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'aCo°ZD® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) <br /> 11/17/2015 <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 CONTACT <br /> NAME. Michele Cr1faS1 <br /> Stahl & Associates Insurance Inc. HONE Ext: (863) 688-5495 FAC,No; (863)688-4344 <br /> IA/91 Lake Morton Drive E-MAIL <br /> ADDRESS.michele.crifasi@stahlinsurance.com <br /> P O Box 3608 INSURER(S)AFFORDING COVERAGE NAIC# <br /> Lakeland FL 33802 INSURERA:Southern Owners Insurance Co 10190 <br /> INSURED INSURERB:FFVA Mutual Insurance Co <br /> Guardian Community Resource Management Inc INSURERC:United States Liability Ins Co <br /> 3020 Bruton Rd INSURER D: <br /> INSURER E. <br /> Plant City FL 33565 INSURER F: <br /> COVERAGES CERTIFICATE NUMBER:Master 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 I ADDL UBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS <br /> X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 <br /> A CLAIMS-MADE ❑X OCCUR DAMAGE TO RENTED 300,000 <br /> PREMISES Ea occurrence $ <br /> 20154809 5/3/2015 5/3/2016 MED EXP(Any one person) $ 10,000 <br /> PERSONAL&ADV INJURY $ 1,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 <br /> POLICYI JECOT- F]LOC PRODUCTS-COMP/OP AGG $ 2,000,000 <br /> OTHER: $ <br /> AUTOMOBILE LIABILITYEOa aBINEDISINGLE LIMIT $ 1,000,000 <br /> A ANY AUTO BODILY INJURY(Per person) $ <br /> ALL OWNED SCHEDULED <br /> AUTOS AUTOS 20154809 5/3/2015 5/3/2016 BODILY INJURY(Per accident) $ <br /> X HIRED AUTOS X NON-OWNEDHired 6 Non-Owned Auto PROPERTY DAMAGE $ <br /> AUTOS Per accident <br /> liability only $ <br /> X UMBRELLA LIAB X OCCUR <br /> EACH OCCURRENCE $ 2,000 000 <br /> A EXCESS LIAB CLAIMS-MADE AGGREGATE $ 2,000,000 <br /> DED I X I RETENTION$ 10,000 4657373401 5/03/2015 5/3/2016 $ <br /> WORKERS COMPENSATION PER OTH- <br /> AND EMPLOYERS'LIABILITY Y/N X STATUTE 7 ER <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ 1,000,000 <br /> OFFICER/MEMBER EXCLUDED? � N/A <br /> B <br /> (Mandatory in NH) WC84000183642015A 1/2/2015 1/2/2016 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 <br /> N yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 <br /> C Professional Liability SP1014974G 4/13/2015 4/13/2016 General Aggregate 2,000,000 <br /> Each Occurrence 1,000,000 <br /> DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> Indian River County Board of THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> County Commissioners ACCORDANCE WITH THE POLICY PROVISIONS. <br /> 1801 27th Street <br /> Vero Beach, FL 32960 AUTHORIZED REPRESENTATIVE <br /> Gerald Powell/CRIFAS <br /> ©1988-2014 ACORD CORPORATION. All rights reserved. <br /> ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD <br /> INS025 0014011 <br />