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CERTIFICATE OF COVERAGE ISSUED ON: 10/2/2012 <br /> COVERAGE PROVIDED BY:PREFERRED GOVERNMENTAL INSURANCE TRUST <br /> PACKAGE AGREEMENT NUMBER:PK FLl 0314006 12-10 COVERAGE PERIOD: 10/1/2012 TO 10/1/2013 12:01 AM <br /> COVERAGES:This is to certify that the agreement below has been issued to the designated member for the coverage period indicated.Notwithstanding any <br /> requirement,term or condition of any contract or other document with respect to which this certificate may be issued or may pertain,the coverage afforded by the <br /> agreement described herein subject to all the terms,exclusions and conditions of such agreement. <br /> Mail to:Certificate Holder Designated Member <br /> Indian River County Senior Resource Association,Inc. <br /> 1801 27th Street 694 14th Street <br /> Vero Beach,FL 32960 <br /> Vero Beach,FL 32960 <br /> LIABILITY COVERAGE WORKERS'COMPENSATION COVERAGE <br /> X Comprehensive General Liability,Bodily Injury,Property Damage <br /> and Personal Injury <br /> Limit$1,000,000/N/A SO Deductible <br /> X Public Officials Liability Self Insured Workers'Compensation <br /> Limit$1,000,000 $1,000 Deductible Statutory Workers'Compensation <br /> X Employment Practices Liability <br /> Limit$1,000,000 51,000 Deductible Employers Liability <br /> X Employee Benefits Liability Each Accident <br /> Limit$1,000,000/N/A SO Deductible By Disease <br /> T.aw F.nfarrement Linhil tv Aggregate Disease <br /> Limit <br /> PROPERTY COVERAGE AUTOMOBILE COVERAGE <br /> X Buildings&Personal Property Automobile Liability <br /> Per schedule on file with $5,000 Deductible Limit$1,000,000 $0 Deductible <br /> TrustLimit <br /> X All Owned <br /> Note:See coverage agreement_for details on wind,food,and other Specifically Described Autos <br /> deductibles. <br /> X Rented,Borrowed and Leased Equipment X Hired Autos <br /> Limit$50,000 TIV See Schedule for Deductible X Non-Owned Autos <br /> X All other Inland Marine Automobile Physical Damage <br /> Limit$250,000 TIV See Schedule for Deductible X Comprehensive See Schedule for Deductible <br /> X Collision See Schedule for Deductible <br /> X Hired Auto with limit of$35,000 <br /> Garage Keepers <br /> Liability Limit <br /> Liability Deductible <br /> Comprehensive Deductible <br /> Collision Deductible <br /> NOTE:The most we will pay is further limited by the limitations set forth in Section 768.28(5),Florida Statutes(2010)or the equivalent limitations of successor law which <br /> are applicable at the time of the loss. <br /> This certificate is issued as a matter of information only and confers no rights upon the certificate holder.This certificate does not amend,extend or alter the coverage <br /> afforded by the agreement above. <br /> CANCELLATIONS <br /> SHOULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANCELLED BEFORE THE EXPIRATION DATE <br /> THEREOF,PREFERRED GOVERNMENTAL INSURANCE TRUST WILL ENDEAVOR TO MAIL60 DAYS WRITTEN <br /> NOTICE,OR 10 DAYS WRITTEN NOTICE FOR NON-PAYMENT OF PREMIUM.TO THE CERTIFICATE HOLDER <br /> NAMED ABOVE.BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF.ANY <br /> KIND UPON THE PROGRAM,ITS <br /> AGENTS <br /> /ORR`REPRESENTATIVES. <br /> eAUTHORIZED REPRESENTATIVE <br /> PGIT-CERT(11/09)PRINTFORM 10/2/2012 <br /> 59 <br />