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2004-229I
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2004-229I
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Last modified
9/27/2016 1:59:56 PM
Creation date
9/30/2015 8:01:31 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Contract
Approved Date
10/12/2004
Control Number
2004-229I
Agenda Item Number
7.I.
Entity Name
The Center for Emotional and Behavioral Health
Subject
Camp Manatee Therapeutic Summer Camp Program
Children's Services Advisory Committee
Archived Roll/Disk#
3223
Supplemental fields
SmeadsoftID
4306
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s <br /> ACORD. CERTIFICATE OF LIABILITY INSURANCEoP ro DATE (MM/DiArr ) <br /> INDIA - 1 11 / 04 / 04 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF IN FORMATION <br /> ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE <br /> Florida Hospital Assoc Ins Svc HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR <br /> 1675 Terrell Mill Rd . ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, <br /> Marietta GA 30067 <br /> Phone * 800 - 476 - 7601 Fax : 770 - 850 - 0988 INSURERS AFFORDING COVERAGE NAIC # <br /> INSURED INSURER A: coatinmta2 Casualty Company <br /> INSURER B: <br /> Indian River Memorial Hospital INSURER c: <br /> Greg Morgan <br /> 1000 36th Street INSURER <br /> Vero Beach FL 32960 <br /> INSURER E: <br /> COVERAGES <br /> THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING <br /> ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR <br /> MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH <br /> POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, <br /> LTR INSRN TYPE OF INSURANCE POLICY NUMBERDATE EWY POLICY EXPIRATION <br /> DATE? (MWRM LIMBS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL. GENERAL LIABILITY PREMISES Ea oocurence S <br /> CLAIMS MADE F�] OCCUR MED EXP (Any one person) S <br /> PERSONAL d ADV INJURY S <br /> GENERAL AGGREGATE $ <br /> GERL AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG S <br /> POLICY JPEC LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea acddent) S <br /> ALL OWNED AUTOS <br /> BODILY INJURY $ <br /> SCHEDULED AUTOS (Per person) <br /> HIRED AUTOS <br /> BODILY INJURY S <br /> NON-OWNED AUTOS (Per acddent) <br /> PROPERTY DAMAGE S <br /> (Per aoddent) <br /> GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ <br /> ANY AUTO EA ACC $ <br /> OTHER THAN <br /> AUTO ONLY: AGG i <br /> EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ <br /> OCCUR FICLAIMS MADE AGGREGATE S <br /> E <br /> DEDUCTIBLE <br /> S <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND x TYOU S [AT OTFI: <br /> ORY LIMITS <br /> A Fit <br /> EMPLOYERS LIABILITY qP- 12 8 5 8 8 4 3 8 01 / 01 / 04 <br /> ANY PROPRIETOR/PARTNER/EXECUTNE 01 / 01/ 05 E.L. EACH ACCIDENT S $ 1 ,0 0 0 0 r O 0 0 <br /> OFFICER/MEMBER EXCLUDED? <br /> If yes, E L DISEASE - EA EMPLOYEE $ $ 1 0 0 0 O 0 O <br /> SPECIAL PROVISIONS below es El, DISEASE - POLICY LIMIT S $ 1 , 000 , 000 <br /> OTHER <br /> DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS <br /> Proof of coverage for above Named Insured . <br /> CERTIFICATE HOLDER CANCELLATION <br /> INDIANC SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION <br /> DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN <br /> NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL <br /> Indian River County IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR <br /> 3, 840 25th Street REPRE TATWES, <br /> Vero Beach FL 32960 Aur IZEDREPRE Ta VE <br /> ACORD 25 (2001 /08) I © ACORD CORPORATION 1988 <br />
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