Laserfiche WebLink
` —%�-2003 THU 12 : 15 PH WH DAY FAX We 5615465772 P . 04 <br /> Self rsrund l. wttr *4 h t-414o <br /> \V. "ITiU" liqudra4lr., l'ha�rnttn, l4rrt Cdr ( 'tRA•t <br /> 'V4 00. (l .orge 4: bjefer, Vi.. Chairmrn. P441afle <br /> {� A4x ialafar"I iy SLmini Nsinc* 1979 Nn Xuc,oa , JAelond <br /> 1'.U. likn 983 P l .a,kehutid, l t. 33.`" 12 -0`181'i • Ntl x• TUNuullitvltri.lRt. eorn ( DRi. lL 9Jrnki, Itl dmf <br /> v* rcicoviu! fr6i ► tSfii �i0!►{) or t K(m-2�?-T6�% • 1 =ax {R43) b6Cr195S <br /> certiricate of Insurance <br /> RE ; 0520 - 25864 Commissioners <br /> ISSUED T0 ; Indian River County Board of County <br /> 1840 25th St <br /> Vero Beach , FL 32960-3365 <br /> , Itis P ' 0 . box 3068 VerS���X2964, <br /> This is to certify that Boys & Girls Club of Iodirnn River Counfyhas secured the payment of any <br /> being subject to the provisions of the Florida Workers' Compensation Law , <br /> workers ' compensation benefits due by insuring their risk with the Florida Retail Federation Self Insurers Fund . <br /> = ^uC`! NUMBER : 952.0-25864 Statutory Limits --State of Florida <br /> Employers Liability <br /> 500 , 000 ( Each Accident ) <br /> EFFECTIVE DATE : Septerribef .2002 $ 500, 000 ( Disease - - Each Employee ) <br /> EXPIRATION DATE : September 13 , 201 <br /> $ 500 , 000 ( Disease-- Policy Limit) <br /> This certificate is not a policy and of itself does not afford any Insurance , <br /> Nothing this <br /> certificate shall be construed as extending coverage not afforded by the policy above or affording <br /> insurance to any insured not named above. <br /> The policy of insurance listed above has been issued to the named insured for the policy period indicated . <br /> Notwithstanding any requirement , term or condition of any contract or other document to which this certificate <br /> may pertain, the insurance made available by the described policy In this certificate Is subject to only the <br /> terms , exclusions and conditions of such policy , Paid claims may have reduced the shown limits . <br /> If the policy described above Is cancelled before the expiration date Indicated , the issuing company will <br /> attempt to mail 30 days ' written notice to the certificate holder named ind for faiovea lure However, theil h Hint company , <br /> its agents or representatives accept no obligation or liability of any <br /> Date 05/ 22/ 2003 <br /> G - air cor.�uicirp , :nc , . Admintetrator <br /> Florida Retail Federation. se1C Insuzers Fund <br />