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A �Q63.0 . CERTIFICATE OF LIABILITY INSURANCE GP ID > � OAE (M:AI7D/YV yI <br /> 0 10 / 10 / 03 1 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF I "JFORMATIO <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Hatcher Insurance , Inc . I HOLDER , THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> P . Q . Son.. 540689 I ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br /> Orlando FL 32654 - CE89 <br /> Phone : 407 - 841 - 2606 Fax : 407 - 341 - 2695 INSURERS AFFORDING COVERAGE ' NAIC # <br /> , NSUlZiCPhil <br /> = adei hia Indemnit o Ins . C <br /> INSU7^ R 4 1 <br /> IN,U;E; n. American International Group <br /> S t . Peters Academy Charter Sch - - - "--- -- - '" ' <br /> St . Peters Human services , Inc r:31Ja= ac <br /> 4250 38th Avenue 1NSU.=_ R D• <br /> Vero Meach FL 32957 - 1711 _ - --• - -.__... .. ' <br /> 1 IhS:,Rc:4 E. i <br /> COVERAGES <br /> THE DOUC' ES OF INSURANCE LISTED BELOW HAVE BEEN :SSUED TO THE INSURED NAMW A.60V= FOR THE POLICY PERIOD INDICATED NOTMRTnSTANOING <br /> ANY RECUJIREMENT , TERM OR CONDITION OF ANY CCNTRACT OR OTHER DOCUMENT WITC RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAN, THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUB.ECT 70 ALL THE TERMS , EXCLUSION$ AND CONDITICNS OF SUCH <br /> POUC: ES. ACGRECATE LIMITS SHOWN MAY NAVE BEEN REDUCED BY PAID CLAIMS . <br /> �UTNUSU & ' I'- - _ -- • - AOLI�� OAT : IM.MI <br /> LTF IR $rZp — " TYPE OF INSUSANCG I PO'_ICY 11UMBEF I QATE MM/DOIYYI • I DATC iM�I1DO/YY} 'LIMITS — Y <br /> GENERAL LIA3I;JTY I S lOOOOQG <br /> A { PPK06275 i09 / 17 / 03 . 1 4 I ?F2EMISES 6awwwercU f_ lOGOOO _ - <br /> i r I CLAIMS MADE ! X I OCCl.P 1 1 MG7 GXP ;Any Ons per.�) — I-S 5000 — <br /> X ! Educators Prof PHPK06 (j% 275 1 09 / 17 / 03 1 09 / 17 / 04 1 ?CRSCNAL3ADYi%0VFY jS 1000000 _ <br /> GENERALAGGR2 ArE 132000000 <br /> _ <br /> I ,TEN• '- A„GGEGAT'e L:.N.T ePPLIES P =P- ' , t ! PRCDIJC:T3 :AN. FMCP ACC S 2000000 <br /> ' AUTOMOBILE LIABILITY ' <br /> ' � rCM&n1EG sw�Ls _Iralr 1 5 <br /> ' ANY AUTO I ! (m woentl <br /> _. ._ ALL OWN Lr AUTOS ! I <br /> I300ILY INJURY ' <br /> per Person)SC� eoLijo At. . 02 <br /> i f <br /> ' I I HRLO ALTOS I I BODILY INJURY •`• � S <br /> I I (Per accident <br /> NON-:WNED ALTOS i I I ) <br /> ` �-4 _ _ __ I i PROPERTY DAMAGE <br /> I (Por auro'ent; I f <br /> LGA-RAOELIABILITY i I AUTO ON'_Y • _A ACCIDENT I5 <br /> I •— <br /> 1 ANY AUTO OTHER TIHAN EA ACC -,• --- <br /> I I I AUTO ONLY, AGG IS <br /> I eEXCESS/UMERELLA LIAMLITY j E i i SACH OCCURRENCE _ i $ 1000000 -_ <br /> A ! �]( ocCUR F-1 <br /> CLAIMZ MADE I RENEWAL OE PHUB012211909 / 17 / 03 09 / 17 / 04 I ACr.GR_=GATS - I S 1000000 <br /> ceuucnrfLc L — - . i f <br /> I X I RETENTION $ 10000 1 I I is <br /> L Jlh <br /> WORKERS COMPENSATION AND I I LX ,iT:,RYUMITE <br /> 8 1 EMPLOYERS LIABILITY I WC7829377 09 / 17 / 03 09 / 17 / 04 ! E. L. EIU HACCICFNT f 100000 <br /> ANY trROPR1E , ORfPArm7MERJ=4aCUTIVE I r-- -- <br /> I � OFcICERM1Ei/ 2ER 9;XCUJCE07 ! EJ . =tA5= • EA ENIPLOYEd 5100000 <br /> If veu, dawr*9 underi —may. <br /> SPECIAL PROVI:tIONS i2clow � � I I FI D'- + YSF_ASE - POLICY :.IMIT i S 500000 <br /> OTHER i I <br /> I ! <br /> : <br /> DESCRIFTION OF OPERATIONS 1 LOCATIONS I VEA ICLES I EX CWS IONS ADDED BY ENDCR5EN7ENT I SPECIAL PROVISIONS <br /> Certificate holder is included as additional insured applicable General <br /> I.isbility Coverage . * Except as required by ilorida Statute . <br /> CERTIFICATE HOLDER CANCELLATION <br /> SCHODIS SHOULD ANY OF THE ABOVE DESCRIOED POLICIES BE CANCELLED BE►ORC TME EXPIRATION <br /> $ CY) OOl District of Indian DATE THEREOF, THE 155VINGINSURER W! LLENCEAVORTOMAIL 30 * DAYSWRTTEN <br /> River Co / Judy Bartletc NO'ICE TO THE CERTIFICATE HOLDER NAMED TO TWE LEFT. BUT FAILURE TO CO SO SHALL <br /> $X 772 - 569 - 4139 IMPOS ' NO OBVOATICN OR LIABILITY OF ANY KIND UPON TH1• IN -LKER , IT3 AGENTS OR <br /> 1990 25th Street REPRESENTATYft: 5. <br /> Vero Beach FL 32960 AUTHQRIZ5e1 LSGNTA <br /> VAGORD <br /> ACORD 25 ( 2001 /08 ) CORPORATION 1 <br />