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---1 GIFF0- 1 OP ID: NF CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIYYYY) 1010412013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER , THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND , EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER( S), AUTHORIZED REPRESENTATIVE OR PRODUCER , AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy( les) must be endorsed . If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement (s ). CONTACT PRODUCER Phone : 312"630"0800 NAME: Schwartz Insurance Agency Inc . Fax : 312-648-4585 PHONE FA 500 West Madison St. , Ste#2760 AIC No Ext) : A1C No): Chicago , IL 60661 E-MAIL Michael L. Schwartz ADDRESS : INSURER( S) AFFORDING COVERAGE NAIC I INSURERA : Markel American Insurance Co . INSURED Gifford Youth Activity Center, INSURER B : Progressive Insurance Company Inc . Angelia Perry INSURER C : 4875 43rd Ave INSURER D : Vero Beach , FL 32967 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN , THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . INAUUL 5UbH POLICY EFF POLICY EXP TR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDIY MMIDDIYYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1 , 000100 A X COMMERCIAL GENERAL LIABILITY 8502CY3955890 06/01 /2013 06/01 /2014 DAMAGE TO RENT Eu� PREMISES Ea occurrence $ 100, 00 CLAIMS-MADE FX ] OCCUR MED EXP (Any one person) $ 10100 A Hired Auto Liab 8502CY3955890 06/01 /2013 06/01 /2014 PERSONAL & ADV INJURY $ 11000, 00 A NonOwned Auto Lia 8502CY3955890 06/01 /2013 06/01 /2014 GENERAL AGGREGATE $ 3, 000100 GEN'L AGGREGATE LIMIT APPLIES PER : PRODUCTS - COMP/OP AGG $ 3, 000, 00 POLICY PROT- LOC NOHAAuto $ 13000, 00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT 1 , 000 00 Ea accident S B ANY AUTO 016544570 -1 06/01 /2013 06/01 /2014 BODILY INJURY (Per person) S ALL OWNED ISCHEDULED BODILY INJURY (Per accident) $ AUTOS X AUTOS HIRED AUTOS NON- OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ _ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION $ $ WORKERS COMPENSATION WC STATU- 'ETR' - APD EMPLOYERS' LIABILITY Y 1 N TO ANY PROPRIETORIPARTNER/EXECUTIVE ❑ N 1 A E.L . EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E . L. DISEASE - EA EMPLOYEE $ If yes, describe under DESCRIPTION OF OPERATIONS below E . L. DISEASE - POLICY LIMIT $ A Professional Llab 8502CY3955890 06 /01 /2013 06/01 /2014 Each Act 11000100 Aggregate 3, 0001000 DESCRIPTION OF OPERATIONS 1 LOCATIONS I VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, If more space Is required) Certificate Holder is an Additional Insured with respect to General Liability coverage if required by written contract or agreement . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Indian River County ACCORDANCE WITH THE POLICY PROVISIONS. 1800 27th St, Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE G le O 1988-2010 ACORD CORPORATION . All rights reserved . ACORD 25 (2010105) The ACORD name and logo are registered marks of ACORD