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r- • ' ® ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 09/29/2017 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). PRODUCERCONTACT • NAME: Mary White John L. Kirby & Associates, Inc. PHONE FAX 4196 Herschel Street (A/C.No.Ext): (904) 387-9798 (A/C,No):(904) 387-9270 E-MAIL maryw@j1kirby.com ADDRESS: rSrw®J Y•com Jacksonville FL 32210 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: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 Counties, Inc. INSURER C:Great American Alliance Ins. 26832 403 N. US Hwy 1 INSURER D: • Fort Pierce FL 34950 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:Cert ID 806 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. ILTR I TYPE OF INSURANCE INSD wVD I POLICY NUMBER I(MMI DY/YYYY)I)POLICY EFF /DIYYYY) LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 DAMAGE TO RENTED S 100,000 CLAIMS-MADE X OCCUR Y GLP113706403 08/10/2017 08/10/2018 PREMISES{Ea occurrence) MED EXP(Any one person) IS 5,000 PERSONAL&ADV INJURY S 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE I S 3,000,000 X POLICY PRO- JECT LOC PRODUCTS-COMP/OPAGG S 3,000,000 OTHER: AUTOMOBILE LIABILITY COMBINEDSINGLELIMIT IS 1,000,000 (Ea accident) A x ANY AUTO CAP113706503 08/10/2017 08/10/2018 BODILY INJURY(Per person) S OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE X AUTOS ONLY X AUTOS ONLY (Per accident) C X UMBRELLALIAB X OCCUR IIPD3113706603 08/10/2017 08/10/2018 EACH OCCURRENCE S 1,000,000 EXCESS UAB CLAIMS-MADE AGGREGATE S 1,000,000 DED I X I RETENTIONS None S WORKERS COMPENSATION I STATUTE I I RIR-H- AND EMPLOYERS'LIABILITY Y I N ANYPROPRIETOR/PARTNERIEXECUTIVE NIA E.L.EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Additional insured: Indian River County per written contract or agreement per Form CG8991 (03/15) . 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. Childrens Services Advisory Committee of Indian River County 4675 28th Court AUTHORIZEDREPRESENTATIVE Vero Beach FL 32967 K ��J ©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