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AC.: RE1 CERTIFICATE OF LIABILITY INSURANCE
<br />DATE(MM/DDIYVYY)
<br />3/28/2017
<br />THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
<br />CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED
<br />BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),
<br />REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
<br />HOLDER. THIS
<br />BY THE POLICIES
<br />AUTHORIZED
<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 />Lassiter -Ware Insurance of Tampa Bay
<br />1300 N. Westshore Blvd
<br />Suite 110
<br />Tampa FL 33607
<br />INSURED
<br />The ARC of Indian River County Inc.
<br />1375 16th Avenue
<br />Vero Beach FL 32960-3768
<br />nnvroarzcc
<br />CONTACT Debra Linkous
<br />NAME:
<br />PHONE (800) 845-8437 FAX (888)883-8680
<br />_(A1C _Np_, F,/it): 1A/C, No):
<br />E-MAIL
<br />ADDRESS: DebraL@lassiter-ware-com
<br />INSURER(S) AFFORDING COVERAGE NAIL #
<br />INSURER A:NEM Hampshire Insurance Company 23841
<br />INSURERB:National Union Fire Insurance 19445
<br />INSURER C:W9SCO Insurance Company 25011
<br />INSURER D :
<br />INSURER E :
<br />INSURERF:
<br />... _.- .-. -- -_ --- --- mm VIJIVIV IVUmDeN:
<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 />WSW R
<br />LTR
<br />TYPE OF INSURANCE
<br />ADDLISUBR
<br />INSD i wvn
<br />POLICY NUMBER
<br />POLICY EFF : POLICY EXP
<br />(MM/DDNYYYY) i (MMIDD/YYYY)
<br />LIMITS
<br />X COMMERCIAL GENERAL LIABIUTY
<br />EACH OCCURRENCE
<br />$ 1, 000 , 000
<br />A
<br />CLAIMS -MADE X OCCUR
<br />DAMAGE TO RENTED
<br />PREMISES (Ea occurrence)
<br />$ 100,000
<br />01LX0921770600
<br />3/30/2017 3/30/2018
<br />MEC) EXP (Any one person)
<br />$ 5,000
<br />- ---- -
<br />GEN'L AGGREGATE LIMIT APPLIES PER:
<br />X POLICY PRO-
<br />JECT • LOC
<br />OTHER.
<br />PERSONAL& ADV INJURY
<br />GENERAL AGGREGATE
<br />PRODUCTS - COMP/OP AGG
<br />Employee Benefits
<br />$ 1,000,000
<br />$ 3,000,000
<br />$ 3,000,000
<br />$ 1,000,000
<br />A
<br />AUTOMOBILE LIABILITY
<br />X ANY AUTO
<br />ALLOVVNED
<br />AUTOS __.
<br />X HIRED AUTOS X
<br />SCHEDULED
<br />AUTOS
<br />01-OVvNED
<br />01CA0699E97050
<br />! °
<br />3/30/2017 3/30/2018
<br />'..
<br />COMBINED SINGLE LIMIT
<br />(Ea accident)
<br />BODILY INJURY (Per person)
<br />BODILY INJURY (Per accident)
<br />PROPERTY DAMAGE
<br />(Per accidert)
<br />PLP.
<br />$ 1,000,000
<br />- _.._... _.
<br />$
<br />$
<br />-
<br />$
<br />$ 10,000
<br />B
<br />X UMBRELLA LIAB
<br />EXCESSLIAB
<br />X
<br />OCCUR '
<br />CLAIMS -MADE '�
<br />EACH OCCURRENCE
<br />AGGREGATE
<br />$ 2,000,000
<br />DED X RETENTION$ 10,000'.
<br />29UD0628415040
<br />3/30/20171. 3/30/2018
<br />$ 2,000,000
<br />$
<br />WORKERS COMPENSATION
<br />AND EMPLOYERS' LIABIUTY YIN
<br />X PER_
<br />STATUTE EORH
<br />ANY
<br />OFFlCER/MEMBEOR EXCLUDES I ECUTIVE -, N / AI
<br />E.L. EACH ACCIDENT $ 2,000,000
<br />C
<br />(Mandatory in NH)
<br />0 yes, describe under
<br />FITWC338262016
<br />6/1/2016 6/1/2017
<br />E.L. DISEASE - EA EMPLOYEE $ 2, 000, 000
<br />DESCRPTION OF OPERATIONS below
<br />E.L. DISEASE - POLICY LIMIT $ 2,000,000
<br />A
<br />Professional Liability
<br />Abuse & Molestation
<br />01LX0921770600
<br />3/30/2017 3/30/2018
<br />!
<br />$1.000,000/$3000,000
<br />$1,000,000/$3000,000
<br />DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached 0 more space is required)
<br />rCDTIrlrNATG uAl nr•r.
<br />Indian River County Fire Rescue
<br />4225 43rd AVenue
<br />Vero Beach, FL 32967
<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 />Mike Shea/DEBRAL
<br />ACORD 25 (2014/01)
<br />INS026 (201401)
<br />©1988-2014 ACORD CORPORATION. All rights reserved.
<br />The ACORD name and logo are registered marks of ACORD
<br />P65
<br />
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