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2011-159
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Last modified
2/11/2016 12:03:30 PM
Creation date
10/1/2015 2:44:22 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Agreement
Approved Date
07/19/2011
Control Number
2011-159
Agenda Item Number
8.I.
Entity Name
Holman Stadium
Indian River County Bar Association
MILB
Subject
Holman Stadium Use Agreement
Area
Holman Stadium
Supplemental fields
SmeadsoftID
10060
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--� INDIA12 OP ID : MA <br /> CERTIFICATE OF LIABILITY INSURANCE DAT07/21 /11vvv) <br /> THIS CERTIFICATE IS ISSUED AS A 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 , <br /> subject to <br /> the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer <br /> rights to the <br /> certificate holder in lieu of such endorsement(s ) . <br /> CONTACT <br /> PRODUCER 772-231 -2022 NAME : <br /> Vero Insurance , Inc . 772_231 _7444 PHONE FAX <br /> 3339 Cardinal Drive _(AIC, No Ext : A/C No): <br /> Vero Beach , FL 32963 E-MAIL <br /> ADDRESS : <br /> Joe Chiarella <br /> INSURER(S) AFFORDING COVERAGE NAIC # <br /> INSURERA : MOuntVernon Fire Ins Co <br /> INSURED Indian River County INSURER B : <br /> Bar Association <br /> Barry Segal <br /> INSURERC : <br /> 621 17th Street INSURER D : <br /> Vero Beach , FL 32960 INSURER E : <br /> INSURER F : <br /> COVERAGES CERTIFICATE NUMBER : REVISION NUMBER : <br /> THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW 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 THE <br /> TERMS , <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. <br /> INSR TYPE OF INSURANCE ADDL SUB POLICY NUMBER MMLDD/YYYY MML <br /> POICY EFF PICY EXP <br /> LTR DD/YYYY LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ 110003000 <br /> A X COMMERCIAL GENERAL LIABILITY CL2601880 07/30/11 08/01 /11 PREM SES Ea occur ence $ 1005000 <br /> CLAIMS-MADE 1XI OCCUR MED EXP (Any one person) $ 11000 <br /> PERSONAL & ADV INJURY $ 11000 , 000 <br /> GENERAL AGGREGATE $ 21000 , 000 <br /> GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ 2 , 0005000 <br /> POLICY PRO LOC $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> Ea accident $ <br /> ANY AUTO BODILY INJURY (Per person) $ <br /> ALL OWNED SCHEDULED BODILY INJURY (Per accident) $ <br /> AUTOS AUTOS <br /> NON-OWNED PROPERTY DAMAGE $ <br /> HIRED AUTOS AUTOS Per accident <br /> UMBRELLA LIAR OCCUR EACH OCCURRENCE $ <br /> EXCESS LIAB HCLAIMS-MADE AGGREGATE $ <br /> DED I I RETENTION $ $ <br /> WORKERS COMPENSATION WC STATU- OTH- <br /> AND EMPLOYERS' LIABILITY Y / N EIR <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEE. L. EACH ACCIDENT $ <br /> OFFICER/MEMBER EXCLUDED? ❑ N / A <br /> ( Mandatory in NH) E. L. DISEASE - EA EMPLOYEE $ _ <br /> If yes , describe under <br /> DESCRIPTION OF OPERATIONS below E. L. DISEASE - POLICY LIMIT $ <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required) <br /> Softball Game taking place at 3901 - 26th Street, Vero Beach , FL 32960 on <br /> 7/30/2011 . Certificate holder is named as additional insured regarding this <br /> event. <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF , NOTICE WILL BE DELIVERED IN <br /> MILB Vero Beach , LLC ACCORDANCE WITH THE POLICY PROVISIONS . <br /> 3901 - 26th Street <br /> Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE <br /> Joe Chiarella <br /> © 1988 -2010 ACORD CORPORATION . All rights reserved . <br /> ACORD 25 ( 2010/05 ) The ACORD name and logo are registered marks of ACORD <br />
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