � <br /> �E6��nOp OF QPE�TIONS ����10N5 f VEHICLEb �Alfaah ACORD 101, Addltloml Remrk� iehaduN �Y men sp�a' nqWn� <br /> CERTIFICATE NOLDER CANCELLATiOM <br /> 2EPHBUI <br /> 9HOULD ANY OF E ABOVE DESCRIBED POWCIES BE GpNCHLLED BEFORE <br /> CI Of ZA h ri11�IS TME �XP�RArm DATE TMEREOF, NOTICE 1MLL BE DEL�RED IN <br /> tY P Y ACCORnANCE III 7HE POLICY PROVISK�NS. <br /> Building Departmont <br /> 5335 Sth Street ` <br /> 2ephyrhills, FL 338540 AYTxPaLEO REPRlE r�rne <br /> 4� <br /> � 7086 9009 ACORD CORPQRATION. All rlghts ressrved. <br /> ACORD Z5 (2004l09) T11e ACORD nam� and logo are registered mark� ACORD <br />
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