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2015-130B
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Last modified
3/30/2017 2:14:32 PM
Creation date
11/5/2015 11:06:48 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Grant
Approved Date
07/07/2015
Control Number
2015-130B
Agenda Item Number
8.I.
Entity Name
Gifford Youth Achievement Center
Subject
Children's Services Advisory Committee
Grant Contract
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GIFFO-1 <br />OP ID: MS <br />'4� oa CERTIFICATE OF LIABILITY INSURANCE <br />DA09/25/2015Y) <br />09/25/2015 <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 to <br />the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the <br />certificate holder in lieu of such endorsement(s). <br />PRODUCER <br />NFP P & C Services, Inc. <br />Co #2091 <br />500 West Madison St., Ste 2760 <br />Chicago, IL 60661 <br />Michael L. Schwartz <br />CONTACT <br />NAME: Nancy Fletcher <br />PHONE <br />ANCON o, Ext): 312-630-0800 FA312-648-4585 No): 312-648-4585 <br />E-MAIL <br />ADDRESS. nancy@schwartzinsurance.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC 4 <br />INSURERA Markel Insurance Company <br />COMMERCIAL GENERAL LIABILITY <br />INSURED Gifford Youth Achievement <br />Center, Inc. <br />Angelia Perry <br />4875 43rd Ave <br />Vero Beach, FL 32967 <br />INSURER B Progressive Insurance Company <br />8502CY3955891 <br />8502CY3955891 <br />8502CY3955891 <br />INSURER C . <br />06/01/2016 <br />06/01/2016 <br />06/01/2016 <br />INSURER D <br />$ 1,000,000 <br />INSURER E . <br />INSURER F . <br />X <br />COVERAGES <br />CERTIFICATE NUMBER: <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 />INSR <br />LTR <br />TYPE OF INSURANCE <br />AODL <br />INSD <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />(MM/DD/YYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />LIMITS <br />A <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />X <br />8502CY3955891 <br />8502CY3955891 <br />8502CY3955891 <br />06/01/2015 <br />06101/2015 <br />06/01/2015 <br />06/01/2016 <br />06/01/2016 <br />06/01/2016 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />CLAIMS -MADE <br />X <br />OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$ 1,000,000 <br />Hired Auto Liab <br />MED EXP (Any one person) <br />$ 10,000 <br />NonOwned Auto Lia <br />PERSONAL &ADV INJURY <br />$ 1,000,000 <br />GEN'L <br />AGGREGATE <br />POLICY <br />OTHER: <br />LIMIT APPLIES <br />PRO - <br />JECT <br />PER: <br />LOC <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />PRODUCTS-COMP/OPAGG <br />$ 1,000,000 <br />NOHA Liab <br />$ 1,000,000 <br />B <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />X <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />01654457-1 <br />06/01/2015 <br />06/01/2016 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1,000,000 <br />- <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />(Per accident) <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />`r <br />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ _ <br />AGGREGATE <br />$ <br />DED <br />RETENTION$ <br />$ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY Y <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />/ N <br />N / A <br />PER OTH- <br />STATUTE ER <br />E.L. EACH ACCIDENT <br />$ - - <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L. DISEASE - POLICY LIMIT <br />$ <br />A <br />Professional <br />Liability <br />8502CY3955891 <br />06/01/2015 <br />06/01/2016 <br />Per Act 1,000,000 <br />Aggregate 3,000,000 <br />DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if mo e space is requi ed) <br />Certificate Holder is an Additional Insured with respect to General <br />Liability coverage if required by written contract or agreement. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />I <br />Indian River CountyTHE <br />1800 27th St. <br />Vero Beach, FL 32960 <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZZEEDREPRESENTATIVERE <br />ACORD 25 (2014/01) <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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