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2■■007 / 05 / 2012 14 : 49 The Crockett Group ( FAX ) 7725629669 P , 001 / 001 :■��® DATE (MMIDD/YYYY) ■ ■ CERTIFICATE OF LIABILITY INSURANCE 7i5i2012 ■ ■*, . IS 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 pollcy ( 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 ). PROCUCER _ . NAME:CONTACT Stacey Bihl , ACSR , AIAM The Crockett Group , Inc , PHCLX ( 772 ) 562 - 9664 FAC No • ( 772 ) 562 - 9668 All. Stacey@thecrockettgroup . com 3375 20th Street EM)RE Suite 110 INSURERS AFFO RDING COVERAGE NAICH Vero Beach FL 32960 INSURER A :Philadel hia Insurance INSURED - - -- --- - -------- INSURER B : Every Dream Has A Price , Inc . INSURER c : 2179 10th Avenue INSURER D : INSURER E : Vero Beach FL 32960 INSURER F : COVERAGES CERTIFICATE NUMBER : 10 / 6 / 2012 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 , NOTW THSTANDING 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 ADDLSUBR TYPE OF INSURANCE POLICY NUMBER MM/DDYIYYYY MMIDDY EXP LTA (YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE S 1 r 000 r 000 DAMAGE TO RENTE X COMMERCIAL GENERAL LIABILITY PREMISES Ta accu D nce S 100 , 000 A CLAIMS-MADE Fx] OCCUR x SINDER06182012 0 / 5 /2012 10 / 6/ 2012 MED EXP (Any one person) Is EXCLUDED x SPECIAL EVENT COVERAGE PERSONAL & ADV INJURY S 11000 , 000 GENERAL AGGREGATE $ 31000 , 000 GEN'LAGGREGATE LIMITAPPLIESPER: PRODUCTS - COMPIOPAGG S 3r000r0O0 X POLICY PFO 7 LOC 5 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accidentS ANY AUTO BODILY INJURY (Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Par eccidenl) 5 NON• OWNED PROPERTY DAMAGE y HIRED AUTOS AUTOS Par eccidenl S UMBRELLA UAB OCCUR EACH OCCURRENCE S EXCESS Il CLAIMS-MADE AGGREGATE 5 OED T RETENTIONS S WORKERS COMPENSATION WC STATU- OTH- , AND EMPLOYERS' UABI UTY YIN ANY PROPRIETORIPARTNER/EXECUTIVEEl NIA E.L. EACH ACCIDENT S OPFICERIMEMBER EXCLUDE D7 ( Mandatory In NH ) E.L. DISEASE - EA EMPLOYEE S If yes, describe under DESCRIPTION OF OPERATIONS below E . L. DISEASE POLICY LIMIT S-T t i DESCRIPTION OF OPERATIONS ! LOCATIONS f VEHICLES IAttach ACORD ioi , Additional Remarks Schedule, If more space is required) CERTIFICATE HOLDER IS INCLUDED AS AN ADDTIONAL INSURED WITH RESPECTS TO THE GENERAL LIABILITY ONLY AND THE EVENT NAME : 4TH ANNUAL FIELD OF DREAMS FUNDRAISER , 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 1800 27th .Street AUTHORIZED REPRESENTATIVE .Vero Beach , FL 32960 Helen Crockett/ SEB ACORD 25 ( 2010105 ) © 1988-2010 ACORD CORPORATION. All rights reserved. INS025goico5) oi ir" ATRI ~ � ^ nd logo are registered marks of ACORD RECEIVED TIME JUL , 5 . 3 . 52PM