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A� ods CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 9/30/2015 THIS 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 policy(les) 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). PRODUCER CONTACT NAME: Mary White EFF (on MM ODYIYYYY) EXP (MOM/DDIYYYY) John L. Kirby & Associates, Inc. PHONE FAX I X COMMERCIAL GENERAL 4196 Herschel Street (904) 387-9798 (A/C,No): (904) 387-9270 -IA/C.N9.gMl: EDDR mar lkirb_ com ADDRESS: y� Y• --I 8/10/2015 Jacksonville FL 32210 EACH OCCURRENCE $ 1,000,000 GEN'L 1 INSURER(S)AFFORDING COVERAGE NAIC p -$ 100,000 INSURERA: Great_ American Assurance Co 26344 INSURED (772) 466-8535INSURERB.Great American Alliance Ins Co AGGREGATE LIMIT APPLIES PER: POLICY L J PRO- 117 LOC OTHER: 26832 Big Brothers Big Sisters of PRODUCTS - COMP/OP AGG $ 3,000,000 St. Lucie, Indian River & Okeechobee Co., Inc INSURERC: _. _____ __. _______ 403 N. US Hwy 1 _ INSURERD. CAP113706501 8/10/2015 Fort Pierce FL 34950 INSURER E: $ 1,000,000 INSURER F : $ BODILY INJURY (Per accident) TIFICATE NUMBER: cert ID 218 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NAMED ABOVE FOR THE DOCUMENT WITH RESPECT HEREIN IS SUBJECT TO LIMITS POLICY PERIOD TO WHICH THIS ALL THE TERMS, INSR TYPE OF INSURANCE rAINSD DDL SWVD POLICY NUMBER EFF (on MM ODYIYYYY) EXP (MOM/DDIYYYY) A X COMMERCIAL GENERAL LIABILITY OCCUR Y GLP113706401 8/10/2015 8/10/2016 EACH OCCURRENCE $ 1,000,000 GEN'L 1 CLAIMS -MADE LJ DAMAGE TO RENT E0 PREMISES IEaocnxrence) -$ 100,000 MED EXP (Anyone person) $ 5,000 PERSONAL a ADV INJURY $ 1,000,000 AGGREGATE LIMIT APPLIES PER: POLICY L J PRO- 117 LOC OTHER: GENERAL AGGREGATE $ 3,000,000 PRODUCTS - COMP/OP AGG $ 3,000,000 $ A AUTOMOBILE LIABILITY • XI ANY AUTO ALL OWNED r- AUTOS X HIRED AUTOS X i— SCHEDULED AUTOS AUTONON-OWNED CAP113706501 8/10/2015 8/10/2016 COMBINED SINGLE LIMIT accident $ 1,000,000 -(Ea BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PrPROPERTY DAMAGE --$ $ B X .-- UMBRELLA LIAB rX OCCUR EXCESS LIAR I CLAIMS -MADE UMB113706601 8/10/2015 8/10/2016 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 DEO X I RETENTIONS None $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERJMEMBER EXCLUDED? (Mandatory in NH) II yes, describe under DESCRIPTION OF OPERATIONS Y / N N / A PEROTH- STATUTE I ER EL. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ below E.L. DISEASE - POLICY LIMIT ; $ DESCRIPTION OF OPERATIONS / LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it mo e space is requi ed) Additional Insured: Indian River County per written contract or agreement per Form CG8224 (12/01). CERTIFICATE HOLDER CANCELLATION Childrene Services Advisory Committee of Indian River County 4675 28th Court Vero Beach FL 32967 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ACORD 25 (2014/01) ©1988.2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD n-.... + ..c 1