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2016-096I
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2016-096I
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Last modified
11/4/2016 10:43:14 AM
Creation date
11/3/2016 1:32:26 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
06/21/2016
Control Number
2016-096I
Agenda Item Number
8.G.
Entity Name
Youth Guidance Mentoring & Activities Program
Subject
Mentoring Academy
Children's Services Advisory Grant Contract
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i <br /> Client#: 66175 YOUTGUI <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCEATE 1 008/19/2016 <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: <br /> The LIMA Companies,Inc. aCC NO Ext):703 739-9300 FAX No: 7037390761 <br /> 2750 Killarney Dr,Suite 202 E-MAIL <br /> ADDRESS: <br /> Woodbridge,VA 221924124 <br /> CUSTOMER ID#: <br /> 703 739-9300 INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURED INSURER A:Alliance of Nonprofits for Ins 10023 <br /> Youth Guidance Donation Fund of IRC INSURER B:Transportation Insurance Compan 20494 <br /> PO Box 121 <br /> INSURER C: <br /> Vero Beach, FL 32961 <br /> INSURER D <br /> INSURER E: <br /> INSURER F: <br /> COVERAGES CERTIFICATE NUMBER: 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 /> IN RIDL UBR POLICY EFF POLICY EXP <br /> LTR TYPE OF INSURANCE NSR D POLICY NUMBER MM/DID MM/DD LIMITS <br /> A GENERAL LIABILITY 201627326 7/22/2016 07/22/2017 EACH OCCURRENCE $1,000,000 <br /> A AGE TO X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence) 5500,000 <br /> CLAIMS-MADE a OCCUR MED EXP(Any one person) 520,000 <br /> PERSONAL&ADV INJURY S1,000,000 <br /> GENERAL AGGREGATE 53,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG 53,000,000 <br /> POLICY PRo- LOC S <br /> A AUTOMOBILE LIABILITY 201627326 7/22/2016 07/22/2017 COMBINED SINGLE LIMIT S <br /> (Ea accident) 1,000,000 <br /> X ANY AUTO BODILY INJURY(Per person) S <br /> ALL OWNED AUTOS <br /> BODILY INJURY(Per accident) 5 <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> X HIRED AUTOS <br /> (Per accident) S <br /> X NON-OWNED AUTOS <br /> $ <br /> $ <br /> UMBRELLA UAB OCCUR EACH OCCURRENCE S <br /> EXCESS LIAB CLAIMS-MADE AGGREGATE $ <br /> DEDUCTIBLE $ <br /> RETENTION S S <br /> B WORKERS COMPENSATION 4024181554 10/24/2015 10/24/2016 1 WC STATU- OTH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVEY YIN <br /> N/A E.L.EACH ACCIDENT $1 OO,000 <br /> OFFICER/MEMBER EXCLUDED? N <br /> (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $100,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 <br /> A I Impr Sexual Cond 201627326 7/22/2016 07/22/2017 $750,000/$750,000 <br /> DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) <br /> Indian River County is included as an additional insured under the general liability policy,as their <br /> interest may appear,as respects to work being performed by the insured. <br /> CERTIFICATE HOLDER CANCELLATION <br /> Indian River County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN <br /> 1801 27th Street ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Vero Beach, FL 32960 <br /> AUTHORIZED REPRESENTATIVE <br /> 1988-2009 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2009/09) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S340895/M340891 BAB <br />
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