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Client#: 1252001 SUNSHREH <br /> ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DDIYYYY) <br /> 5/01/2017 <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 I ACT Patsy Penn <br /> USI Ins Svcs,SmCL Vero Beach PHONE 813-321-7566 F� 610-537 2527 <br /> (A/C,No,Ext): (A/C,No): <br /> 2045 14th Ave. E-MAIL ats enn usi.com <br /> Vero Beach, FL 32960 ADDRESS: P Y•P @ <br /> INSURER(S)AFFORDING COVERAGE NAIC# <br /> INSURER A:American Casualty Company of Re 20427 <br /> INSURED INSURER B:Continental Casualty Company 20443 <br /> Sunshine Rehabilitation Center of India INSURER C:Bridgefield Employers Insurance 10701 <br /> 1705 17th Avenue <br /> Vero Beach, FL 32960 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 /> LTR TYPE TYPE OF INSURANCE I NSRWVD L I POLICY NUMBER POLICY EFF POLICY EXP LIMITS <br /> (MMIDD/YYYY) (MM/DD/YYYY) <br /> A X COMMERCIAL GENERAL LIABILITY I B2024668724 02/11/2017 02/11/201d EACH OCCURRENCE 51,000,000 <br /> I DAMAGE TO RENTED <br /> CLAIMS-MADE X I OCCUR PREMISES(Ea occurrence) $300,000 <br /> fMED EXP(Any one person) 510,000 <br /> PERSONAL 8 ADV INJURY 51,000,000 <br /> GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 52,000,000 <br /> X POLICY ECOT LOC PRODUCTS-COMP/OP AGG 52,000,000 <br /> OTHER: 5 <br /> COMBINED SINGLE LIMIT <br /> A AUTOMOBILE LIABILITY I �B2024668724 02/11/2017 02/11/201d,(EOMa accidINent) $$1,000,000 <br /> ANY AUTO ' j BODILY INJURY(Per person) S <br /> ALL OWNED SCHEDULED BODILY INJURY(Per accident) S <br /> AUTOS AUTOS <br /> X HIRED AUTOS X AUTONON-OWNEDS I(Per acPROPERTc tlY ent)DAMAGE S <br /> I I 5 <br /> B x UMBRELLA LIAB X I OCCUR B2095573894 02/11/2017 02/11/2018 EACH OCCURRENCE Si 000,000 <br /> EXCESS LIAB (CLAIMS-MADE! AGGREGATE 51,000,000 <br /> DED I X RETENTION S10,000 I I S <br /> C WORKERS COMPENSATION 83005252 04/01/2017 04/01/2019 X (STATUTEIERH- <br /> AND EMPLOYERS'LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT s500,000 <br /> OFFICER/MEMBER EXCLUDED? y N/A <br /> (Mandatory in NH) I E.L.DISEASE-EA EMPLOYEE 5500,000 <br /> If yes,describe under <br /> DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT 5500,000 <br /> A Comm Property B2024668724 02/11/2017 02/11/2018 Building-$1,085,837 <br /> BPP-$325,838 <br /> Ded-$500 AOP/5%W/H <br /> DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) <br /> CERTIFICATE HOLDER CANCELLATION <br /> This certificate is for SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE <br /> THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN <br /> information only. ACCORDANCE WITH THE POLICY PROVISIONS. <br /> Please contact USI Insurance <br /> Services, LLC to confirm AUTHORIZED REPRESENTATIVE <br /> coverage. <br /> ©1988-2014 ACORD CORPORATION.All rights reserved. <br /> ACORD 25(2014/01) 1 of 1 The ACORD name and logo are registered marks of ACORD <br /> #S20417716/M20417681 PXPEW <br />