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10/ 10/2003 15 : 16 HCIR 4 1 ??25634564 N0 . 143 D02 <br /> A008D INSURANCE BINDER oP , D ,� DATE <br /> THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. <br /> PRODUCER COMPANY plNpl R >r <br /> (A/CrNo �)rt): 800 - 729 - 4149 90411 <br /> Fireman ' s Fond Ins . Cos . <br /> FFFeCTIVI!DATE 11ME DATE McNeary Healthcare FY, TIME <br /> 6525 Morrison Blvd . , Suite 200 AM '- � � 12:01 AM <br /> Charlotte NC 28211 10 / 12 / 03 PM 12 / 11 /H03 r NOON <br /> Florida Hospital_ Auzooiation _ TH16OINOERISISSUED TOEXTEND COVERAGE INTNEABOVE NAMED COMPANY <br /> CODE; SUB CODE: <br /> PER EXPIRING POLICYC MZG80819831 <br /> CUETQ ER ID: INDIA- 1 I DESCRIPTION OF OPERATIONSNEHICLEWPROPERTY (Indudlnp Location) <br /> INSURED <br /> Indian River Manorial Hospital <br /> Greg Morgan <br /> 1000 34th Street <br /> Vero Beach FL 32960 <br /> COVERAGES LIMITS <br /> TYPE OF INSURANCE COVERAGE/FORMS DEDUCTIBLE COINS X AMOUNT <br /> PROPERTY CAUSES OF LOSE <br /> BASIC _ BROAD ] SPEC <br /> I <br /> I <br /> GENERAL LIABILITY I EACH OCCURRENCE f <br /> COMMERCIAL GENERAL LIABILITY FIRE DAMAGE (Any ono firs) S�� <br /> CLAIMS MADC I OCCUR MED EXP (Any cn. palsan) $ <br /> PERSONAL d AOV INJURY S <br /> GENERAL AGGREGATE $ <br /> RETRO DATE FOR CLAIMS MADE: PRODUCTS a COMP/OP AGG $ <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMITS 2 , 000 000 <br /> .X ANY AUTO BODILY INJURY (Por person) f ` <br /> ALL OWNED AUTOS BODILY INJURY (Pm acr:dam) f <br /> SCHEDULED AUTOS PROPERTY DAMAGE <br /> _ HIRED AUTOS MEDICAL PAYMENTS 155 , 000 <br /> NON-OWNED AUTOS PERSONAL fNJURY PROT f <br /> -DUMP P OT <br /> L UNINSURED M46TORIST S1 , 0 0 0 , 0 0 0 <br /> f f .. <br /> AUTO PHYSICAL DAMAGE DEDUCTIBLE X j ALL VEHICLES SCHEDULED VEHICLES i X ACTUAL CASH VALUE <br /> XCOLLISION- 500 STATED AMOUNT S <br /> X I OTI(ERTHAN COL' 250 _ OTHER <br /> GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER THAN AUTO ONLY <br /> EACH ACCIDENT <br /> - I AGGREGATE4114 <br /> ExCESS LIABILITY <br /> EACH OCCURRENCE <br /> UMBRELLA FORM AGGREGATE S r• <br /> OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: $ELF•INSURED RETENTION S <br /> WC STATUTORY LIMITS <br /> WORKER'S COMPENSATION E.L. EACH ACCIDENT <br /> AND - - - <br /> EMPLOYER'5 LIABILIYY E.L. DISEASE - EA EMPLOYEE S <br /> E.L, DISEASE • POLICY LIMIT f <br /> SPECIAL BHYSICAT. DAMAGE ( CONIT ) : Ambulanoeya G Heavy Units : $ 500 DOd . Comp 6 $ 1000 FEES f <br /> CONDITIONS/ ped Collision Ambulance Equipment ; $ 102 , 470 scheduled Equipment / 41 , 000 <br /> COVERAGES Dad except $ 50000 as respects wind/hail and flood / " Broad Form " TAXES S <br /> ESTIMATED TOTAL PREMIUM S <br /> NAME & ADDRESS <br /> MORTGAGEE ADDITIONAL INSURED <br /> LOSS PAYEE -- <br /> LOAN 0 <br /> AUT R{ D EPREZTAT <br /> Fl ida HospitWAociation <br /> ACORD 75-S ( 1 /98 ) NOTE : IMPORTANT STATE INFORMA ION ON REVERSE SIDE OACORO CORPORATION 1993 <br />