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2003-253C
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2003-253C
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Last modified
11/22/2016 11:36:40 AM
Creation date
9/30/2015 7:46:49 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
09/23/2003
Control Number
2003-253C
Agenda Item Number
7.D.
Entity Name
Boys & Girls Club of Indian River County
Subject
Children's Services Advisory Grant Contract
Archived Roll/Disk#
3207
Supplemental fields
SmeadsoftID
3908
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IM DAY FAX N0. 5615465772 P , 02 <br /> ACORDM CERTIFICATE OF LIABILITY INSURANCE <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Day Agency, Inc. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 11320 SE Federal Hwy. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> Hobe Sound FL 33455 <br /> 772-546-5767 INSURERS AFFORDING COVERAGE NAIC A� <br /> INSURED Boys dI Girls Club of Indian River County, Inc. MsuRERA: MaOtf Insurance Co <br /> PO Box 3068 MIRER B: <br /> Vero Beach FL 32964 INSURER C: <br /> INSURER O: <br /> INSURER E <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO ThIC INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, <br /> NOTWITHSTANDING <br /> ANY REQUIREMCNr, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RCSPECT TO WHICH THIS CERTIFICATE MAY <br /> BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN Is SUBJECT To ALL THE TERMS, EXCLUSIONS AND CONDITIONS <br /> OF SUCH <br /> POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCFD BY PAID CLAIMS. <br /> INTR ' DD' TYPE OF INV IRANCE POLICY NUMBER POUC'( EFFECTIVE POLICYE%PIRA710H LIMITS <br /> GENE4AL LIARILITY EACH oCCURRII+CE s 1 , 000,000 <br /> — n DAMAGE TO RENThD <br /> IA I X COMMERCIAL GENERAL L" ILITY 8502CY2201282 09113102 09113103 -PREWSE.S.Z-ft FCC s 100,000 <br /> 1 CWMSMAOE OCCUR MED EXP Annnc efson S 000 <br /> PERSONAL 4 ADV INJURY S1 ,000,000 <br /> GENE RAI. ACCR£GATE s 3.000.000 <br /> GEN'L AGGREGATE UMITAIPLIESPER: PRODUC' COWtOP AGG S 1 ,000 _ 0 <br /> X POLICY - I `'ftO LOC <br /> I AUTOMOBILE LIABILITY COhIeINED SINGLE LIMIT S 1 ,000,000 <br /> A X ANY AUTO 8502CY2201282 09113102 09113103 (Ca °ctae''I ) <br /> X ALL OWNED AUTOS BODILY INJURY S <br /> SCHEDULED AUTOS (Pcr p=n) <br /> X HIRED AUTOS BODILY INJURY S <br /> X NON•OWNED AUTOS (Pei acaaml) <br /> 1 <br /> Pfi.Of%ER7Y DAMAGE S <br /> (Per aCCI::ern) <br /> GARAGE LIABILITY AUTO OWY -F.AACCIDENT S <br /> ANY AUTO OTHER THAN , FA ACC S <br /> AUTO ONLY: ACG S <br /> - _ !'_v�RELLALIABILITY EACH OCCURRENCE is <br /> OCCVft CLAIMS MADE AGC,RF.GATE S <br /> S <br /> 1 <br /> DEDUCTIBLE S <br /> RETENTION S 1 <br /> WCSTATU. OTH- <br /> WORKERS COMPENSATION AND <br /> EMPLOYERS' LIABILITY <br /> ANY PROPRIFTOR/PARTNER/EXECUI NE E.L. FACN ACCIDENT 1 <br /> • OFFICEWL4EMBER EXCLU0007 E1. DISEASE - Ell EMPLOYE . i <br /> N wyn dc-= bu undar <br /> . P AI PROVISKIN9 WowF.L. DI`rEASC - P'OLICY LIMIT S <br /> I OTHER <br /> I <br /> .�E£;CIPT10N OF OPERATIONS I LOCATIONS ( VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> C_ r:; `: css„ oider Is additional Insured for General Liability 6 auto <br /> 30 Days notice applies except for non-payment of premium <br /> CERTIFICATE HOLDER CANCELLATION <br /> SHOULD ANY Of THE ABOVE DESCRIBED POLICIES 8E CANCELLED BEOR>: THE EXPIRATION <br /> Indian River County 10 DAYS WRITTEN <br /> Board of County Commissioners DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TD MNL <br /> I NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO 50 SHA <br /> 1840 25th St <br /> IMPOSE NO OBLIGATION OR LIABILITY OF ANY KING UPON THE INSURER ITS AGENTS On <br /> Vero Beach, FL 329603365 <br /> REPRESENTATNE.4. <br /> i AUTHORIZED REPRESENTATNEAJD> <br /> " <br /> ACORD 25 (2001108 ) CORD CORPO ON 1988 <br />
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