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ACC>R& CERTIFICATE OF LIABILITY INSURANCE DADDIYYYY) 5 / 22 / 20/ 2011 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( ies) 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). PRODUCER CONTACT NAME : Penny Garrett Lassiter - Ware Insurance PHONE 352 . 787 . 3441 X105 FAX 888 . 883 . 8680 AIC 1317 Citizens Blvd . MAIL -- - - -- . ( NJ - — ADDRESS : - - - - -- - PRODUCER 0042350 CUSTOMER ID 010 Leesbui� FL 34748 INSURER(S) AFFORDING COVERAGE_ _ NAIC # INSURED INSURERAMOunt Vernon Fire Insurance Co 26522 Indian River County Healthy Start Coalition INSURERS : 1615 10th Avenue INSURERC : Vero Beach , FL 32960 - 6231 - - — INSURER D INSURERE : INSURER F : COVERAGES CERTIFICATE NUMBER : 11 / 12 GL 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 . INSR - --- ADDL SUBR _ _ POLICY EFF POLICY EXP - - - _ LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER IMMIDDIYYYYI I (MMIDDIYYYYILIMITS GENERAL LIABILITY P2103140C 05 / 01 / 201105 / 01 / 2012 ' — EACH OCCURRENCE $ 1 , 000 , 000 DAMAGE TO RENTED -- -- X _COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence $ 100 , 000 A J CLAIMS-MADE [ X ] OCCUR X j MED EXP (Any one person 5 000 PERSONAL & ADV INJURY $ Excluded GDIN ERALAGGREGATE _ $ 21000 , 000 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMP/OP AGG $ Excluded POLICY F PER& LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ( Ea accident) $ ANY AUTO ---- --- — -__._ - _. ALL OWNED AUTOS BODILY INJURY (Per person) $ - -- --- - - - -- BODILY INJURY (Per accident) $ SCHEDULED AUTOS ---- ----- ------ PROPERTY DAMAGE HIRED AUTOS (Per accident) $- NON-OWNED AUTOS --- _. — �._$ — UMBRELLA LIAB OCCUR EACH OCCURRENCE $ - - EXCESS LIAB I -CLAIMS-MADE- AGGREGATE t DEDUCTIBLE - '�I — $ - - — RETENTION $ - $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS' LIABILITY Y / N TQR IMIT R ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ NIA E . L. EACH ACCIDENT $ (Mandatory in NH) If as , describe under E . L . _DISEASE - EA EMPLOYE _$ _ __ _ y . DESCRIPTION OF OPERATIONS below ' E . LDISEASE . POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required) Certificate holder is also additional insured with regards to General Liability per policy forma . 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 . Board of County Commissioners 1801 27th Street AUTHORIZED REPRESENTATIVE Vero Beach , FL 329603365 Penny Garrett / PENNYG � 7YL ACORD 25 ( 2009/09) © 1988-2009 ACORD CORPORATION . All rights reserved . INS025 (200909) The ACORD name and logo are registered marks of ACORD