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SU BST -5
<br />OP ID: JS
<br />,a►` JRL CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MMY)
<br />02111/120142014
<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
<br />Ryan Weaver Insurance, Inc.
<br />CenterState Bank Bldg.
<br />855 21 st Street - 2nd Floor
<br />Vero Beach, FL 32960
<br />Ryan M. Weaver
<br />CONTACT
<br />PHONE FAX
<br />(Arc No Ext: (AIC, No):
<br />E-MAIL
<br />ADDRESS:
<br />INSURER(S) AFFORDING COVERAGE
<br />NAIL 1
<br />INSURER A : Markel
<br />38970
<br />INSURED Substance Abuse Council of IRC
<br />1507 20th Street
<br />Vero Beach, FL 32960
<br />INSURER B: Bridgefield Employers Ins Co
<br />8502SS3346804
<br />"
<br />"t
<br />INSURER c : Philadelphia Insurance Co.
<br />01/15/2015
<br />INSURER D:
<br />$ 1,000,000
<br />INSURER E :
<br />$ 100,000
<br />INSURER F :
<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 />LTR
<br />TYPE OF INSURANCE
<br />ADOL
<br />INSR
<br />SUBR
<br />W
<br />POLICY NUMBER
<br />POLICY EFF
<br />(MM!DOYYY)
<br />POLICY EXPWWIIY
<br />(MMIDDIYYYY)
<br />LIMBS
<br />A
<br />GENERAL
<br />X
<br />LIABILITY
<br />COMMERCIAL GENERAL LIABILITY
<br />8502SS3346804
<br />"
<br />"t
<br />01/25/2014
<br />01/15/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />DAMAGE TD RENTEO
<br />PREMISES {Ea occurrence}
<br />$ 100,000
<br />CLAIMS -MADE
<br />X
<br />OCCUR
<br />MED EXP (Any one person)
<br />$ 5,000
<br />X
<br />Sexual Molestatio
<br />PERSONAL & ADV INJURY
<br />$ 1,000,000
<br />X
<br />Professional Liab
<br />GENERAL AGGREGATE
<br />$ 3,000,000
<br />GEN'L AGGREGATE LIMIT APPLIES PER
<br />POLICY JECCT Ii LOC
<br />PRODUCTS- COMP/OP AGG
<br />$ 3,000,000
<br />Emp Ben.
<br />$ 1,000,000
<br />A
<br />AUTOMOBILE
<br />X
<br />LIABILITY
<br />ANY AUTO
<br />ALL OWNED
<br />AUTOS
<br />HIRED AUTOS
<br />X
<br />SCHEDULED
<br />AUTOS
<br />SWNED
<br />AUTO
<br />8502SS3346804
<br />01125/2014
<br />01/25/2015
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />$ 1,000,000
<br />BODILY INJURY (Per person)
<br />$
<br />BODILY INJURY (Per accident)
<br />$
<br />MAGE
<br />PROPERTY ACCIDENT)
<br />$
<br />A
<br />X
<br />UMBRELLA LIAB
<br />EXCESS LIAB
<br />X
<br />OCCUR
<br />CLAIMS -MADE
<br />4602SS3346813
<br />01/2512014
<br />01/25/2015
<br />EACH OCCURRENCE
<br />$ 1,000,000
<br />AGGREGATE
<br />$
<br />$
<br />DED X RETENTION $ 10000
<br />B
<br />WORKERS COMPENSATION
<br />AID EMPLOYERS' LIABILITY
<br />ANY PROPRIETOR/PARTNER/EXECUTIVE
<br />OFFICER/MEMBER EXCLUDED?
<br />(Mandatory in NH)
<br />If yes, describe under
<br />DESCRIPTION OF OPERATIONS below
<br />YIN
<br />N 1 A
<br />196-24851
<br />01/1012014
<br />01/1012015
<br />WC STATU-
<br />TORY LIMITS
<br />OTH-
<br />ER
<br />E L EACH ACCIDENT
<br />$ 1,000,000
<br />E L DISEASE - EA EMPLOYEE
<br />$ 1,000,000
<br />E L DISEASE- POLICY LIMIT
<br />$ 1,000,000
<br />C
<br />D&O
<br />PHSD908536
<br />01/25/2014
<br />01/25/2015
<br />Dir & Off 1,000,000
<br />DESCRIPTION OF OPERATIONS ! LOCATIONS 1 VEFICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
<br />FICATE HOLDER
<br />CANCELLATION
<br />Board of County Commissioners
<br />1801 27th St St, Bldg A
<br />Vero Beach, FL 32960
<br />1
<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 />i1
<br />ACORD 25 (2010/05)
<br />© 1988-2010 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />
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