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SEP-24 -2003 WED 022152 PM WM, DAY , INC , <br /> FAX NO, , 772 546 5772 P , 02 <br /> 1 � <br /> Florida Retail P% dwatim <br /> >�,• V �� <br /> Insurers <br /> <` tRdmiNixlarad {r .�llN!!ai{J W, `L3rU " Rut14ra1, Jc. C'hMrmtntr ( ' n ('rnh r <br /> '{y S�nCR ��ry Cite+tgt Said kr , tirccClWirhnn, P«aJfr�<, <br /> � 1?0, Iifxx Gltg • l .;itcalanrt, 17. 3380309�a • �y� y, :,sruuna+UlK)l�Ilrl$•rrom <br /> 665,6W or i - 90 -_8 764K • !� i* tiiea.r . JJ4rlred''�'••— '� ' I ) 7 � • �ax (�63} <br /> GF,C} trJ:�K '� rtlurl. PckvlY. 11drfrrnr! <br /> in ,alovR. Wj <br /> 1tIY , 1<ukm,aullr <br /> Certiricate of Insurance <br /> RE : 0520 -25864 <br /> ISSUED TO : Indian River county Board of county commissioners <br /> 1840 25th St <br /> Vero Beach , FL 32960 -3365 <br /> This is to certify that BQYs & Girls _gub ofJndian Riyer Count�C, Inc p� <br /> being Subject to the provisions of the Florida Workers ' <br /> Compensation Law,has sec the paycment Of arty , <br /> compensation benefits due by insuring their risk with the Florida Retail Federation Self Insurers Fund . <br /> POLICY NUMBER : 020 - 25864 Statutory Limlts--State of Florida <br /> EFFECTIVE bgTE ; epk�m�Lif Employers Liability <br /> $ 500, 000 ( Each Accident) <br /> EXPIRATION DATE : Sep er bAr 13 . 2Q04 $ 500, 000 ( Disease - - Each Employee ) <br /> $ 500 , 000 ( Disease- - policy Limit) <br /> This certificate is not a policy and of itself does not afford any insurance . Nothing contained in this <br /> certificate shall be construed as extending coverage not afforded by the policy shown 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 requirements 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 /> t �rmsr exclusions arid 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 above . However, the Issuing company, <br /> its agents or representatives accept no obligation or liability of any kind for failure to mail such notice , <br /> Date 09/24/2003 <br /> sVst•Iit consulting , Inc . , ,ldrniniatrator <br /> Florida Retail Federation Self insurere Fund <br />