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t;tk--io-�UU4 'IHU 03;4:; P!'1 AJG PRM UNIT <br />rAk NO, 4073550742 <br />P. 05 <br />AgoRn CERTIFICATE OF LIABILITY INSURANCE OP ID ]; DATEINLIIDO1nYYI <br />2NDIAiiR <br />04/15/04 <br />PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br />ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE <br />A. J. Gallagher & Cc - Orlando HOLDER, THIS CERTIFICATE DOZES NOT AMEND, EXTEND OR <br />7380 Sand Lake Rd. Suite 390 ALTER THE COVERAGE AFFORDED SY THE POUCIES BELOW. <br />Orlando FL 32819 <br />Phone: 407-370-2320 Fax; 407-37 D-3057 INSUR9RSAFFORDING COVERAGE MAIC 8 <br />INbUREO INSURA: Caieed ubsioaa: Yauurance Ce. +~ <br />RPI <br />Indian Inver AOCC INSURER G: <br />Seth 3ordau Disk Xanager INSURER C; <br />.1840 25th S�. INSURCRD: <br />Vero BeaCh FL 32960 <br />---r—'— <br />;0VERAGES <br />THE POLICIC•S OF INSURANCE LISTED BELOW NAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br />ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT W" RESPECTTD WHICH THIS CERTIFICATE MAYBE ISSUED OR <br />MAY PEri TA•N, THE INSURANCE AFFORDED BY THE POLICES DESCP.IBED HEREIN IS SUEJECT TC ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH <br />POUCI=S. ALCREGATE LIMITS SHOWN MAY WAVE SEEN KD'JCED BY PAID CLAIM°u: <br />IRSR NSRC — TYPE OF INSURANCE —^ POU NUM4lxZk I OLQdnTFTOTIV T7C7E5� 1TiTtJ <br />DATE MMIMIYY DArk IM16VDD1YY' LIWTS <br />A I <br />ERAL LIABILITY <br />L-oz'-"tO&iVERCIALGP14ERALLLABiLrry <br />x OCCUR <br />CLAIME ,X7 <br />CP 00 6 5.4 6 9 <br />10/01/03 <br />10 /01 / D4 <br />�? <br />EACH OCCURRENCE S <br />P t£A� ilk Se ee occurence; I S <br />MaD HAT IAnY Dne Amon) { 3 <br />900,000 :Cs $100,000 <br />PERSONAL&ADV INJURY S sir <br />GENERAL AGGREGATE $1000000 <br />GEN'LgGGREOATELINITAPPLIESPER;I <br />POLICY 7 29Tr. LOC <br />- <br />PRODUCTS-GOMPlOPAGG S including <br />. AUTOMORMEUABILNY <br />ANY AUTO I <br />'THIS INSLWNCE is <br />� <br />•� <br />OQN®INED SINGLE LIMIT S <br />(Ea acdaent) <br />ALL owNt D Aur05 1 <br />SCHEDULED AUTOS(Per <br />IiIREDAUTOS ! <br />NON•C,'WNEQAUTDS <br />l I <br />-• • I <br />_... <br />THE F1 L7RIDA !!( p <br />PERSONS INSURED If <br />CARRIERS DO NOT HA <br />OF THE FLORIDA INN <br />ACT TO THE EXTENT <br />FE2COVERY FOR THE O <br />LM �pj <br />u UM Lima*(per <br />T <br />ANC6 <br />AW IWHT OP <br />t3ATOq!! OF <br />N <br />I <br />I <br />-.— <br />D Y INJURY S <br />acnan) <br />--i <br />BODILY INJURY � b � <br />1Poracudert) —I <br />- --• --- <br />FROPEity OAMAOF. I L <br />(Peraeeaenq <br />GAARAGELIMLITY <br />AUTO ONLY - EA ACCIDENT E <br />OTrC-RTHAN I ACC S <br />AUfO ONLY! AGC F <br />-�ANYAUTO <br />I <br />EXC&SSIUMBRELLA LIABILITY <br />I <br />EACH OCCURRENCE _ <br />OCCUR LJ CLAIMS MADE <br />I AGGREGATE p ,. <br />S <br />OEOJCTI9LE <br />5 <br />RETENTION STH <br />WORKERS COMPENSATION AND <br />EMPLOYERS' LIABILRY <br />ANY PROF'RIETORIPARTNER/EXECIITNE <br />OFFICERIMEMSER EXCLUDED? <br />' <br />TORY LIMfTS i ER <br />E.L.EACHACCIDENT to <br />E.L. DISEASE - EA EMPLOYES S <br />tt YyCS pnsrrihe undo' <br />SP£GXLAL PROVISIONS below <br />E.L. DIS[ASE -POLICY UNI f $ <br />OTHER <br />A <br />PROPERTY COVERAGE <br />CPDD65469 10/01/03: 10/01/04 real & $1,000,000 <br />$900K XS $100K ersonal incl sir <br />G£SCRIF i 1014 OF `}PERAT)CNS 1 LOCATIONS I VEHICLES I EXCLUSIONS ADDED 8Y ENDORSEMENT I SPEWAL PROVISIONS <br />As proof of insurance for Indian Xiver. County IBOCC regarding their <br />lease/purchase of equipment as shown on schedule seat to 10G dated 04/7.4/04. <br />Certificate Holder is loss Paye® in relation to the list of itAn <br />CERTIFICATE MOLDER CANCELLATION <br />$Jr�+.�lliQD SHOULD ANY OFTHE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br />DA79 YHEREOF. THE ISSUING INSURER %V" ENDEAVOR TO MAIL DAYS WRITTEN <br />NOTICE TO THE CERTIFIGA7& MOLDER NAMED TO THE LEFT, BUY FAILURE TO DO SO SHALL <br />HBFS Equipment Leasing IMPOSE NO00LIGATIONORLIA81 YOFANYKINDUPONTHA RER.IT$AGENTSO <br />4333 Edgewood Rd, Suite 400 <br />Cedar Rapids Iii 5.2499 hEPRE3ENTATIVE$_'_.._._..._ <br />ACORD 25 <br />CORPORATION 1988 <br />