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ACouo. CERTIFICATE OF LIABILITY INSURANCE OF ID n " E { AIDD/YYVY ) V <br /> S : p_ESMA , 10 / 10 03 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OP INFORMATIO <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Hatcher Insurance , Inc . I HOLDER , THIS CERTIFICATE COE $ NOT AMEND , EXTEND OR <br /> P . O . Bor.. 540689 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW <br /> Orlando FL 32854 - CE89 <br /> Phone : 407 - 841 - 2666 Fax : 407 - 641 - 2695 INSURERS AFFORDING COVERAGE NAIL # <br /> INs. .TERA Philadelphia Indemr_ ity Ins . ! Co <br /> IrISURERG. American International Group <br /> Sh . Peters Academy Charter Sch <br /> St . Peters Human Services , Inc r:3vr= RC <br /> 4250 38th Avenue NSU.R'_ R 0' <br /> Vero Beach FL 32957 - 1711 <br /> COVERAGES - <br /> THE POLICES OF INSURANCE LISTED BELOW HAVE BEEN :SSUEO TO THE INSL.RED NArArD A6OV= FOR THE POLICY PERIOD INDICATED NOTM/ITnSTANDING <br /> ANY REQUIREMEN r, TERMOR CONDITION OF ANY CCNTRACT OR OTHER DOCUMENT WITH RESP ;CT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTA,N, THE INSURANCE AFFCRDED BY THE POLICES DESCRIBED HEREIN I$ SUB:ECT TO ALL THE TERMS , EXCLUSIONS AND CONDI7I0N3 OF SUCH <br /> POLICIES. ACCRECATE LIMITS SHOWN MAY HAVE BEEN REDUCED 91' PAID CLAIMS , <br /> Imo_- . _ . . . _ r- - . . . - 0610-67VI!1 ET j P73L r_ RATIGN PEYP, r-- - <br /> . . ._._ _._. ._ <br /> LTR INSRO TfPE Of IN3URANCE ?-- PO _ICY NUMBER DATE MMIDOIYY) I DAT . (MVIOIDIYY) I LLVITS <br /> 6ENERALUA31JTY I I I EACH CCC RRENC_ ' S 10_00000 <br /> j A X , CCMMEnALGeIERALLIA2a:TY PHPK060275 09 / 17 / 03 , -1 09 / 17 / 04 ; oREMISESEaowae0ce) ! S100000 <br /> i r CLAIMS MADE ; X I OCCVP I 1 MC7 CXP ;A,1y On. Pry+) ) S 5000 . <br /> X_ ! Educators Prot I PHPK060275 I 09 / 17 / 03 I 09 % 17 / 04 �eRscNALaAmilv.,vuY js L000000 <br /> j , I GENERA. AOGREW 'E ! s 2000 ) 00 _ <br /> I i r' �— 12000000 <br /> I .3 En•L ACwGEGAT'c L:MT ePPaE .. F �-. , ROCU'c:T� :�ON R•LP AGC S <br /> AUTOMOBILE LIABILITY <br /> COMBINED S.nN]LS _!I:1T ; S <br /> ' ANY AUTO I I (=9 tCC�enQ <br /> I ALL OWNMJTOS BC'DtLY IN:URY ' <br /> r . . Sc,. eDLT_80 A' -'r= I ' I (Per Dersm) <br /> i I 1 HREO ALTOS I I ; . . <br /> I I BODILY INJURY , S <br /> I NOWw,M NED ALTOS I ;Pcr accidwrtJ ) _— <br /> f �-4 _ _ I PROPEiTY DANA= $ <br /> G'x aecloent <br /> ! I AUTO NLY • 7A ACCIDENT I $ <br /> i � OARAQELIABILITY O <br /> � _ , _ _ •. <br /> ANY AUiO AX EA ACC <br /> I I I AUTO ONLY. AGG S <br /> "%GESSAIMERELLA LIAOILITY I I SACH OCCURRc40E ! S 1000000 <br /> A I '�{ OCCUR CLA)MEMADE ! RENEWAL OE' PHUB012211909 / 17 / 03 09 / 17 / 04 I AGGRCGn -__•- I S 1000000 <br /> RETENTCRt s :10000 I I i s <br /> I WORKERS r„OMPENSATION AP40 I I I. X iTQRY L MITa I <br /> EMPLOYERS LIABILITY ' 09 / 17 / 04 j E. L. EACH AupnCENT E 100000 <br /> WC7829377 09 / 17 / C3 _ <br /> B ' ANY PROPRI^ORIPARTMER/=YoCUTIVd r- _ — •• • 100000 <br /> orriccnnaEr,. 2ER FXCUJCE�7 <br /> I ) E. L. DI3G!3� - EA EAIPLOY� 5 <br /> If vrj, d96t me under <br /> I SP.Ctda PROYSIONS below I I I E D'l�.•'F-ASE - POLtCV :.!MIT i S 500000 <br /> OTHER <br /> I <br /> I <br /> 1 I I i I <br /> 1 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS I VEMELES / EXC.USIUNS ADDED BY ENDCRSEM.ENT 1 SPECIAL PROVISIONS <br /> Certificate holder it included as additional insured applicable General <br /> Liability Coverage . * Except as required by Florida Statute , <br /> CERTIFICATE HOLDER CANCELLATION <br /> SCHODIS SHOULD ANY OF THE ABOVE DESCRIBSD POLICIES BE CANCELLED BEsORC THE EXPIRATION <br /> school District Of Indian DATE THEREOF, THE 155LHNGINSURER W! LLENCEAVORTOIAAIL 30 * DAVSWR! T-rEN <br /> River Co / Judy Bartlet 7z NOTICE TO THE CERTIFICATE HOLDER NAMED f0 THE LEFT, 3UT FAILURE TO CO SO SHALL <br /> FX 772 - 569 - 4139 IMPOSE NO OBLIGATIC14 OR LIABILITY OF ANY KING UPON TMG INSUKER , IT3 AO =MNTS OR <br /> 1990 25th Street REPRE5ENTATIC 3. <br /> Vero Beach FL 32960 AUTHQRIZ56r e34NTA / %• • / <br /> ACO PORTION <br /> A RD 25 (2001 '08 ) CORA1 <br />