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11-12377
Zephyrhills
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Building Department
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2011
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11-12377
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Last modified
6/11/2012 12:57:57 PM
Creation date
6/11/2012 12:57:56 PM
Metadata
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Building Department
Company Name
ZEPHYRHILLS FIRE DEPARTMENT
Building Department - Doc Type
Permit
Permit #
11-12377
Building Department - Name
ZEPHYRHILLS FIRE DEPARTMENT
Address
38410 6TH AVE
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�� INTRFIR-01 NIBLACKD <br /> ACORO CERTIFICATE OF LIABILITY 1NSURANCE °��°°"'""' <br /> �� 9t13l2011 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO WGHTS UPON THE CER7IFICATE HOLDER. THIS <br /> CER7IFlCATE DOES NOT AFFIitMAT1VELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BYTHE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTTME A CONTRACT BEiVYEEN THE ISSUING INSURER(S), AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. <br /> I IMPORTANT: If the certificate hdder is an AODtTIONAL INSURED, the policy(+es) must be endorsed. If SUBROGATION IS WANED, subject to <br /> the tertns and conditions of the policy, certain policies may require an endorsement A staGemerrt on this certficate does not confer rights to the <br /> certificate hdder in lieu of such end orsemerrt(s). <br /> ���� License # L000107 � Yn►ian Slnofford <br /> IOA Longwood PHONE Fau <br /> 1855 West State Road 434 � E, : (407) 788�000 ��, � 788-7933 <br /> Longwood, FL 32750 �� vivian.swoffond(�ioausa.com <br /> 61SlIRBt(S) AFFORDOiG COVERAGE NAIC # <br /> �R w: Tudor lns Co 37982 <br /> wsurs�o � e : <br /> Intrepid Fire Protection, LLC ��R �= <br /> 314 E Azalea Ave. iNSUr� o: <br /> Tampa, F133612 � <br /> INSURER F • <br /> COVERAGES CERTiFlCATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THAT THE POL IqES OF INSURANCE USTEO BELOW HAVE BEEN ISS{JED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATE�. NOTWfTHSTANDING ANY REQUIREMENT, TERM OR GONDITION OF ANY CON7RACT OR OTHER DOCUMENT WffH RESPECT TO WHICH THiS <br /> CERTIFICATE MAY BE ISSUED �t MAY PERTAIN, THE INSURANCE AFFORpED BY THE POIJGES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDff10NS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CUUMS_ <br /> �� 7YPE � INSURIWCE yyyp POUCY NUMBER N DD � POLIf.YEI� LIMfiS <br /> GENERAL LIABLLRY � <br /> g encr+occuw�ENCE S 1,DOO,O�O <br /> A X COMMERGAL GENERAL LIABILfTY I � GP0737134 8/3/2D71 � SI3IZO�2 p���S Ea xwrrence S 'IOO�OOO <br /> CWMS-MADE � OCCUR i � � ` MED EXP (Nry one personj S S�OOO <br /> I � � � j PERSONAL 8 ADV INJURY S 1,000,000 <br /> � ' � � (�IER/1L AGGREGJ+TE S Z,OOO <br /> GENL AGGREGATE LIMIT APPLIES PER � � i � PRODUCTS - COMP/OP A6G ; ��OOO�OOO <br /> POLiCY �� LOC � S <br /> A�p�{� Upg�y �OMBI� UMR E <br /> � <br /> /WY AUTO j � � � . BODILY INJURY (Per person) S <br /> ALL OWNED SCHEDULm i BODILY INJURY (Per acddent) S <br /> AUTOS AUTOS <br /> HIRED AUTOS A�ON-0WNED ' I i PROPER �DAMAGE _ <br /> j <br /> E <br /> �� V � OCCUR ' i i EACJi OCCURRENCE S <br /> EXCESS LIAB _ CLAIMS-MADE � ` i I 1 AGGREGATE S <br /> DED RETENT�oN 5 —}°- I I I � . s <br /> YIIORI�RS GOYPB�SATION 1 � ' T� S IM S EF2 <br /> AND EMPLOYERS' WBtT' <br /> ANY PROPRIETORRAR7NER�D�CUTNE Y� � N! A i I ' � EL EACH ACGDENT E <br /> OFFlCETtI��iB�IBER EXCLUDED? � <br /> M� �^ N� � ; I ' EL. DISEASE - EA EMP S <br /> Hyes descnbe � � — <br /> DESCRIPTION OF OPERAT1pNS bebw E.L DISEASE - POLJCY UMR S <br /> A General Liability � PC,P0737134 Sl3t2011 ; 8/3/2012 Included <br /> E <br /> ^ � i � I <br /> i <br /> DESCI�TION ��ERATWNS ! LOCATIOliS / VEFUCL.ES (/Waeh ACORD 101. Mdidond Ranarks Sehedule, � more spa�s is raQuired) <br /> CERTIFICATE HOLDER CANCELLATION <br /> i SHOULD ANY pF 7HE ABOVE DESCR�ED POUCIES BE GANCE�IED BEFORE <br /> � 7HE EXPNiA710N DATE THEREOF, NOTICE YVILL BE DELIVERED IN <br /> I ACCORDANCE WRH THE POLICY PROVISIONS. <br /> 3 <br /> � wtrrHOt�n �xrwrne <br /> City of 2ephyrhills Building DepartmerTt <br /> 5335 8th Street � �. ,tr- t ) <br /> ilis FL 33542 �� <br /> � 1988-20�0 ACORD CORPORATION. All rights reserved. <br /> ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br /> aiE ._ - — . ���>- - _.,.. ..�:. ' <br />
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