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DATE(MMIDD/YYYY) ACOR" CERTIFICATE OF LIABILITY INSURANCE 64. � 09/28/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Mary White John L. Kirby & Associates, Inc. PHONE 387-9798 X 387-92704196 Herschel Street A/C No x • (904) FA E-MAIL Jacksonville FL 32210 ADDRESS: ma lkirb .com INSURERS AFFORDING COVERAGE NAIL 9 INSURERA:Great American Insurance Co. 16691 INSURED (772) 466-8535 INSURER B:Great American Assurance Co. 26344 Big Brothers Big Sisters of - St. Lucie, Indian River & Okeechobee Co. INSURER C:Great American Alliance Ins. 26832 403 N. IIS Highway 1 INSURER D: Fort Pierce FL 34950 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 518 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. /NSRTYPE OF INSURANCE NSID SUER POLICY NUMBER MMLY EFF LTR DD/YYYY) IMMIDOIYYYYJ LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 TO RENTED CLAIMS-MADE FXIOCCUR GLP113706402 08/10/2016 08/10/2017PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ S,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: I GENERAL AGGREGATE $ 3,000,000 X POLICYE]JEC7 F LOC PRODUCTS-COMP/OP AGG $ 3,000,000 OTHER: $ AUTOMOBILE LIABILITY (CEO, SINGLE LIMIT $Ea acddent 1,0001000 A X ANY AUTO CAP113706502 08/10/2016 08/10/2017 BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) E AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE _ X AUTOS ONLYAUTOS ONLY Per accident) $ C X UMBRELLALIAB X OCCUR UMB113706602 08/10/2016 08/10/2017 EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 DED X RETENTION E None $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY YIN PER I ERH ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ _ OFFICERIM EMBER EXCLUDED? ❑ NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 5 5 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Children's Services Advisory Committee 1801 27th Street AUTHORIZED REPRESENTATIVE Vero Beach FL 32960 ��1 ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD Page 1 of 1