Laserfiche WebLink
a : e <br /> ACORD,,, CERTIFICATE OF LIABILITY INSURANCE OP ID DATE (MWDD/YYYY) <br /> INDIA - 1 11 / 04 / 04 <br /> PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION <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: Continental Casualty Company <br /> INSURER B: <br /> Indian River Memorial Hospital INSURER C: <br /> Greg Mor an <br /> 1000 36th Street INSURER D: <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 /> MW 0%I <br /> LTR INQ <br /> TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE MMR) DATE MM/ LIMITS <br /> GENERAL LIABILITY EACH OCCURRENCE $ <br /> COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurenee f <br /> CLAIMS MADE OCCUR MED EXP (Any one person) S <br /> PERSONAL d ADV INJURY f <br /> GENERAL AGGREGATE f <br /> GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMPIOP AGG S <br /> POLICY JEC LOC <br /> AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT <br /> ANY AUTO (Ea ecddent) S <br /> ALL OWNED AUTOS <br /> BODILY INJURY s <br /> SCHEDULED AUTOS (Per Person) <br /> HIRED AUTOS <br /> BODILYINJURY $ <br /> NON-OWNED AUTOS (Per accldent) <br /> PROPERTY DAMAGE f <br /> UW soddenq <br /> GARAGE LIABILITY ALTO ONLY EA ACCIDENT f <br /> ANY AUTO EA ACC f <br /> OTHER THAN <br /> AUTO ONLY: AGG f <br /> EXCESS/UMBRELLA LIA8KJTY EACH OCCURRENCE f <br /> OCCUR F1 CLAIMS MADE AGGREGATE S <br /> f <br /> DEDUCTIBLE S <br /> RETENTION $ $ <br /> WORKERS COMPENSATION AND X TORY LIMITS ER <br /> A EMPLOYERS' LIABILITY <br /> ANY PROPRIETOR/PARTNER/EXECUTNW - 128588438 01 / 01 / 04 E O1 / O1/ 05 E.l, EACH ACCIDENT S $ 1 f 0001000 <br /> OFFICER/MEMBER EXCLUDED? E.L. DISEASE - EA EMPLOYEE i $ 1 0 0 0 1 0 0 0 <br /> III <br /> yes, <br /> I4L P �ROVISIONS below <br /> under <br /> SPECIAL E.L. DISEASE - POLICY LIMIT S $ 3L e 0 0 0 1 0 0 0 <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 /> 1840 25th Street REPRE TATLVES. <br /> Vero Beach FL 32960 AUT IZEDRfPRE TA VE <br /> ACORD 25 (2001108) © ACORD CORPORATION 1968 <br />