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Sent By : John L Kirby $ Associates Inc . ; 904 387 9270 ; Oct - 14 - 04 12 : 39PM ; Page <br /> 2 / 2 <br /> ,q�Ra� CERTIFICATE OF LIABILITY INSURANCE pp DATE <br /> S <br /> STI.LIC 1 10 / 14 <br /> 0 <br /> PRODU"A THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> John L . Kirby & AssoClates HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 4196 Herschel Street ALTER THE COVERAGE. AFFORDED BY THE POLICIES BELOW, <br /> Jacksonville FL 32220 - 2260 <br /> Phones 904 - 387 - 9796 Faxt904 - 367 - 9270 INSURERS AFFORDING COVERAGE MAX # <br /> INSURED - mSURERA: Granite State Insurance Co . <br /> Big Brothers Big Sisters of tNstutERB. <br /> St . Lucie County <br /> 4131 South US 4 INSURER C: <br /> Bldg Suite INsuR�RD. ' <br /> Ft . Pierce FL 34982 <br /> INSURER E <br /> COVERAGES <br /> I HE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THF. INSURED NAMLU ABOYK. FOR THE POLICY PERIOD INOIC,,ATED. NOTWII KSTANDING <br /> ANY REOUIREMENI , TERMOR CONDITION OF ANY CONTRACT OR OYHER DOCUMCNT WITH NKSPECT TO WNICH THIS CER70CATF MAY BE ISSUED OR <br /> MAY PERTAIN. Tkr.. INSURANCE AFFORDED BY THE POLICIES DFSCRIBED HERON IS SUBJECT TO ALL THE I*EMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEFN RCDUCFO BY PAID CI AIMS. <br /> ILTR SK NS TYPE OF INSURANCE POLICY NUMBER POLICY EFFECT ON LIMITS <br /> OATt WDCVYY DATE MMlD <br /> GENERAL LIABILITY EACHOCCURRENCC S 1 000100 <br /> MAPAA13IFTITRENTED $ 100 000 <br /> A X X CUMMFRCIALGENERAL LIAKIIITY 02 - LX - 6442539 - 0 08 / 10 / 04 08 / 10 / 05 PREFAISES.ttac � 1 .. <br /> CLAIMS MAt& u OCCUR _MED EW' (Any aw parson) S S , 00 0 <br /> j YFRC,ONAL 5 ADV INJURY s 1 000 1 00 <br /> GENLRAI AOCAI ELATE - $ 2 000 OO <br /> GERLAGGRF.GATELIMITAPPLIES PFR• PRODUCTS - COMPIOPAGG : 11 0 9.000 <br /> POLICY PA;T LOG <br /> AUYOMOBILE LIABILITY COMBINFO SINGLE LIMIT <br /> (Ea accidetrt) S <br /> I ANY AUTO <br /> ALL OWNED AUTOS - BODILY INJURY S <br /> ` SCHEDULEDAUIOS (PcPn +) <br /> i <br /> HIREOAUTOS : 130DILYINJURY <br /> .• NON-OWNCDAUTOS (Pa accident) S <br /> PROPERTY DAMAGE : Il <br /> - (Pm xodent) <br /> GARAGE LIABII ITY - AUTO ONLY - EA ACCIDENT S <br /> ANY AUTO OTHER IHAN FAACC $ <br /> i AUTO ONLY: AGG S <br /> EXCESSMA48RELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR n CLAIMSMADE AC-,GRCGATE , ,, S <br /> S <br /> DEDUCTIBLE $ - <br /> RETENTION S $ <br /> WORKERS COMPENSATION AND LIMITS -.- I tR <br /> EMPLOYERS' LIABILITY <br /> E.L. EACH ACCIDENT S <br /> . ANY PROPRIETOWPARTNFRIEXCCUTNE '- <br /> 0FFK:FRtM0ADCR 0(CLU0Ebi E.L DISEASE . EA EMPLOYEF S <br /> I II yes, naccnhn wvjef <br /> SPECIAL PROVISIONS below GL. DISEASE - 1°OLICY LIMB i <br /> OTHER <br /> i <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES t EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> Additional Insureds Indian River County ad respects to general liability as <br /> Funding Grantor . <br /> CERTIFICATE HOLDER CANCELLATION <br /> ISD=Am SHOULD ANY OF THE ABOVE 0WRIBED POLICIES FIX CANCELLED BEFORE THE EXP11ATION <br /> DAT9 THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAR_ 10 DAYS WIRJ TTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO 00 30 LL <br /> Indian River County IMPOSE NO ODWATION OR LIABILITY OF ANY KIND UPON THE INSURER. RS AGENTS OR <br /> 2625 19th Ave REPRasENTATrves. <br /> Vero Bench FL 32960 AUTHORREDREPRESENTAT <br /> John L . Kitb <br /> ACORD 25 (2001108) or — bor� %b� W%C0R*rRPOMTIOII1988 <br />