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= c� c4i T Lv . 1' I Flilficr� _ i,J_:I I�'FiJI_c i14 411 1-G , � '��I� F' . h1 . _ _ 'l� 1 AC,ORD CERTIFICATE OF LIABILITY INSURANCE GP 10 DATE (MMIDOIYYYY) ST:PK! 09 / 23 / 03 �RODucsR THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Hatcher Insurance , Inc . HOLDER, THIS CERTIFICATE DOES NOT AMEND , EXTEND OR P . O . Box 540659 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Orlando FL "32894 -0689 Phone : 407 - 841 -2686 Fax 407 - 841 -2688 i INSURERS AFFORDING COVERAGE NAIC # -I.IICU�R-ED - - � &.lsur.C, A ph Riladelphia Indemnity Ins . to PiSURER15: American Ir_ternational Group St . Peters Academy Charter 3c'i - -- - - St . Peters Human Services , Inc NS!IkERt: -� 4250 38th Avenue rlNSURER0 I Vero Beach FL 32967 - 1711 r-- ---- IN6JRER E: COVERAGES THE POLICIES OF oNSURANCE LiSTED BELOW HAVE SEEN ISSUED TO THE INSURED vAMED ABOVE FOR THE PO_ICY PERIOD INDICATED . NOTWI THSTAK)ING ANY REQUIF.E)JEN T TERM OR CON DITICN OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHI0i THIS CERTIF.CAT ! MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFOROED BY THE PCLICIES CESCRIBED HEREIN IS SUBJECT TO ALL THE TERNS , EXCLU91ONS AND CONDITIONS OF SUCH POLICISS , AGGREGATE LIN41I7S SHOVIN NI AY HAVE BEEN REDUCED OY PAID CLAING , - - — - - -- T PGLIC�FFFE TfJE POLZR E3li�1RxTI0N _ _. . LTR INSRO TYPE OF INSURANCE POLICY NUM6ER DATE IMMIO9IYYI I OATS ( MM!CDIYY) UMTS DENERALLLSIL'TY I FACHCLGVRF. EN(;F S 1000000 A i rx 1CCIAWRGIA. GENEriA`_ UAPI!rTY PHPK060275 I 09 / 17 / 03 ; 09 / 17 / 04 ?Rctut:SEs ;E3 u;:c :o_nc�1 _ E 100000 CLAIMSt/AD'c $ j OCCUR i MADEX= :Ar.VCneperson, is 5000 .. . -...... . . I �� •_ — I PEK $CNAL 6 ADV ;NJURY Is 100 ,0000 ---- - -- I CENPAA: AGC-mECA -S $ 2000000 i ACGREC) A`S LIMIT APFutm$ FSR 2000000 S' CGMPr'J�= A :�G _ $ 2000000 — f I ROUPUf 4 JECT OC AUTOfAOBIIE LIABIU?V —� I GCM9:N�,'G SiNGLE LWIT (E3 ANY RUTG I 9001^.e e; I j CtH�CJLEC ? UTQa (Per erum1., ;7v f__ A_L GWNEC AJTO., I F09, LY Ir4,I I --- NREDA=T S i RCCILI INJURY S NOiwOWNEC AJTOS (PP acddart I � II PR ^PE4':Y DAMAGE �I - j (Rc: acclewt) 15 i _ 1 GARAGE MASILITYAUTO ON v • EA ACCICENT 5 ANY AJ'O I OTHER THAN pA ACC 5 .__ i ! I I AUTO ONLv. EXCE£SME!BRELLAAU E'I_ITY EACH OCCURRENCE f S 1000000 A X OCCUR I Ci, AIMSMADE � RENEWAL OF PHUB012211909117 / 03 k 09 / 17 / 04 1' AGGREGATE � 5 1000000 _ -- i 7C R=_-retirGN s 10 Roo I � � • � s I WORKERS COMPENSATION AND I �+CRY LI11 ' 1' d _ ftp EMPLOYERS' LIABILITY WG` 782937 7 ` 09 / 17 /003 j 09 / 17 / 04 x. L. % CH A!=9KT - £ 100000 B I AM' PRC,PP,IRORlPARTNERF..JCEMTN•E I I ! .. i I '= L clseasE - FA =r.IP_c Is s 100000 �,F I FICeRRAEM6 r'. EXGLUGED? ..._ —_ . . 19 yah, daw-ke urrer 1 F. . L. CISEASE POLr_`r 0.1i 1, $ 50 O 110 C GZEC' AL PRON3SONS belay, I _ I OIFHFR I 1 I I DESCRIPTION OF OPERATIONS I LOoAT10Ns 1 VEHICLES I EXCLUSIONS, ADDED 13 EN0 RSEMENT I SPEOIAr PROVISIONS Certificate holder is included as add:. tional insured applicable General Liability Coverage . *Except as required by Florida Statute . I CERTIFICATE HOLDER CANCELLATION SCHODI3 SHOULD AOF THr ABOVE OBSCRtBEO /501-101155 515 CANC = LED BEFORE THE EXPIRATION NY School District Of Indian LATE , rEREOP TME ISSUINO INSURER WILL ENDEAVOR TO MAIL 30 * OAYS WRITTEN River Co / Judy Bartlett NOTICE TO THE CERTIFICATE HOLDER NAIAEO TO THE LEFT, BUT FAI _URE TO DO SO SHALL y, 772 - 569 - 4139 IMPOSE NC OBLIGATIO R LIABILITY OF ANY K1NC IIPON THE INSURER, ITS AGENTS OR 1990 25th Street REPRESENTATIVES _ Vero Beach FL 32960 AUTHORIZED REP A RD 25 (2001 /08 ) ORD CORPORATION 1 TOTAL PtOl