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Client# : 66175 YOUTGUI <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DAT /08/2D/YYYY) <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, subject <br />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 /> Elf <br /> holder in lieu of such endorsement(s) . <br /> PRODUCER <br /> NT <br /> The CIMA Companies , Inc. (CIM ) NAME: <br /> PHONE 703 739.9300 <br /> 2750 Killarney Dr, Suite 202 ac No Ext'. FAX No) , 7037390761 <br /> E-MAIL <br /> Woodbridge , VA 221924124 ADDRESS: <br /> PR DUCER <br /> 703 739 =9300 CUSTOMER ID #: <br /> INSURED INSURER(S) AFFORDING COVERAGE NAIC # <br /> Youth Guidance Donation Fund of IRC INSURER A : Alliance of Nonprofits for Ins 10023 <br /> PO Box 121 INSURERS : Transportation Insurance Compan 20494 <br /> Vero Beach , FL 32961 INSURER C : <br /> INSURER D <br /> INSURER E : <br /> INSURER <br /> COVERAGES CERTIFICATE NUMBER : F <br /> 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 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 TERMS , <br /> EXCLUSIONS AND CONDITIONS OF SUCH POLICIES . LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS . <br /> IN R DDL UBR <br /> LTR TYPE OF INSURANCE POLICY EFF POLICY EXP <br /> N R D POLICY NUMBER MM/OD/YYYY MM/DD/YYYY LIMITS <br /> A GENERAL LIABILITY 201127326 <br /> 07/22/2011 07/22/201 EACH OCCURRENCE $ 1 000 000 <br /> X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED <br /> CLAIMS-MADE 19 OCCUR PREMISES Ea occurrence $500 , 000 <br /> MED EXP (Any one person ) $20s QQQ <br /> PERSONAL & ADV INJURY $ 110001000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER : GENERAL AGGREGATE $ 3 , 000 , 000 <br /> POLICY PRO LOC PRODUCTS - COMP/OP AGG $ 3 , 000 , 000 <br /> JFCTA AUTOMOBILE LIABILITY $ <br /> 201127326 07/22/2011 07122/201 COMBINED SINGLE LIMIT <br /> ANY AUTO <br /> (Ea accident) 1 000000 <br /> ALL OWNED AUTOS BODILY INJURY (Per person) $ <br /> SCHEDULED AUTOS BODILY INJURY (Per accident) $ <br /> X HIRED AUTOS PROPERTY DAMAGE <br /> $ <br /> X NON-OWNED AUTOS (Per accident) <br /> $ <br /> UMBRELLA LIAR $ <br /> OCCUR EACH OCCURRENCE <br /> EXCESS LIAB CLAIMS-MADE $ <br /> DEDUCTIBLE AGGREGATE $ <br /> RETENTION $ $ _ <br /> B WORKERS COMPENSATION $ <br /> AND EMPLOYERS' LIABILITY 402418155410/24/2011 10/24/201 WC STATU- OTH- <br /> OFFICER/MEMBEER EXCLUDED? ECUTIVE Y NJ NIA <br /> (Mandatory in NH) E . L . EACH ACCIDENT $ 100 , 000 <br /> If yes, describe under E . L. DISEASE - EA EMPLOYEE $ 100 , 000 <br /> DESCRIPTION OF OPERATIONS below <br /> E.L. DISEASE - POLICY LIMIT $ 500 , 000 <br /> DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101 , Additional Remarks Schedule, if more space is required) <br /> RE : Heli -Drop Ball Bash & BBQ - February 11 , 2012 <br /> Vero Beach , LLC is included as an additional insured under the general liability policy , as their interest <br /> may appear, as respects to work being performed by the insured . <br /> CERTIFICATE HOLDER CANCELLATION <br /> VeroTown , LLC SHOULD ANY OF T :THEREOF2 <br /> DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Attn : Nancy Gollnick THE EXPIRATION DNOTICE WILL BE DELIVERED IN <br /> 3901 26th Street ACCORDANCE WITICY PROVISIONS , <br /> Vero Beach , FL 32960 AUTHORIZED REPRESENTATIVE <br /> © 1988-2009 ACOrRD CORPORATION . All rights reserved . <br /> ACORD 25 (2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S286826/M284405 <br /> BAB <br /> . _. � <br /> e ,,. <br />