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14-15702
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2014
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14-15702
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Last modified
8/27/2015 11:18:04 AM
Creation date
8/27/2015 11:18:02 AM
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Building Department
Company Name
DRIFTWOOD
Building Department - Doc Type
Permit
Permit #
14-15702
Building Department - Name
DRIFTWOOD CONDO ASSOC
Address
38333 COTTONWOOD PL
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Client#: 1094922 BMFHIIfVC <br />� � ,4CORD CERTIFICATE O� LIAB LITY INSURANCE DATE(MMlDD/YYYY) <br /> 10/08/2014 <br /> THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY A D CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EX END OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A ONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORI2ED <br /> REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. <br /> IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the po icy(ies)must be endorsed.if SUBROGATION IS WAIVED,subject to <br /> the terms and conditions of the policy,certain policies may require an en orsement.A statement on this certificate does not confer rights to the <br /> cerlfffcate holder in lieu of such endorsement(s). <br />. PROOUCER NAMEACT Avonelle McClean <br /> USI Insurance Services, LLC PHONE 561 693-0500 <br /> 2054 Vista Pkwy,Suite 400 E�ILo E:c: nrc Ho: 855 420-6662 <br /> West Palm Beach,FL 33411-2718 <br /> aooRess: avonelle.mcclean@usi.biz <br /> 561 693-0500 INSURER(S)AFFORDING COVERAGE NAIC# <br /> iNSU�Ra:Auto Owners Insurance Company 18988 <br /> INSURED INSURER B: <br /> BMFHI Inc. <br /> 11212 Black Walnut St INSURERC: <br /> Hudson, FL 34669 INSURERD: <br /> INSURER E. <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: <br /> THIS IS TO CERTIFY THA7 THE POLICIES OF INSURANCE LISTED BELOW HA E BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD <br /> INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION O ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDE BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HA E BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADDLSUBR <br /> �TR TYPE OF INSUR,4NCE INSR WVD POLICY NUMBER MMIDDY EFF MMIDDryYYP LIMITS <br /> A CENFRAI LIABILITV 72595097 11/30/2013 11/30/201 EACHOCCURRENCE s1 000 000 <br />� � X .-.nn+r,ip�tUa�GENERALLIABILITY DAMAGET RENTED <br /> •�- PREMISES Ea occurtence SJ���00 <br /> ..� •�'�:,�r.iAUE � X�OCCUR MED EXP(My one person) 5Jr�0� <br /> PERSONAL 8 ADV INJURY $��OOO�OOO <br /> GENERALAGGREGATE $'I�OOO�OOO <br /> GEN'LAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG S��OOO�OOO <br /> POLICY PR� <br /> JECT LOC g <br /> AUTOM081LE LIABILITY COMBINED SINGLE LIMIT <br /> Ea acddent $ <br /> "^%`'^�=`�� BODILY INJURY(Per person) $ <br /> a, •' � �SCHEOULED BODILY INJURY Per accident S <br />� �' ' �`.- � _,AUTOS � ) <br /> NON-OWNED PROPERTY DAMAGE <br /> •'�•t=.%"�. ��•`• AUTOS Peraceident $ <br /> $ <br /> UMBRELLALIAB pCCUR EACH OCCURRENCE 5 <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE S <br /> DED RETENTION$ 5 <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> �AND EMPLOYERS'LIABILITY Y/N <br /> �N`'P«OPRiFTnR�c�ARTNER/EXECUTIVE E.L.EACHACCIDENT 5 <br /> •' r�•'. • i�� '_xCLUDED� � N!A <br /> !rvlTnuatorymNH) E.L.DISEASE-EAEMPLOYEE $ <br /> �;.ai.�ii��lr,;�.,i .�:'ERATIUNSbelow E.L.DISEASE-POLICYLIMIT 5 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES(Attach ACORD 101,Additionai Remark Schedule,If more space Is required) <br /> Those usual to the insured's operations. <br /> i <br /> CERTIFICATE HOLDER CANCELLATION <br /> Cit of Ze fl rhills SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />� Y P Y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> 5335 8th Street ACCORDANCE WITH THE POLICY PROVISIONS. <br />? � ZEPHYRHILLS, FL 33542 <br /> AUTHORIZED REPRESENTATIVE <br /> �� <br /> O 1988-2010 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2010/05) 1 of 1 Thc ACCi�D name �nd logo are regis ered marks ofACORD <br /> #S13491655/M13489732 AUMHJ <br />� <br />�. <br />
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