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2015-130F
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2015-130F
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Last modified
3/30/2017 2:17:03 PM
Creation date
11/5/2015 11:19:35 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Grant
Approved Date
07/07/2015
Control Number
2015-130F
Agenda Item Number
8.I.
Entity Name
Redlands Christian Migrant Association
Subject
Children's Services Advisory Committee
Grant Contract
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AC R®® <br />s.v CERTIFICATE OF LIABILITY INSURANCE <br />DATE (MM/DD/YYYY) <br />08/13/2015 <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 1-813-229-8021 <br />M. E. Wilson Co., Inc. <br />300 W. Platt St. <br />Ste 200 <br />Tampa, FL 33606 <br />CONTACT <br />NAME: Kelly B. Sutton, CIC <br />PHONE 813-349-2233 FAX 813-229-2795 <br />(A/C. No. Ext): (A/C, No): <br />E-MAIL <br />ADDRESS. ksutton@mewilson.com <br />INSURER(S) AFFORDING COVERAGE <br />NAIC # <br />INSURER A: ZENITH INS CO <br />13269 <br />INSURED <br />Redlands Christian Migrant Association, Inc. <br />402 W. Main Street <br />Immokalee, FL 34142-3933 <br />INSURER B : <br />INSURER C : <br />INSURERD. <br />$ <br />INSURER E : <br />INSURERF: <br />COVERAGES <br />CERTIFICATE NUMBER: 44784776 <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 />LTRJ((SD <br />TYPE OF INSURANCE <br />ADDL <br />SUBR <br />WVD <br />POLICY NUMBER <br />POLICY EFF <br />/Y <br />IMM/DDYYY) <br />POLICY EXP <br />(MM/DD/YYYY) <br />LIMBS <br />COMMERCIAL GENERAL LABILITY <br />EACH OCCURRENCE <br />$ <br />CLAIMS -MADE <br />OCCUR <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$ <br />MED EXP (Any one person) <br />$ <br />PERSONAL & ADV INJURY <br />$ <br />GE <br />'L AGGREGATE <br />POLICY <br />OTHER: <br />LIMIT APPLIES <br />PRO- <br />JECT <br />PER: <br />LOC <br />GENERAL AGGREGATE <br />$ <br />PRODUCTS - COMP/OP AGG <br />$ <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />_ <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <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 />OCCUR <br />CLAIMS -MADE <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />DED <br />RETENTION $ <br />$ <br />A <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY <br />ANY PROPRIETOR/PARTNER/EXECUTIVE <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory In NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />Y N <br />N / A <br />Z071611404 <br />08/16/15 <br />08/16/16 <br />R <br />STATUTE PER <br />IERH <br />E.L. EACH ACCIDENT <br />$ 500,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 500,000 <br />E.L. DISEASE - POLICY LIMIT - <br />$ 500,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) <br />CERTIFICATE HOLDER CANCELLATION <br />Indian River County <br />1801 27th Street <br />Vero Beach, FL 32960 <br />USA <br />SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br />THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br />ACCORDANCE WITH THE POLICY PROVISIONS. <br />AUTHORIZED REPRESENTATIVE <br />ri2j2q\N' <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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