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2003-085
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Ali 1 '-' r VJ 1J11 1 �. IiJ ' . i .l <br /> L; UUj ,, 01J1 <br /> FPRODUCERCERTIFICATE OF LIABILITY INSURANCE ) PID C OATEIMWiNF001 03 / 04 / 03 <br /> Sibley & Harvey ERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> Ins of Brevard LLC ONLY AND CONFERS NQ RIGHTS UPON THE CERTIFICATE <br /> m Road HOLDER. THIS CERTIFICATE DO&S NOT AMEND, EXTEND OR <br /> Melbourne FL 32940 ALTS THE COVERAGE AFFpR6E0 BY THE POLICIES BELOW. <br /> Phone : 321 - 751 - 3737 Fax : 321 - 751 - 3738 <br /> INSURED INSURERS AFFORDING COVERAGE <br /> INSURERA. Mount Vernon Fire Insuranea Co <br /> Niney rive ggo� th , Inc . wFugaas, Florida Retail Federation _ <br /> oMr . seph einpterPl _rNSUaexc:B32am So. 110040 <br /> INSURERD: <br /> COVERAGES INSURER E — <br /> TME POLICIES OF INSLk1ANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVG FOR TIG POLICY PERIOD INDICATED NOTWITHSTANDING <br /> ANY REQUIREMENT• TERMOR CON'OITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE ISSUED OR <br /> MAY r, ERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJCCT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> P0 : 1CIE6 AGGREGATE L• MITS 8HlI MAY HAVE BEEN REDUCED BY PMD CLAIMS. <br /> LTR i TYPE Oil IIII SURANvE POLICY NUMBER ION <br /> GENERAL LIABILITY DATE JIMI IDD OAT M! LIMITS • - <br /> A -7X CONW!ERCIALCENEIiALLIABILITY CL2257413EACH OCCURRING ( $ 1 , 000 , 000 <br /> 03 / 01 <br /> L I CCAIMSNADE � q � / 03 03 / 01 / 04 FIRE DAMAGE , 000 <br /> L - • I OCCUR s 100 <br /> I _ <br /> MED EXP (Any 05P pe son) IS 1 OO 0 _ <br /> ?ERSONAI- R APV INJURY S 1, 00011 000 <br /> II GEN•LAGGREGATELIMIT APPLES ill GENERALAGGREGATE <br /> 12 , OOO , OCO <br /> I i POLICY ,F1ERC LOC PRODUCTS COMP/OPAGG I $ Included <br /> AUTOMOBILE LIABILITY I - <br /> A ANY AUTO I CL2257413 ! COMBINED SINGLE LIMIT <br /> / 01 / 03 03 / 01 / 04 ( Ell ab"I)d?°' 511000 , 000 <br /> AI-L ONNED AUTOS 03 <br /> SCHEDULED AUTOS 16004r w.lUHr <br /> IPcr penon} : <br /> )[ I 1111m AUTOS 1 <br /> X NON-OWNEDAUTOS BODILY INJURY S — <br /> (Pee attidel <br /> PROPERTY DAMAGE <br /> GARAGE uA6lJTY <br /> IPOrOCCIII L <br /> !� ANY AUTO AUTO ONLY • GA ACCIDENT $ <br /> ' I <br /> On-E,R THAN EAACC S <br /> ' AUTO ONLY. <br /> Fill LIABILITY Al S <br /> CCI 1EACH CX:CIIRRFNCF $ _ <br /> , I CLAIMS MADE <br /> AGGREGATE $ <br /> _ _ I OEOUCTISLE <br /> . .RfTENTpN $ S <br /> i WORKERS COMPENSA74N AND S <br /> B GMPLOYER!' LIAWLItY 24545 X T RY I IjIRil <br /> 03 / 01 / 03 03 / 01 / 04 EL. CACHACCODCN7 x100 , 000 <br /> EL DISEASE - EA EMPLOYEE S 100100C _ <br /> Ol U.L 016 EASE - POLICY LIMIT S 500 ) OO <br /> � I I <br /> I <br /> OESCRIPTIONOFOPERATION LOCATIONSNEHICLESJEXCLLISIONSAIBYENDORSEMENYI6PECIALPROVISIONS <br /> Certificate Holder is named as Additional Insured as respects the general <br /> liability , The additional insured applies only as respelI operations I <br /> performed by the insured . <br /> CERTIFICATE HOLDER y ADDMONAL INSURED; INSURER LETTPJt: CANCELLATION <br /> IRCNTYA SHOULD ANY OF THE ABOVE 0E6CRI86P POLICiE5 BE CANCELLED BEFORE THE EXPINATIOIJ <br /> Indian River County DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL <br /> Indian River County — DAYS WRITTEN <br /> Administration Building NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL <br /> 2625 19th Avenue IMPOSE NO OBLIGATION OR UA191UTY O NY KIND UPON THE INSURER, ITS AGENTS OR <br /> Vero Beach FL 32960 - 3361 REPRESENYArro .e <br /> t '001 <br /> ED <br /> A IVE <br /> ACORD 26-S (7197) Saott M . SteeleAwl <br /> ® AC RD ON 1988 <br /> Y <br />
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