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Client#: 85 UIUNAL ACORDTM CERTIFICATE . OF LIABILITY INSURANCE DATE (MWDD/YY) 04/14/2003 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ARTHUR J GALLAGHER & CO ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 8200 NW 41st Street, Ste, 200 HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Miami , FL 33166 305 592 -6080 INSURERS AFFORDING COVERAGE INSURED CATHOLIC CHARITIES/SAMARITAN CENTER INSURER A: UNITED NATIONAL INSURANCE COMPANY INSURER B: TNCRRG 10 P . O . BOX 109650 DIOCESE PALM BEACH INSURER C: SAFETY NATIONAL INSURANCE COMPANY PALM BEACH GARDENS , FLORIDA 33410 -9650 INSURER 0:INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE i POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS A i GENERAL LIABILITY ICP65197 =04 04/01 /03 104/01 /04 EACH OCCURRENCE $ 1 000 000 & ' X 1COMMERCIAL GENERAL LIABILITY 1050 -04 04/01 /03 04/01 /04 FIRE DAMAGE (Anyone fire) $INCLUDED B — CLAIMS MADE X I OCCUR i MED EXP (Any one person) $NIL i PERSONAL & ADV INJURY $ 120001000 GENERAL AGGREGATE $ (\f/A GEN'L AGGREGATE LIM IT APPLIES PER : PRODUCTS - COMP/OP AGG $ 1 000 , 000 POLICY ! JECT i LOC I A AUTOMOBILE LIABILITY i CP65197 -04 04/01 /03 04/01 /04 COMBINED SINGLE LIMIT & X : ANY AUTO 1050 -0404/01 /03 04/01 /04 (Ea accident) $ 1 , 000 , 000 -- B ! X_ ! ALL OWNED AUTOS ! I BODILY INJURY X SCHEDULED AUTOS (Per person) $ i X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS $ (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY I AUTO ONLY . EA ACCIDENT $ ANY AUTO i EA ACC $I OTHER THAN AUTO ONLY: qGG $ EXCESS LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION $ I $ A WORKERS COMPENSATION AND CP65197 -04 04/01 /03 04/01 /04 X WC STATU- OTH- EMPLOYERS' LIABILITY Y IMI & ISP4329 -FL-04 04/01 /03 04/01 /04 E.L. EACH ACCIDENT $ 1 , 000 , 000 C E. L. DISEASE - EA EMPLOYEE $ 1 , 000 , 000 E.L. DISEASE - POLICY LIMIT $ 1 , 000 , 000 OTHER i DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RE : COUNTY FUNDING FOR THE SAMARITAN CENTER, 3650 41 ST, VERO BEACH , FL. INDIAN RIVER COUNTY IS NAMED AS ADDITIONAL INSURED AS AGREED , CATHOLIC CHARITIES OF THE DIOCESE OF PALM BEACH , INC. P . O . BOX 109650 , PALM BEACH GARDENS , FL 33410 CERTIFICATE HOLDER ADD MONAL INSURED ; INSURER LETTER: CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBED POLICIESSE CANCELLED BEFORE THE EXPIRATION INDIAN RIVER COUNTY, FLORIDA DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 1840 25TH STREET NOTICE TOTHE CERTIFICATE HOLDER NAMED TOTHE LEFT, BUT FAILURE TO DOSOSHALL VERO BEACH , FL 32960 - 3365 IM POSE NO OB LIGATION OR LIABILITY OF ANY KIN DUPON THEINSURE R, ITSAGENTS OR REPRESENTATIVES. AUTHORI EDR RES TATIVE t� ACORD 25-S (7/97) 1 of 2 #S48474/M47843 BRR 0 ACORD CORPORATION 1988