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2015-130N
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Last modified
3/30/2017 2:20:30 PM
Creation date
11/5/2015 11:55:07 AM
Metadata
Fields
Template:
Official Documents
Official Document Type
Grant
Approved Date
07/07/2015
Control Number
2015-130N
Agenda Item Number
8.I.
Entity Name
Gifford Youth Orchestra
Subject
Children's Services Advisory Committee
Grant Contract
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GIFFO-3 <br />OP ID: AS <br />,4CCERTIFICATE OF LIABILITY INSURANCE <br />�--- <br />DATE(MM1� <br />10!07122015015Y) <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(les) 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 IIeu of such endorsement(s). <br />PRODUCER <br />Ryan Weaver Insurance, Inc.PHONE <br />CenterState Bank Bldg. <br />855 21st Street - 2nd Floor <br />Vero Beach, FL 32960 <br />Jaime Klekamp <br />CONTACTEJaime Klekamp <br />FAX FAX <br />(A1C, No, Ext): (AIC, No): 772-567-4931 <br />E-MAIL <br />ADDRESS. <br />INSURER(S) AFFORDING COVERAGE <br />NAIC 0 <br />INSURERA Auto Owners Insurance Co <br />18988 <br />INSURED The Gifford Florida Youth <br />Orchestra, Inc. <br />8 Vista Gardens Trail #102 <br />Vero Beach, FL 32962 <br />INSURERS <br />72497415 <br />INSURERC <br />09/29/2016 <br />INSURERD <br />$ 1,000,000 <br />INSURER E <br />CLAIMS-MADE <br />INSURER F <br />OCCUR <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 />TYPE OF INSURANCE <br />INSD,D <br />SUBR <br />POLICY NUMBER <br />POLICY EFF <br />(MMIDDIYYYYI <br />POLICY EXP <br />(MMIDDIYYYY) <br />LIMBS <br />A <br />X <br />COMMERCIAL GENERAL LIABILITY <br />72497415 <br />09/29/2015 <br />09/29/2016 <br />EACH OCCURRENCE <br />-15717A7717517717715- <br />PREMISES (Ea occurrence) <br />$ 1,000,000 <br />CLAIMS-MADE <br />X <br />OCCUR <br />$ 50,000 <br />MED EXP (Any one person) <br />$ 5,000 <br />PERSONAL & ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 2,000,000 <br />GE <br />X <br />'L AGGREGATE <br />POLICY <br />OTHER: <br />LIMIT APPLIES <br />PROJECT <br />PER: <br />LOC <br />PRODUCTS- COMPIOP AGG <br />$ 2,000,000 <br />$ <br />AUTOMOBILE <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS_ <br />HIRED AUTOS <br />_ <br />SCHEDULED <br />AUTOS <br />AO TON -AUS <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />((Pere cide tDAMAGE <br />$ <br />$ <br />UMBRELLA LIAB <br />EXCESS LIAB <br />OCCUR <br />CLAIMS -MADE <br />1 <br />EACH OCCURRENCE <br />$ <br />AGGREGATE <br />$ <br />$ <br />DED <br />RETENTION $ <br />WORKERS COMPENSATION <br />AND EMPLOYERS' LIABILITY YIN <br />ANY PROPRIETORIPARTNERIEXECUTIVEN <br />OFFICER/MEMBER EXCLUDED? <br />(Mandatory in NH) <br />If yes, describe under <br />DESCRIPTION OF OPERATIONS below <br />1 A <br />PER <br />STATUTE <br />OTH- <br />ER <br />E.L EACH ACCIDENT <br />$ <br />E.L. DISEASE - EA EMPLOYEE <br />$ <br />E.L DISEASE - POLICY LIMIT <br />$ <br />DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached K more space is required) <br />CANCELLATION <br />I <br />IRCBLDG <br />Indian River County <br />770 5087 <br />1800 27th Street Bldg A <br />Vero Beach, FL 32960 <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 />Jaime Klekamp <br />ACORD 25 (2014101) <br />© 1988-2014 ACORD CORPORATION. All rights reserved. <br />The ACORD name and logo are registered marks of ACORD <br />
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