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2011-078F
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2011-078F
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CERTIFICATE OF LIABILITY INSURANCEV DATE ( MMroon^i^(Y) <br /> 10/2512011 <br /> THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER , THIS <br /> CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES <br /> BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER ( S ) , AUTHORIZED <br /> REPRESENTATIVE OR PRODUCER , AND THE CERTIFICATE HOLDER . <br /> IMPORTANT : If the certificate holder is an ADDITIONAL INSURED , the policy( ies ) must be endorsed . If SUBROGATION IS WAIVED , subject <br /> to <br /> the terms and conditions of the policy, certain policies mayiequire an endorsement . A statement on this certificate does not confer rights to the <br /> certificate holder in lieu of such endorsement ( s ) . <br /> CONTACT <br /> PRODUCER NAME. _ _ - <br /> Waddell Insurance Group PHONE 772 231 -1313 1 FAX 772 231 - 1314 <br /> LAIC. No. Ext) .( 772 ) _ l 1A1C_ No� � � <br /> 3599 Indian River Drive East E - MAIL <br /> ADDREss : - — -- <br /> Vero Beach FL 32963 CUSTOMER ID a : <br /> - - T <br /> INSURERS AFFORDING COVERAGE NAIC p - <br /> INSURED IN SURER A Illinois National Insurance Company <br /> INSURFR B Granite State Insurance Company _ <br /> Sun -Up of Indian River , Inc . INSURER r. - <br /> 2455 5th Street, SW INSURER D - - -- - <br /> Vero Beach , FL 32962 INSURER E <br /> INSURER F . <br /> COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOVJ HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY <br /> PERIOD <br /> INDICATED . NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS <br /> CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL <br /> THE TERMS . <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS <br /> INSRI — .. _. . . _ . - 4YVR �.' - POLICY EFF POLICY EXP <br /> TYPE OF INSURANCE AL DL ( MM1DD1'fYYY _ LIMITS <br /> GENERAL LIABILITY �11 <br /> _ _P_OLICY NUMBER ( MMfDDIYYYY) I. A( I I tX'( :t1RJd 14-4-NCE 51 0000 , 000 <br /> ITR (NSR - - - - t - ---- - <br /> 1014 N1 <br /> I iAWV %1 11 ) <br /> A x c(xuM- lxaAL (I N wu I AttunY 06LX0072488287000 812612011 812612012 LP[ LN1SLH_(Leoccwr�Bcr 5250 000 <br /> - - -� M I , I XP (Ally one peisow 5. 10 , 000 <br /> Cl n1nrc . Mux x x:ct I� PrIY ;Uf Vtf ,� Ar )v IwLrn S1 , 000 , 000 <br /> - - - <br /> x Abuse/ Molestation <br /> - 000 <br /> ( I t4 RAI A(�(� 4 ( ,n1F $ 3900 0 <br /> - Ira txK I cxnYa� n( x3, 00Q000 <br /> A - - <br /> O('14 t ;nIf I IM I APP( Il tl PF It <br /> - -- <br /> x <br /> POI ICY � � 1111.�Cr � t (X; <br /> I AUTOMOBILE LIABILITY (.ii1W,I1VU ;INc ;I F I IMi <br /> I ;I ,< culen0 51 , 000 , 000 <br /> Al, <br /> A ANrlO � 06CA0062684647000 118/26/2011 8126120121 ,( H �uYln� ltlr S <br /> All (WrAI ) AIII (Y; I I( AM YI t4l( Uy del accident ) 1 x - - <br /> SCII DL LLD ALfIIk( PR( WCR1Y DAfW1t{ S <br /> '. i iPel acculnnh <br /> X 11114- DAtII0Y; ''.. <br /> X t414 ( VVP41 ) At I ( x ; <br /> X UMBRELLA LAB x oc( l r. ( ) ;a_r4lnr :r 51 , 000 , 000 <br /> B _ <br /> E )( CESSLAB ( A Al W, RNuI )t 02UD0003839497000 8/2612011 8/26/2012 , n. ix ( nn 51 , 000 , 000 <br /> X [ 4 It NTION S 10 , 000VVGI <br /> x <br /> WORKERS COMPENSATION JORY] Pill El I SIATll iClfR <br /> AND EMPLOYERSLIABILITY ./ 1 N <br /> ANY PRUPWF 10P/1 'Ar2IN IVI' M CillIVEA( J IAGO DFNI _ IS <br /> M M <br /> YI ICC IU4F. RI:. XCI I I )I IJ9 �� Nf A ' <br /> F I UL,I A ,E I � I M-'LUYI i t <br /> (Mandatory in NH) <br /> Itdenulhe andel I . ULiFASi: F'OIICYLIMI i s _ <br /> I )I CI41 ' pr )nl ( * ( 41 IU111 ( I1 Iwlnbv _ <br /> ° A Employee Benefits — 06LX0072488287000 8126/2011 18126/2012 1 000 , 000 <br /> A Professional Liability ' 06LX0072488287000 118/26/2011 8/26/2012 $ 1 , 000 , 000 each act $3 , 000 , 000 agg <br /> DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLE _ ( Attach ACORD 101 , Additional Remarks Schedule , if more space is required) <br /> Abuse/Molestation Limit : $2 , 000 , 000 <br /> I <br /> CERTIFICATE HOLDER CANCELLATION <br /> Indian River County Commissioners SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN <br /> 1801 27th Street ACCORDANCE WITH THE POLICY PROVISIONS , <br /> Vero Beach , FL 32960 <br /> AUTHORIZED REPRESENTATIVE /' < GLC > <br /> Fax : 770-5100 GWL4* Gtr' <br /> -- Oc 1989 - 2009 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 ( 2009109 ) The ACORD name and logo are registered marks of ACORD <br />
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