13-14191 - Laserfiche WebLink

Browse Search

Ac°� CERTIFICATE OF LIABILITY INSURANCE DATE�MM/DDlYYYY) 3/5/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR AITER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED � , REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,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 ceRificate holder in lieu of such endorsement s. PRODUCER NAME: '� Britton Gallagher PHONE FAx � One Cleveland Center, Floor 30 - - ac "°: - _ E-MAIL � 1375 East 9th Street nnoRess: I I, Cleveland OH 44114 INSURER S AFFORDINCa COVERAGE NAIC# ' INSURER A: �I INSURED INSURER B. � Galaxy Fireworks Inc. �r,suReR c. 204 E. Martin Luther King Blvd INSURER D. Tampa FL 33603 �NSUReR e: �I INSURER F. � COVERAGES CERTIFICATE NUMBER:�624783743 REVISION NUMBER: �, THIS IS TO CERTIFY THAT THE POLICIES OF INSURAN�ED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, R CONDITION OF AMY C�NTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, ' EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR 7ypE OF INSURANCE POLICY EFF POLICY EXP LTR IN R WVD POLICYNUMBER MMlDD/YWY MM/DD/YYYY LIMITS A GENERAILIABILITY 4200908-03 /10/2013 /10/2014 EACHOCCURRENCE $1,000,000 I X COMMERCIAL GENERAL LIABILITY PREMISES Ea xcurrence $50,000 � CLAIMS-MADE �OCCUR MED EXP(Any one person) $ I �, PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $2,000,000 POLICY PR� X LOC $ AUTOMOBILE LIABILITY , Ea accident ' ANY AU70 BODILY INJURY(Per person) $ AUTOS NED AUTOSULED BODILY INJURY(Per accident) $ I� NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Peraccident $ , $ ' UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ � DED RETENTION$ � ' WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIA8ILITY Y�N , ANY PROPRIETOR/PARTNER/EXECUTIVE E L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED� � N�A '� (Mandatory in NH) E L.DISEASE-EA EMPLOYE 5 If yes,describe under DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATiONS!VEHICLES (Attach ACORD 107,Additional Remarks Schedule,if more apace is required) '� Stand Location. 5943-5953 Gall Bivd.Zephyrhills, FI 3542 Additional Insured: City of Zephyrhills, Pasco County Board of County Commissioners, Mark Ayer and all their agents, representatives and subsidiaries CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Zephyrhills, Pasco County Board of County ACCORDANCE WITH THE POLICY PROVISIONS. Commissioners and Mark Ayer 7162 Reading Rd. Suite 730 qUTHORIZED REPRESENTATIVE Cincinnati OH 45237 ��F�x�� O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010I05) The ACORD name and logo are registered marks of ACORD