Fort Walton Beach Council agenda — 02-26-13--regular — reading text

w-w-  Mj le yoop 61 jo luawaoeiday £ LO-£ L 911 : ZOZZ) uoponilsuoo yogyS - ( 119 £ 30-£ L auawyoell\/ 7.7 e Nr Q CERTIFICATE OF LIABILITY INSURANCE 2/ 812013 amam produces Lion lnsutance Company This Ceregcate b bei aae merteroflnfsnam n -- Y- nd confers as dgkls YY 2739 U. S. Highway 19 IN iwegylIeyw Piesdv6New does nntimend, odend Prefab, a.ma.m Holiday, FL 34691 727) 938 -5562 Imsures Affording Coverage NAIC i IW75 Win basumnm Company nsured: South East Personnel Leasing, Inc. & Subsidiarie Imuer : 2739 U. S. Highway 19 N. l eetB Holiday, FL 34691 I10. me Insurers: Coverages peso., aimaaxenPeobswwnam brennswaroee mP• am aw. emrve pyryp• n0aiwraea. mva anoemrm .emen.urmorwraomaamrP+r• c Pamei menwmre :pe<naoni Lnamm6<ae ra9oe Isswaormw oenan. lna imxaaa anxme WM• Pdgesaescnbeenaeaiszuyenx aueurme .masmsana< om apmdsampatlas. n9fla9are rn: IS Moemainarebaannw<eb av cea<Mrta. Policy Espsebui Dery Limits rvm Type of Insvance Policy Number PerMMJUDHY) ryDaysENeo" MMODNY) EeNa<arame ENERAL LIAMUTY Commerotal Corral flabby cama9um erteaorewseslEA Claims Me& [] Occur Meo Fiy Pemood AM Ibra, eneml egwagwa fimit apples pet 6 GererA PSgWme pdry 1. 11, LW PnJiPS. C• rmgpapl ccsmre SimeLr:31 UTOMOBILE LIABILITY IEa A« a• n; anww So " Ml u oxmew: o: Ps" s—) F011s dAnpa WPoPV' Ne Ni ePob arvrymt MMy DamWa P. A< P. l eecnaoneae FxCESSWRIBRELLA LIABILITY Awmcye aw w.m Mee• ceaam A Workers Compensation and Empbyem' Leblgty WC 71949 01N1Q013 0MIn014 x R. t. I I E0. sLW] OW E. L EUbA¢ itleN Aryprepnnmbeimerleaaakv otfindmarnber excluded? NO E1D@ease - Ee Employee Aam.OW If YVS, describe udx speeq pPNSOnsbNOw. E. Disease. Policy nmih 11. 000. 00J Prue, ubn Insurance Company is A. M. Bast Company rated A- ( Excellent . AMB N 12616 Descriptions of OperaUonslLecagons ehlcleslexcluslons added by Endarsement /special Pmvisions: pimtm: $ 159. 032 G cmge only aposs b adbe empbyee( f) of SouM Eso Employee leasing Serv3a, Inc Met art eased m Me fotlowng Yile nt Company': Shiloh CbrimmOon, U- C. Coverage ant, apples m inluks Into i by SeuM East Personnel fusing ,Inc, & SUbsidfil acdve emPkmtt( s) , wblk working b Forks. Cwemge does not s, y m mass, emPMtt(sj miMece Mct conbacicn,) of the Client Company or any oNeremiq. A be M Me acEVeempblee(s) kased In Me Can fanpany un be d»aiwl by faeiy a request W ( 727) 937 -2136 or by . 1169 N7) ads 5562. Project Name: FAX SSM6 96401165UE 1026- 12( JG) I REISSUE 12-0 12( SO) Rrssvtl 1 VIM 2( S) f REISSUE 0208- 13( SD) DMe: m LB 2012 CER3FPCRTE WILDER CITY OF FT WPLTON fiFl3GH WICELLITOH WeMaeeeme aettnoeepoaeesceumewbaromuaemreooneKbe •re aaraa. Maia. nPb so rsluew N msNl lnrt<se m sM'x • mi 30m, s- nenra<em W <as the roics,.. .. eas nors.ryraykods,- Ce. er. o' e is wre, mos Ra 107 MIRACLE STRIP PKWY SW FT WALTON Ini FL 32540  MA 1e 4300 Oupsix3 ; o lueweouldeN £ LO -£ L 911 : ZOZZ) uo4enA1suo0 40114S - 018 £ LP£ L : 1uew43e11tl , 0 na ao' Y A a Q# 6292130 STATE OF FLORIDA DEPARTMENT OF BUSINESS AND PROFESSIONAL' REGULATION CONSTRUCTION INDUSTRY LICENSING BOARD :$ EQ# L22082202575 LICENSE N B R '? 0:i- ? 7T±;,, 08" 22 2012 120048771 - >.CGC 1517288Ya' *' fir. a/ `s They; GENE " CONTRACTOR - w,q 1, Named below I6 CERTIFIED y`yr " Under the provisions of Chaprer' 4 R F3 - Expiration date: AUG 31, 20141 J MALLIN„ SHAWN ;. GLENN SHILOH CONSTRUCTION LLC` 1295 BEVERLY " ST FORT WALTON BEACH FL 32, 4 tiyx I KEN- LAWSON RICR' 9COTT - SECRETARY GOVERNOR ntsPf AY AS REQUIRED BY LAW  Md 12 51300 6U! ls!x310 3uawaoeldaa ELO- E1 811: ZOZZ) ualonulsuo0 yo!!4S - 018 EL0 -EL : 11, 10wyoe77y m na aIT 2012 - 2013 sm0an COLLECTOR RECEIPT NO. L `