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JUN- 14 - 2010/ 0,10N ) 12 : 18 han P. 0/ 0/ 1 / 00/ 4 <br /> DATE AC. ORP CERTIFICATE OF LIABILITY INSURANCE 04 / 2M/ 2010 <br /> - � 04 / 20 / 2010 <br /> PRODUCER ( 321 ) 984 - 3270 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> COBB WALLS INSURANCE AGENCY INC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> HOLDER. THIS CERTIFICATE DOES NOT AMEND , EXTEND OR <br /> P 0 BOX 411355 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW_ <br /> MELBOURNE FL 32941 - 1355 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: OLA DOMINION INSURANCE CO <br /> L n OF BREVARD , LLC INSURER R <br /> ADDRESS N ' MAIL. , INC , INsuRERC: <br /> 404 E , New Haven Ave . INSURER D: <br /> Melbourne r'L 32935 - INSURER E. <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVC rOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY <br /> REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , <br /> THE INSURANCE AFFORDED BY TME POLICICS DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF <br />SUCH POLICIES . <br /> AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR ADO'L! POLICY EFFECTIvt POLICY EXPIRATION LIMIT5 <br /> LTR INSRD TYPE OF INSURANCE POLICY NUMBER DATE (MMIDOfYY) DATE ( MM)DDYYI <br /> I <br /> GENERAL LIABILITY DPG71683 06 / 25 / 2009 06 / 25 / 201. 0 EACHOCCURRENCE $ 1 , 000 , 000 <br /> AMA t 1 tNl 900 , DDO <br /> X COMMERCIAL GENERAL, LIABILITY PREMISES ( Es occurrence? <br /> CLAIMS MADE FX OCCUR / / / / MED EXP (Any one peraon) $ 1. 5 , 000 <br /> PERSONAL & ADV INJURY $ 1 r QQD r OQQ <br /> GFNFRAI. AGGRF.GATr: $ 2 r 000 r 000 <br /> GEN'L AGGREGATE LIh11TAPPLIES PER: PRODUCTS - OOMPIOP AGG $ 21 000 r 000 <br /> POLICY F1 <br /> PE QOT 171 LOC / / / / 14PD99 11QDD , ODD <br /> AUTOMOBILF LIABILITY / / / / COMBINED SINGLE LIMIT $ <br /> ( En <br /> ANY AUTO <br /> ALL OWNED AUTOS / / / / BODILY INJURY <br /> (Porpor:on) <br /> SCHEDULED AUTOS <br /> HIRED AUTOS / / / / BODILY INJURY <br /> ( Par arrldont) $ <br /> NON-OVVNED AUTOS <br /> PROPERTY DAMAGE $ <br /> (Por octibont) <br /> GARAGE LIABILITY AUTO ONLY - FA ACCIDENT S ANY AUTO / / / / OTHER THAN <br /> EA ACC $ <br /> AUTO ONLY; AGE $ <br /> EXCESSIUM13RELLA LIABILITY / / / / EACH OOOUNRENCF <br /> OCCUR CLAIMS MADE AGGREGATE 3 <br /> DEDUCTIBLE <br /> RETENTION 5 IU $ <br /> A WORKERS COMPENSATION AND wCC71609 06 / 25 / 2009 06 / 25 / 2010 X o�YyI LAMIT <br /> EMPLOYERS' LIABILITY 10O ODD <br /> ANY PROPRIETOMPARTNERIEXECUTIVE E. L. EACH ACCIDENT r <br /> OFFIGERJMEMBFR EXCLUODD? / / / / E. L. DISEASE - EA EMPLOYEE $ ZOO , 000 <br /> It vee, describe antler <br /> SPECIAL PROVISIONS below E.L. DISEASE - POLICY LIMIT E 500 , 000 <br /> A OTHER ZmplQyee Diabonesty DPG71683 06 / 25 / 2009 06 / 25 / 2010 in t 50 , 000 <br /> DESCRIPTION OF OPERATIONSILOCATIONSIVGHICLMFXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS <br /> CERTIFICATE HOLDER CANCELLATION <br /> ( — — SHOULD ANY OF THC ABOVE DESCRI13ED POLICIES BE CANCELLED BEFORE THE <br /> Attn : Risk Management EXPIRA TE THEREOF, THE ISSUING INSURER %MLL ENDEAVOR TO MAIL <br /> 03 DAY6 WRI £N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT <br /> Indian River County ALLURE TO DO S HALL IMPOSE Np BUGATION OR LIABILITY OF ANY KIND UPON THE <br /> 1801 27th Street INSURER IT ENTS OR P E5 TA E <br /> T REPRESENT TI <br /> Vero Beach FL 32960 - <br /> AGORD 25 ( 2001 /08 ) ACORD CORPORATION 1968 <br />