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HOMEFAI <br />OP ID: BR <br />AC RI CERTIFICATE OF LIABILITY INSURANCE <br />DATE 09/22/DDIYYYY) <br />09/22/2014 <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 />Brown & Brown of Florida, Inc <br />Suite 400 <br />1401 Forum Way <br />West Palm Beach, FL 33401 <br />Kyle Bloemers <br />CONTACT <br />NAMEPHONE: <br />I FAX <br />(A/C, No, E1 1 (A/C, No): <br />POLICY EXP <br />(MM/DDIYYYY) <br />ADDRESS: <br />INSURER(S) AFFORDING COVERAGE <br />NAIC 11 <br />INSURER A: Granite State Insurance Co + <br />X <br />INSURED Homeless Family Center, Inc. <br />715 4th Place <br />Vero Beach, FL 32962 <br />INSURERB:* Comp Options Ins Co + <br />10834 <br />INSURER c : Travelers Casulty & Surety Co+ <br />EACH OCCURRENCE <br />INSURER D : New Hampshire Ins Co + <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />INSURER E : Aspen Specialty Insurance Co+ <br />10717 <br />INSURER F : <br />CLAIMS -MADE <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 />INSRLTR <br />TYPE OF INSURANCE <br />ADDL <br />NSR <br />SUBR WVD <br />POLICY NUMBER <br />POLICY EFF <br />(M MIDD/YYl'Y) <br />POLICY EXP <br />(MM/DDIYYYY) <br />LIMITS <br />A <br />GENERAL <br />X <br />LIABILITY <br />COMMERCIAL GENERAL LIABILITY <br />X <br />02LX0240556420001/09/2014 <br />01/09/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />DAMAGE TO RENTED <br />PREMISES (Ea occurrence) <br />$ 100,000 <br />CLAIMS -MADE <br />X OCCUR <br />MED EXP (Any one person) <br />$ 10,000 <br />PERSONAL E. ADV INJURY <br />$ 1,000,000 <br />GENERAL AGGREGATE <br />$ 3,000,000 <br />GEN'L AGGREGATE <br />7 POLICY <br />LIMIT APPLIES <br />RO- <br />j7 <br />PER- <br />LOC <br />PRODUCTS - COMP/OP AGG <br />$ 3,000,000 <br />Emp Ben. <br />$ 1,000,000 <br />D <br />AUTOMOBILE <br />X <br />LIABILITY <br />ANY AUTO <br />ALL OWNED <br />AUTOS <br />HIRED AUTOS <br />SCHEDULED <br />AUTOS <br />NON -OWNED <br />AUTOS <br />01CA0190499630 <br />01/09/2014 <br />01/09/2015 <br />COMBINED SINGLE LIMIT <br />(Ea accident) <br />$ 1 ,000,000 <br />BODILY INJURY (Per person) <br />$ <br />BODILY INJURY (Per accident) <br />$ <br />PROPERTY DAMAGE <br />JPER ACCIDENT) <br />$ <br />A <br />X <br />UMBRELLA UAB <br />EXCESSLIAB <br />X <br />OCCUR <br />CLAIMS -MADE <br />02UD0428647980 <br />01/09/2014 <br />01/09/2015 <br />EACH OCCURRENCE <br />$ 1,000,000 <br />AGGREGATE <br />$ 1,000,000 <br />$ <br />DED X <br />RETENTION $ 10,000 <br />B <br />WORKERS COMPENSATION <br />AND 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 />Y / N <br />N / A <br />OCOCWC000113101 <br />09/11/2013 <br />09/11/2014 <br />X <br />WC STAT- <br />TORY LIMITS <br />OTH- <br />ER <br />E.L EACH ACCIDENT <br />$ 500,000 <br />E.L. DISEASE - EA EMPLOYEE <br />$ 500,000 <br />E.L DISEASE - POLICY LIMIT <br />$ 500,000 <br />C <br />E <br />Crime <br />PROPERTY <br />105549971 <br />PBU919214 <br />01/09/2014 <br />01/09/2014 <br />01/09/2015 <br />01/09/2015 <br />Fidelity 500,000 <br />ERISA 500,000 <br />DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 1D1, Additional Remarks Schedule if more space is required) <br />Indian River County Local Housing Assistance Program Community <br />Development Department are Additional Insured with respects <br />to General Liability as required by written contract. <br />CERTIFICATE HOLDER <br />CANCELLATION <br />INDIA70 <br />Indian River Cty Local Housing <br />Assistance Program Community <br />Development Dept Admin Bldg A <br />1801 27th Street <br />Vero Beach, FL 32960-3388 <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 />© 1988-2010 ACORD CORPORATION. All rights reserved. <br />ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD <br />